Mental health courts (MHCs) operate at the nexus of legal, medical, and welfare borders, often articulating themselves as rehabilitative alternatives to incarceration by offering supervised treatment in the community. As such, they provide a unique window into the micro-processes and practices of contemporary rehabilitation efforts, especially after forty years of punitive social control. In this dissertation, I ethnographically investigate mental health court practices over the course of two years to understand how therapeutic ideas are imagined and deployed in order to achieve rehabilitative aims. I specifically attend to courtroom discourses, how conceptions of addiction, illness, and criminality are weaponized as sites of intervention for treatment, monitoring, and punishment, and examine the ideological formations that are imbricated with these discourses and their material effects. Findings indicate that MHCs work from what I conceptually term “rehabilitative imaginaries,” which are built from real narratives and stigmatizing notions of pathology and criminality that shape how defendants are treated, managed, and sanctioned. These imaginaries are cemented through coercion, paternalism, and personal responsibility practices emblematic of the neoliberal punitive turn, and defendants are typified as risk-prone “criminal addicts” despite having complex and diverse backgrounds, lives, and normative experiences. Even though many defendants obtain sobriety and gain access to scant social services, this typification process has several hidden costs, including deeper criminal legal involvement, removal from their homes and neighborhoods into recovery houses, which may sometimes lead to material precarity (e.g. loss of housing and employment), and intrusive regulation of social and intimate relationships, particularly for women. Paradoxically, the sum effect is that many defendants are placed at psychiatric, emotional, and material vulnerability—all in the name of addiction recovery.