Why this bill will make Sacramento County Jail’s mental health crisis worse | Opinion
About 90% of inmates in the Sacramento County jail awaiting a sentence have been diagnosed with a serious mental illness, according to a 2024 report from Adult Correctional Health. This jail is Sacramento County’s largest mental health service provider, and instead of progress toward better care, legislation threatens to make things worse
State Assemblymember Stephanie Nguyen, D-Elk Grove, introduced Assembly Bill 46, seeking to derail an existing life-line for incarcerated people with mental health diagnoses (a process called mental health diversion). This bill would make it harder for these people to get the mental health care that they need and make it easier to simply punish them. Now is not the time to double down on a broken system.
Mental health diversion is a pretrial program that diverts people away from incarceration and connects them to relevant mental health and substance use treatment in situations when those needs were a significant factor in the circumstances leading to an individual’s arrest. Rather than perpetuating cycles of harm via incarceration, mental health diversion connects people with services that address the root cause of their behavior and supports access to basic necessities like housing.
Our local law enforcement apparatus cares only about the crime and not the mental illness that can drive it. The poor level of mental health care services at the Sacramento County Main Jail came under intense scrutiny in 2020, when the county faced a lawsuit over jail conditions. Since then, court-appointed experts monitoring the facility have continued to document the severity of the crisis.
One such expert on mental health care, Dr. Mary Perrien, recently reported that every patient she encountered was receiving inadequate mental health care from the main jail, with many experiencing immediate and serious harm due to the deprivation of care.
This situation isn’t unique to Sacramento nor is it solely attributable to inadequate funding, staffing or management. Jails are high-stress environments designed for detention — not healing. Everything that takes place within these facilities is regimented under the pretense of efficiency.
Now, Nguyen’s bill, AB 46, seeks to keep more mentally ill inmates incarcerated by undermining how they can seek treatment via diversion programs instead. The legislation would undermine standardized eligibility requirements and the weight of clinical assessments by increasing a judge’s discretion to deny applications. This would also give prosecutors more tools to oppose someone’s access to mental health diversion.
AB 46 would also require someone to have a diagnosis prior to their alleged offense and be issued within the last five years in order for it to be considered a causal factor. This change would be devastating: Many people do not have adequate access to mental health care prior to legal system involvement — much less community-based treatment. Requiring a prior diagnosis would effectively prevent the most under-resourced members of our community from accessing mental health diversion and make it a privilege available only to those who could afford to seek out a diagnosis.
Sacramento County Sheriff Jim Cooper, a vocal proponent of this bill, has publicly acknowledged on many occasions that the Main Jail is the largest provider of mental health services in the county. His support for AB 46 suggests he’s willing to keep it that way.
This bill isn’t about improving public safety, it’s about punishing those most in need of care. AB 46 threatens to disrupt a proven solution that has benefited countless members of our community. We must reject these misleading narratives and instead work to expand — not dismantle — mental health diversion. Although the legislation has cleared the Assembly, the state Senate has a chance to kill this legislation before it reaches the desk of Gov. Gavin Newsom.
Sacramento’s mental health advocates have long been urging those in power to improve and expand community-based mental health resources, increase funding to crisis intervention teams and improve access to basic needs like housing, food and medical care, which would prevent mental health crises and help address the root causes of crime. In reality, however, little has changed.
This story was originally published July 9, 2025 at 5:00 AM.