In the UK the notion of diverting people suffering from mental disorders from the criminal justice system to treatment within the health service is not new (Home Office, 1990), nor is the concept of a court-based psychiatric assessment and liaison service (Joseph & Potter, 1990; James & Hamilton, 1991; Joseph, 1992). Similarly, the concept of 'specialist'courts is not a novelty in the USA (Bean, 1998; Schwartz & Schwartz, 1998). We report on the first specialist mental health court in the USA and propose a modification of the current provision of psychiatric services to courts in England and Wales by combining elements of the mental health court with current court diversion practice.