The Georgia Department of Juvenile Justice (DJJ) has, by default, become the mental health system for at-risk youth in the State of Georgia. Increasingly, large numbers of youth with alcohol, drug abuse, and mental health (ADM) problems are engaging in behavior and committing offenses which bring them in contact with the juvenile justice system. Previously, while in the custody of DJJ, the ADM needs and problems of these youth were addressed by a system with very limited treatment-oriented programs, staff, and resources. In an effort to improve this situation, Georgia created the Office of Behavioral Health Services (OBHS), with the following key components: (1) all mental health, substance abuse, and specialized behavioral health services and treatment programs, including those for sex offenders and low functioning youth, are integrated under a single management authority which reports to the Director of the OBHS; (2) the OBHS has budget responsibilities for allocation and management of youth treatment services; (3) a Mental Health Oversight Committee within OBHS is responsible for efficient coordination and use of resources; and (4) five Regional Mental Health Coordinators will support programs at DJJ institutions and community-based facilities. The paper concludes that, if left unresolved, the lack of a continuum of care will continue to pose a challenge as DJJ seeks to promote regional service development, community involvement and accountability, and promote the availability and accessibility of alternatives for youth.