REDWOOD CITY — A Pasadena radiologist was hearing footsteps and suffering from delusions about the nation’s fentanyl crisis, the war in Ukraine and the possibility of his children being kidnapped around the time his family’s Tesla — which he was driving — plunged off Highway 1 last year near Devil’s Slide, a psychologist testified Wednesday.

Dharmesh Patel’s psychosis, and his potential recovery, took center stage at a hearing Wednesday to determine whether the doctor will be admitted into a mental health diversion program rather than face trial on charges of attempting to murder his wife and two children in the January 2023 crash. If a judge grants Patel’s request, the charges against him could be dismissed over the next couple of years, after he completes a court-ordered treatment program.

On Wednesday, a clinical and forensic psychologist said Patel was a good candidate for the diversion program because he was a low risk for harming anyone else after showing strong progress over the past year.

“I see him as someone who is very motivated and amenable to treatment,” said the psychologist, Mark Patterson, who was called to the stand by Patel’s attorney. The clinician added that it was “clear to me he has a good capacity” to respond to treatment.

If the request is granted, a Stanford psychiatric clinician, James Armontrout, said he’d oversee Patel’s treatment, which would include intensive outpatient care involving group and individual therapy sessions, as well as meetings with himself and a psychotherapist.

San Mateo County prosecutors, however, have filed motions opposing the request. They are expected to call their first witness when the case is back in court on May 2.

Prosecutors say Patel intentionally tried to kill his wife and their two small children by driving off a 250-foot cliff onto a rocky beach outside Half Moon Bay. Patel suffered injuries to his leg and foot, while his wife suffered more severe injuries. Their 7-year-old child was seriously injured, and their 4-year-old only suffered bruises.

Patel later pleaded not guilty, claiming the family’s Tesla had been experiencing tire issues that may have caused the crash. He allegedly told investigators that he stopped three times at gas stations that day to put air in his left-rear tire while driving to the Devil’s Slide area. He added that the car’s tire-pressure sensor light had turned on beforehand, authorities say.

He has since been held without bail at the San Mateo County jail.

Patel’s mental state has been a central issue in the case, with his wife initially telling first responders that her husband was “depressed” and that “he was going to drive off the cliff. He purposely drove off.” Investigators also said the Tesla’s self-driving features did “not appear to be a contributing factor” in the incident.

Ultimately, the radiologist appeared to be experiencing a single expression of major depressive disorder that day, along with psychotic features and anxious distress, Patterson testified Wednesday. In the days before the crash, Patel grew increasingly delusional and overwhelmed about headlines from around the world, such as the war in Ukraine and the U.S. fentanyl crisis, the psychologist said.

Patel’s greatest delusions revolved around the risk of his children being kidnapped and molested, which appeared to be tied in some way to his concerns over the accused sex-trafficker Jeffrey Epstein, the psychologist added.

Patterson’s diagnosis came after the psychologist conducted 18 tests and spoke to Patel, along with the radiologist’s brother and sister.

Patel, the psychologist added, “still feels a lot of remorse.” But he shows few, if any, lingering signs of such depression, Patterson testified. And he stopped having delusions, even after being taken off anti-psychotic medication while being held without bail at the San Mateo County jail.

Prosecutors on Wednesday questioned Patterson about why he did not interview Patel’s wife before completing his report; Patterson said he did not believe such an interview would have given him significantly new information. Prosecutors also questioned whether the radiologist’s illness more closely resembled schizoaffective disorder, an often-chronic condition similar to schizophrenia. At least one other doctor has diagnosed him with that condition, according to court testimony.

They also focused extensively on statements that Patel made in the days immediately after the crash where he denied having suicidal thoughts or any mental issues. And they hounded Armontrout and Patterson about whether the radiologist himself or his family could be trusted to truthfully report any re-emerging signs of paranoid delusions, given that doing so could ultimately re-start criminal proceedings and leave him at risk of imprisonment.

State legislators in 2018 established the mental health diversion program as a way for eligible defendants to see their cases dismissed if they successfully complete a rigorous and lengthy treatment program.

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To be eligible for the program, defendants must be diagnosed with a mental illness that has a direct connection to their alleged crime. The mental illness also must be treatable within the duration of the diversion program, which is two years for felony cases and one year for misdemeanor cases.

People accused of serious felonies, such as murder, are ineligible for the program. However, the charges that Patel faces, which include attempted murder, make him eligible.

Even if Patel does win entry into the program, it’s unclear whether he will be able to practice medicine anytime soon. Last year, a judge granted a request by the Medical Board of California to bar Patel from practicing medicine while he awaits trial on the charges, with the agency arguing that Patel represented “an alarming danger to the public” in light of an “impairment of cognitive abilities needed to safely practice medicine.”

The medical board has said Patel will continue to be barred from practicing medicine “until the order is modified by the court or the criminal case against him concludes.”