For years, policy makers in Texas have known of the severe harm caused by holding people in isolation. Yet Texas continues to hold thousands of people in isolation for years on end, sometimes decades. In May 2019, Texas held 4,165 people in solitary confinement. On average, people placed in solitary confinement spend approximately five years in isolation. Amazingly, Texas holds more prisoners in prolonged solitude—six years or longer—than all the other states and Federal Bureau of Prisons combined. As detailed in this report, the practices in Texas buck a national trend of reform in this area.