Sacramento County Public Defender’s Office Uses Pretrial Program to Connect People with Mental Health Needs to Services and Support

August 16, 2023

Facing increasing numbers of people with mental health needs and co-occurring substance use disorders in the Sacramento County (CA) Jail, the Sacramento County Public Defender’s Office realized many of their clients would benefit from a holistic defense approach, which seeks to address social support needs while aiding in legal representation. To work toward this effort, they received Justice and Mental Health Collaboration Program funding in 2019 to embed social workers in their office, build a pretrial support program, and screen defendants for eligibility. The program aims to increase defendants’ access to case planning and community services, reduce the jail population, and increase community safety by reducing recidivism. Since the start of the pretrial program in 2021, social workers have linked or referred 998 people to mental health services, 669 to substance use support, and 596 to housing.

Staff at The Council of State Governments (CSG) Justice Center interviewed Sacramento County Defense Attorney Tiffanie Synnott to better understand their efforts.

Editor’s note: This interview has been edited for length and clarity.

Who are some of the partners you have worked with and how have they been helpful in making your program a success?

The success of the Sacramento County Pretrial Support Program is the result of working with system and community partners toward a shared goal of making our community safe. These partnerships have helped us improve public safety by identifying people’s needs while still in custody, linking people to relevant services for their needs, and even being the ones to provide the services. The Pretrial Support Program would not have the impact and positive outcomes without system partners such as the District Attorney’s Office, the Sheriff and Probation Departments, the Departments of Behavioral Health, Health Services, and Human Assistance, the Substance Use and Prevention Team, and many others. In addition to our system partners, community partnerships have been instrumental in our success, including with groups such as the NAACP, Sacramento Area Congregations Together and Exodus Project, which provides services such as picking up clients from jail upon discharge, taking clients to the Sheriff’s Department or Probation to check in, connecting people to employment and housing, providing mental health counseling, and more.

Your program uses law students and embedded social workers to connect people to diversion opportunities. How has this aided in your success?

The law students in our program go into the jail and conduct in person assessments on people prior to arraignment. These assessments are conducted using four different evidenced based tools/screeners.  Other areas of need, such as education, employment, family dynamics involving dependents, physical health, and transportation, are identified during the screening, as well as information related to language preference, gender pronouns, veteran status, race/ethnicity, foster care/child protective services history, and community ties. The law students then provide the results to the attorneys, identify whether someone may be appropriate for a collaborative/diversion court, and either refer the case to community-based organizations for immediate access to services or to our embedded social workers. Over a two-year period (from January 2021 to January 2023), the law students screened over 4,255 people in custody. Of those screened, 54 percent needed mental health support, 47 percent substance use support, 49 percent housing support, and 82 percent needed further social worker support.

The social workers within our program then work with clients both in and out of custody and support linkage to system partners. They are trained on how to navigate front door access to mental health, substance use, and housing through our justice partners.

What have been some of the biggest hurdles in implementing this pretrial program in your county? How have you overcome those?

One of our biggest hurdles in implementation was COVID-19. The pandemic significantly impacted the availability of services for individuals once released from custody. However, as a result of the pandemic, we were forced to collaborate more closely with partners, and it opened up platforms to discuss the needs surrounding the pretrial population in ways in which we could build and improve services.

A secondary hurdle was having system and community partners embrace holistic defense. The criminal justice system can be punitive in nature, but holistic defense shifts the focus away from punitive and instead toward a client-centered approach. This approach addresses people’s needs without fear of self-incrimination through attorney-client privilege.  In the context of pretrial, this approach is critical in achieving improved outcomes for the individual, maintaining the presumption of innocence, and ensuring public safety. While this wasn’t an easy shift, we found that focusing on the common goal of public safety among all justice and community partners, helped us work better together and improve outcomes.

If you could give advice to another county or public defender’s office interested in replicating your diversion model, what would it be, and would you do anything differently?

The pretrial support program we implemented was an innovative program based on holistic defense that used a multi-system approach. Although holistic defense is not new, education around the importance of using a holistic defense approach was necessary. My advice for anyone interested in replicating this program is to spend time talking to system partners about the benefits of holistic defense and the importance of creating safe spaces of confidentiality in light of the presumption of innocence when someone is facing criminal charges. While educating system partners, it is equally important to learn as much as you can about them, too. Understanding everyone has a role to play and identifying ways in which you can all support each other will only result in success for everyone. Additionally, I would say: don’t forget to include your community partners as you roll out your diversion program. Community partners will help identify barriers and obstacles to services while keeping you grounded in client-centered work.

To learn more about how other states and localities are developing innovative programs to improve behavioral health responses in their communities, sign up for the CSG Justice Center’s monthly Justice & Well-Being newsletter.


Photo by August de Richelieu via

About the author

Steven Diehl
Senior Policy Analyst, Behavioral Health
Steven Diehl provides training and technical assistance under the Justice and Mental Health Collaboration Program for projects focused on the implementation of specialty courts. Prior to joining the CSG Justice Center, he served as the 17th Judicial District Treatment Courts
coordinator in Central Pennsylvania. There, he oversaw 8 Specialty Court Programs, which also served as National Mentor Court Programs under the direction of the National Drug Court Institute and the U.S. Department of Justice. Steven earned his BS in criminal justice from York College of Pennsylvania and his MS in criminal justice administration with a concentration in justice administration from Loyola University New Orleans.
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