A treatment and accountability court, sometimes called a mental health court, is not actually a separate court. It is a specialized court docket, or calendar, in which participants receive ongoing treatment for their mental illness while being closely monitored by local mental health providers, probation officers, and the court. It is a collaborative program involving representatives from the court, mental health providers, prosecutors, public defenders, and community advocates, all working toward providing treatment and restoring the individual to a crime-free life.

Those with mental illness, including: Chronically Incarcerated Individuals: Data from 2010 for the U.S. Department of Housing and Urban Development show that approximately 21% of the nation's jail inmates have a recent history of a mental health condition. Many individuals experience frequent and routine jail stays for low-level criminal behavior caused by mental health issues that impede their daily functioning. From 2000 to 2008, one such individual spent an average of 223 days per year in the Athens-Clarke County Jail at a cost of approximately $10,000 per year (nearly $80,000 total). While in jail, the individual was only able to receive basic medical care. Today, this individual would be eligible for TAC participation, and would be closely supervised and receive targeted mental health treatment while living in the community. Individuals with Co-occurring Substance Abuse: A recent snapshot of a felony drug court indicates that as many as 40% of the participants have a diagnosable mental health condition, although most are not receiving treatment. Further estimates from the National GAINS Center note that as many as 72% of those diagnosed with mental illness also have a co-occurring substance abuse disorder. Homeless Individuals: Data from 2010 for HUD show that an estimated 46% of the nation's homeless adult population live with severe mental illness and/or substance abuse disorders. These individuals often experience longstanding housing instability and repeat involvement with the criminal justice system. Individuals involved with Civil Commitment and Mental Incompetency Proceedings: Changes in Georgia law now allow the state to release individuals referred to state hospitals for reasons of mental incompetency, provided they meet minimal levels of stabilization. The referring court is held responsible for monitoring such individuals in community-based treatment.

The Athens-Clarke County Jail currently has more than 450 inmates. Based on HUD's finding, there are more than 90 people in need of treatment in the Athens-Clarke County Jail at any one time. At the last county homeless count, over 120 of 475 homeless individuals, or approximately 25%, had severe mental illness, and nearly all of these had some interaction with the criminal justice system. Fewer mental health services are available locally each year, further disconnecting those in need. A downward spiral often occurs, which eventually leads these individuals into the criminal justice system.

There are over 25 mental health courts in the state at various levels in the court system, compared to over 60 drug courts. For example, there are mental health court programs in Atlanta (Fulton), Decatur (DeKalb), Gainesville (Hall), Columbus (Muscogee), Savannah (Chatham), and Macon (Bibb). Many have been established within the last five years, although some have been operating for ten years or more. Albany, Georgia, in Dougherty County is a national learning site.