Research techniques in the fields of mental health courts and diversion need to be improved. As well, insights are provided as to how the evaluations of these programs could be strengthened. There are reports from jurisdictions managing mentally disordered accused in the criminal justice system without the benefit of these programs. A distillation of the commonalities from those jurisdictions suggests that providing the police with better options at first instance (pre-arrest diversion), broader discretion on the part of the prosecutor (pre-plea diversion), and greater jurisdiction on the part of the courts (to impose treatment and monitoring) may have provided those jurisdictions with an adequately functioning system which, as of yet, has not created a need for mental health courts and formal diversion programs. Recommendations are made for future directions.