The North Dakota State Hospital, on the southern rim of the James River valley overlooking Jamestown, North Dakota, has since 1885 been North Dakota's primary institution for treating the mentally ill and confining the criminally insane.
The North Dakota territorial legislature authorized a "hospital for the insane" in 1883. On May 1, 1885, the State Hospital opened, four years before North Dakota was granted statehood. Along with the University of North Dakota, it is the only institution in North Dakota to predate statehood. The first superintendent was Dr. O. Wellington Archibald, who had previous worked for the US Army at Fort Abraham Lincoln near Mandan, North Dakota.
The new institution was praised by authorities of the time. Crowding, however, forced the institution to expand repeatedly, as the number of inmates grew from 106 in 1886 to 819 in 1912, and then to 1,288 by 1920.
Along with many other states, North Dakota practiced forced sterilization of its patients. The practice began in 1914, and continued until the 1950s.
In June, 1937, Governor Bill Langer - one of North Dakota's most controversial political figures - fired Superintendent J.D. Carr, appointing Henry G. Owen in his place. Owen then fired 75% of the institution's staff, hiring their replacements, a January 30, 1939 report in the Fargo Forum alleged, due to their contributions to the state's governing Non-Partisan League and other political connections.
A January 30, 1939 report in the Fargo Forum detailed the results of state special examiner Clyde Duffy's report on his investigation into the political abuses, and their costs both financial and in quality of patient care. Duffy quoted a hospital employee "The new employees didn't know how to treat the patients. They called them bad names, cussed and swore at them. Some said they would run away and some did run away."