Dharmesh Patel, 42, has pleaded not guilty to three counts of attempted murder.

His wife Neha and their son and daughter, aged four and seven at the time, were in the car.

Patel, a radiologist, was driving his white 2021 Tesla Model Y along the Pacific Coast Highway south of San Francisco, when it plunged several hundred feet off the cliff at Devil's Slide.

All four survived the crash in what one official called an "absolute miracle".

Patel's wife, who suffered serious injuries, spoke for the first time in court since the incident on 2 January last year.

She told the proceedings on Thursday in Redwood City, California, her husband should be released from jail and sent home under a mental health diversion programme, according to The Mercury News.

Mrs Patel blamed her husband's actions that day on "a mental health episode beyond any of our understanding and control" and said "things will be different" if he is allowed to return home to their family, the California-based paper reported.

"We need him in our life," she reportedly said, giving evidence to the courtroom via a video call.

"We're not a family without him."

She spoke at length about the impact of her husband's absence on their children, saying she has often found her daughter crying at night, the newspaper reported.

Her son has asked why it's "taking so long" for his father to return home, she said, adding the boy was "heartbroken".

Noting that Friday is the couple's 16th wedding anniversary, she described her husband as a "kind and altruistic" man, who "has been my best friend for more than 25 years".

"Seeing my kids in emotional pain is one of the hardest things I've had to endure," she said.

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The court previously reportedly heard Patel suffered from a major depressive disorder - and a psychotic episode on the day of the crash.

Mark Patterson, a psychologist who gave evidence for the defence, told the court that in the days before the incident Patel grew increasingly delusional and believed his children were at risk of being kidnapped and molested.

His mental state has been a key issue in the case, with his wife reportedly initially telling rescuers her husband was "depressed" and "he purposefully drove off" the cliff.

The trial continues.