Advocates call for Bexar County jail reforms after deaths
Add Axios as your preferred source to
see more of our stories on Google.
The women's side of intake at the Bexar County Adult Detention Center in 2019. Photo: Bob Owen/San Antonio Express-News via Getty Images
A coalition of advocates on Tuesday proposed stronger mental health treatment options and more independent accountability at the Bexar County jail, changes aimed at preventing further in-custody deaths.
The big picture: At least 92 people have died while in custody at the Bexar County jail since 2020.
- The nonprofit Texas Jail Project, which has been tracking the deaths, says Bexar County is among the deadliest jails in Texas on a per capita basis.
State of play: Bexar County has seen one more jail death so far this year than Harris County, a jail that has more than double the capacity of Bexar's, per the Express-News.
- A woman died at the Bexar jail this month after an apparent medical emergency, the Express-News reported. County officials said jail staff described her as detoxing from opioids before the emergency.
- She is the seventh person to die in Bexar County jail custody this year. Five of those deaths were caused by apparent medical episodes.
"Any member of the community who wishes to protest may do so, and we will always stand by their right to peacefully protest," sheriff's deputy Joshua Hamby tells Axios in a statement.
The framework, released by ACT 4 SA and other groups, also calls for:
- Timely screening for medical emergencies, suicide risk, mental illness, alcohol and drug withdrawal, chronic health conditions and needed medications. Advocates questioned the depth and number of screenings that do occur.
- Treatment or other response if a condition is identified during screening.
- Timely communication with families through a dedicated family liaison office when someone in custody is seriously injured or dies.
What they're saying: "More jail beds will not correct missed medical warning signs, interrupted medications, untreated withdrawal, failed mental health referrals, delayed court action, weak communication between agencies, or the lack of meaningful accountability after serious failures," Steve Huerta, executive director of All of Us or None Texas, said in a statement.
- "Being in jail shouldn't mean losing doctor-prescribed medications and living conditions that destroy people," Anthony Pestello, who has been detained in the jail, told reporters Tuesday.
Zoom in: The county-owned University Health System, which provides medical care at the jail, gives everyone a screening that includes a health questionnaire of medical and mental health conditions, spokesperson Elizabeth Allen tells Axios.
- Anyone with a condition that requires ongoing treatment is referred within University Health to establish a treatment plan while they are in custody, Allen says.
- University Health completed more than 14,400 mental health assessments from October 2025 to May 31, 2026, she adds. It also uses standardized tools to measure someone's withdrawal symptoms and guide treatment.
- Hamby, with the sheriff's office, says family notification is dependent on the investigating agency.
Zoom out: The city and county have jointly been exploring a potential center that would divert people experiencing mental illness away from the jail and toward treatment.
- It appears to have support from several elected officials, although there are no immediate plans.
What's next: The Bexar County Commissioners Court is expected to discuss the jail next month.
Editor's note: This story has been updated with more comment from University Health, among other minor updates.