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The criminal legal system has historically struggled to respond to persons with mental health issues facing criminal charges in terms of both promoting public safety and addressing their needs. While the number of Alternatives to Incarceration (ATI) programs operating in the New York City area has increased in recent years, there is still a limited number designed to respond to people with these specific needs, and research on the application and effectiveness of these specialized programs is even less existent. In 2022, the Center for Justice Innovation launched an initiative to help operate two court programs in NYC, one at the Red Hook Community Justice Center in Brooklyn and the other at the Midtown Community Justice Center in Manhattan. This initiative, referred to as Misdemeanor Mental Health Court (MMHC), aims to address the needs of individuals experiencing mental health challenges while simultaneously increasing public safety. This study analyzes program data to examine the differences between MMHC and more traditional ATI programming. It also uses qualitative analysis of participant interviews to assess the program’s impact on participant mental health and other outcomes, its ability to connect participants to relevant mental health services, and to identify strengths and areas for improvement.