Raymond Riles arrived on Texas’s death row in 1976, the year President Gerald Ford lost his reelection bid and the first “Rocky” movie debuted in theaters. Riles had been sentenced to death in Houston for killing a used car salesman named John Henry.

Forty-five years and eight presidents later, Riles remains there, having survived three cancelled execution dates to become the longest serving death row prisoner in the state—and likely in the nation. He lives in near-total solitary confinement. Like many longtime death row prisoners, experts have repeatedly deemed him to be delusional and “grossly psychotic.” Sometimes he describes himself as God or “King Moto-Cherry Velt-Love.” Other times he worries that he will be sacrificed to Satan by his demonic captors. He once set himself on fire.

He may get to leave death row soon. This week, Harris County District Attorney Kim Ogg announced her support of a new punishment trial for Riles, paving the way for him to get a life sentence and live out his days in the general prison population if judges agree. “These cases are heartbreaking because the process takes so long,” Ogg said in a press release. “It just prolongs justice and healing for the families of the dead.”

Riles’s case—and the time it has taken to resolve it—is far from unique and raises troubling questions about how prisoners can languish on death row for decades, even when they are too mentally ill to execute.

Read the full article about mental illness on death row by Keri Blakinger and Maurice Chammah at The Marshall Project.