EDITORIAL: 90 jail deaths later, when will Bexar County officials act?

CaSandra Monette Pearson will be remembered as a mother, daughter, niece and friend.

She was the 89th person to die in the Bexar County Adult Detention Center since 2020.

Then on Thursday, at 5:30 p.m., Elizabeth Anne Nero, 57, died at the jail due to what likely was detoxification issues, officials said. We have reached a grim milestone: 90 deaths since 2020, and five deaths this year.

Bexar County has one of the deadliest jails in Texas, if not the country.

Many jail deaths go unnoticed. Not so with Pearson, whose death on May 17 has inspired protests and calls for reforms. Like so many people in the Bexar County jail, Pearson struggled with addiction and mental health challenges. Like so many other jail deaths here, Pearson's case raises profound questions about whether she should ever have been in the jail and why Bexar County is moving so slowly to implement reforms, especially the creation of a jail diversion center to provide mental health and medical care to vulnerable people.

As we have chronicled in our "Jailed to death" series, the Bexar County jail is in crisis. For years, its mortality rate - the number of deaths per 100,000 people in a given population - has far exceeded national norms, as well as other large Texas jails.

When looking at jail deaths from 2020 through 2025, the jail here stands out for neglect and failure. The 85 deaths in that time far exceed the 65 and 61 deaths in Tarrant and Dallas counties. In Texas, only the Harris County jail had more deaths. But while the Harris County jail had 110 deaths from 2020 to 2025, it is roughly twice the size of the Bexar County jail.

Overcrowding fuels the crisis. The jail is so packed, Bexar County has spent millions of dollars in recent years to house inmates in other counties. Imagine if those funds instead were dedicated to treatment and diversion.

That would be a radical and welcome change, but there is no diversion center for people with mental health and addiction issues who are accused of low-level offenses. People in crisis like Pearson or Nero.

A diversion center alone will not solve the jail's many problems. A diversion center will not end "double magistration," a cruel redundancy in which people who are arrested by city police go through booking twice - first at a city of San Antonio facility, and then again at the jail. A diversion center will not modernize the jail. Built in 1988, it is a dingy and dark place lacking in technology. Its unit for people with serious mental health issues, where a man languished for months and died covered in feces in 2023, feels like a dungeon.

But a diversion center is a starting point to reduce jail deaths and change lives. It has worked in Harris County, it is beginning to work in Travis County, and it would work here. All that is needed is Bexar County commissioners to act with urgency.

Pearson's death has become a community flash point, prompting a recent protest outside the jail. Pearson was just 29. She had a 7-year-old daughter, Aria. Her only prior arrest was in 2016 on an assault charge.

She was also sick. As her family members first told Express-News reporter Annasofia Scheve, Pearson had sickle cell anemia, a genetic disorder that can block blood flow and cause immense pain. That pain, family members said, led to opioid addiction and mental health challenges.

Pearson cycled in and out of hospitals for pain treatment, and she could be difficult, especially if she was going through withdrawal, her family said. She was on that cycle when she was placed in Methodist Hospital Stone Oak and then arrested March 10 for allegedly assaulting a nurse.

Pearson's family members have questioned how, given her sickle cell anemia and mental health, the incident escalated to an arrest. They have wondered whether Pearson received adequate care in jail, alleging her weight dropped from 135 pounds to 113 pounds.

"Did the incident at the hospital warrant her going to jail?" Michael Pearson, her uncle, told us during a recent interview. "She was clearly a mental patient. ... When you have issues with mental patients, you're just going to call the police on them?"

These are important questions that deserve, if not an independent investigation, then at least political consideration. Was jail the right place to send her? Could CaSandra Pearson have been better served in diversion?

"It breaks my heart that we continue to do the same things over and over again when we can really help these people by diverting them from jail and getting them into treatment as soon as possible," said Jelynne LeBlanc Jamison, president and CEO of the Center for Health Care Services, the mental health authority for Bexar County.

Abouth this series

This is the sixth installment of our series about deaths at the Bexar County jail.

The series has called for a number of reforms, including creating a diversion center, investing in mental health beds and ending deadly double magistration. We have also launched a Bexar County Jail Tracker dashboard.

If you have a loved one who died in the Bexar County Adult Detention Center and would like to discuss the case, email Josh Brodesky, Express-News opinion editor, at jbrodesky@express-news.net.

Jamison told us she has 16 beds at the Josephine Recovery Center in the center of the city that could accommodate a pilot diversion program.

Local officials have studied diversion elsewhere, and it's past time to put those lessons into practice, she said.

"We've been spending a lot of time on the road visiting and learning what (other counties) do," she said. "We're spending less time getting busy and getting something going here."

The jail crisis is really a humanitarian crisis. Jail deaths are not a reflection of the inmates but of our community.

"Just because someone makes a mistake or has to be incarcerated, that don't mean they're not human," Stephanie Shoels, CaSandra Pearson's aunt, told us.

CaSandra Pearson wasn't just the 89th person to die in the Bexar County jail since 2020. She was a mother, a daughter, a niece, a friend.

"We just don't want to see any other family go through this pain, you know, if it's avoidable," Michael Pearson said May 29.

Less than a week later, there was another jail death.

Too many families know this pain. Too often, it is avoidable.

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This story was originally published June 5, 2026 at 11:02 AM.