North Dakota's Department of Corrections and Rehabilitation (DOCR) operates one of the smallest prison systems in this series. Four adult facilities house approximately 1,200-1,300 people total: the North Dakota State Penitentiary (Bismarck, maximum and medium security, 815 capacity), James River Correctional Center (Jamestown, medium security, 420 capacity), Missouri River Correctional Center (Bismarck, minimum security, 151 capacity), and the Dakota Women's Correctional and Rehabilitation Center (New England, women, 126 capacity). A new women's facility -- the Heart River Correctional Center in Mandan -- broke ground in April 2025 and is expected to open in fall 2027.
Small system, documented behavioral health staffing challenges: North Dakota is ranked sixth in the nation for drug and alcohol abuse but 43rd in behavioral health workforce availability. Historical reporting from DOCR's own clinical director noted only three psychologists shared among the state's four prisons -- a staffing level that limits individualized clinical care.
The cornerstone of North Dakota's prison mental health and SUD treatment is the Tompkins Rehabilitation and Corrections Center, located on the North Dakota State Hospital campus in Jamestown. Tompkins is a 90-bed dedicated treatment facility -- operated by DHS and contracted by DOCR -- providing around-the-clock SUD and mental health treatment services, cognitive behavioral programming, and individualized treatment planning.
For community reentry, DOCR's flagship program is Free Through Recovery -- a community-based behavioral health program providing peer support, recovery services, and care coordination for justice-involved individuals with behavioral health conditions.
North Dakota does not have active federal court oversight of DOCR prison mental health care.
What North Dakota Prisoners Are Entitled To
Under Estelle v. Gamble (1976) and DOCR policies:
- Mental health screening at intake.
- Mental health services through DOCR's treatment department at all adult facilities.
- Access to the Tompkins Rehabilitation and Corrections Center for intensive SUD and mental health treatment when warranted.
- Crisis intervention and suicide prevention.
- Case management beginning six months before release for seriously mentally ill prisoners.
- A 30-day supply of medication and a 30-day prescription upon release.
Mental Health Screening at Intake
DOCR conducts health screening for all incoming prisoners, including behavioral health assessment. The assessment identifies mental health history, substance use conditions, and active psychiatric medications. At Tompkins, assessment begins with a full evaluation and diagnosis, and the treatment team then develops a customized treatment plan.
If your person has a psychiatric history, provide documentation at intake -- prior hospitalizations, diagnoses, and active medications -- to support accurate initial classification and medication continuity.
DOCR Mental Health Services
DOCR's Treatment Department at its adult facilities provides mental health services throughout incarceration. At the North Dakota State Penitentiary and James River Correctional Center, DOCR employs psychologists (historically, three psychologists shared among the four state prisons). Mental health professionals provide:
- Crisis intervention and suicide risk assessment.
- Mental health evaluations.
- Individual counseling.
- Group programming.
- Referrals to Tompkins for more intensive treatment.
- Six months of pre-release case management for seriously mentally ill prisoners.
A unit in the James River Correctional Center in Jamestown has historically housed seriously mentally ill prisoners, providing a housing alternative for those whose needs exceed what the general population setting can accommodate. Verify current JRCC mental health unit status at publish.
The Tompkins Rehabilitation and Corrections Center
Tompkins Rehabilitation and Corrections Center is located on the campus of the North Dakota State Hospital in Jamestown. It is a dedicated treatment facility -- not a standard correctional housing unit. Key facts:
Operator: The Department of Human Services (DHS) operates Tompkins; DOCR contracts the beds.
Capacity: 90 beds total -- two wards of 30 beds each for males (60 beds) and one ward of 30 beds for females. DOCR assumed control of the 60-bed male unit in 2019.
Conditions: Provides around-the-clock SUD and mental health treatment services.
Services: Evaluation and diagnosis upon admission; customized treatment plan developed by the treatment team; individual and group therapy; cognitive behavioral treatment (cognitive restructuring groups to reduce risk of reoffending); treatment of addiction and co-occurring mental health disorders.
Approach: Utilizes cognitive restructuring as the primary evidence-based approach -- helping people reframe negative thoughts, improve mental wellbeing, and reduce anxiety.
Tompkins represents the most intensive mental health and SUD treatment resource within the DOCR system. It is on the State Hospital campus, giving it access to a clinical environment and DHS clinical staff beyond what a standard prison can provide.
The North Dakota State Hospital (NDSH)
The North Dakota State Hospital (Jamestown, Stutsman County) is the state's primary inpatient psychiatric hospital. NDSH provides:
- Inpatient psychiatric care for civil commitment patients.
- Forensic psychiatric evaluation services for courts.
- Competency evaluation and restoration for defendants found incompetent to stand trial.
- A campus that includes Tompkins Rehabilitation and Corrections Center.
For DOCR prisoners who require hospital-level inpatient psychiatric care beyond what DOCR facilities or Tompkins can provide, NDSH is the primary referral destination. The shared campus between Tompkins and NDSH means that the escalation pathway from corrections to the hospital level is geographically compressed.
The Free Through Recovery Program
Free Through Recovery (FTR) is DOCR's community-based behavioral health program, established by the 2017 North Dakota Legislative Assembly as a term of parole or an alternative to incarceration. DOCR and DHS developed and implemented FTR together. The 2021 Legislative Assembly appropriated $11 million for FTR ($8 million from the general fund, $3 million federal). Key features:
Who qualifies: Justice-involved individuals (or those transitioning out of prison) who have a behavioral health condition and moderate to severe substance use disorder and are at risk of criminal justice involvement.
What FTR provides: Peer support; recovery services; care coordination; care planning and referrals; connection to local mental health and SUD treatment providers; monitoring in collaboration with probation, parole, and clinical services.
When FTR applies: Available as a term of parole (allowing parole officers and courts to require FTR participation as a condition of release) or as an alternative to incarceration for people whose behavioral health needs are the root cause of their criminal behavior.
FTR directly addresses the 6th-in-the-nation drug/alcohol abuse rate paired with 43rd-in-the-nation behavioral health workforce availability. By using peer support and care coordinators rather than only licensed clinical staff, FTR extends the reach of behavioral health services beyond what the licensed workforce alone could provide.
Release and the 30-Day Medication Bridge
DOCR provides a 30-day supply of medication and a 30-day prescription to prisoners with serious mental illness upon release. This bridges the gap between release and the first community mental health appointment.
Pre-release case management for seriously mentally ill prisoners begins six months before release. The case manager works with the prisoner to identify:
- Where they are going to live.
- A nearby community mental health or SUD treatment provider.
- What supports will be in place.
DOCR acknowledges that case management post-release has historically been a weakness -- the DOCR's own clinical director stated the state "must do a better job following up with released offenders, particularly the mentally ill." The Free Through Recovery program and its care coordination function are designed to help fill this gap.
Behavioral Health Workforce Gap
North Dakota's behavioral health workforce shortage affects both the prison system and the community mental health network that released prisoners need to access. Key documented data:
- North Dakota is ranked 6th nationally for drug and alcohol abuse.
- North Dakota is ranked 43rd nationally in behavioral health workforce availability.
- Only 12% of probation officers in a CSG survey said substance abuse treatment was available and accessible for their clients.
- About 70% of judges reported having sentenced people to prison partly because behavioral health treatment was not available in the community.
This workforce gap makes the Free Through Recovery program's care coordinator model especially important: coordinators help navigate a sparse system and connect people to what services are available.
The Heart River Correctional Center
North Dakota broke ground on a new women's prison -- the Heart River Correctional Center in Mandan -- on April 2, 2025. The facility:
- Is the first prison in North Dakota's history specifically designed to house women.
- 191,500 square feet; 304 beds.
- Expected cost: $166.8 million.
- Projected completion: fall 2027.
- Designed with rehabilitation as a core mission, including space for employment and educational services.
The current women's facility, the Dakota Women's Correctional and Rehabilitation Center in New England, is small (126 capacity) and has limited space for specialized programs. Heart River represents a significant investment in both capacity and rehabilitation infrastructure for women in DOCR custody.
What Families Can Do
If your person is in North Dakota DOCR custody and has a mental illness:
Provide psychiatric history at intake. Supply documentation of prior hospitalizations, diagnoses, and active medications. This supports accurate initial classification and medication continuity.
Know the Tompkins option. If your person has a serious mental illness or co-occurring SUD and mental illness, ask whether Tompkins Rehabilitation and Corrections Center has been considered. Tompkins provides around-the-clock intensive SUD and mental health treatment on the State Hospital campus with individualized treatment planning.
Know the James River mental health unit. Historically, JRCC has housed seriously mentally ill prisoners in a dedicated unit. Ask whether your person at JRCC is in the mental health unit or whether a mental health unit placement has been considered.
Know the six-month pre-release case management right. If your person has serious mental illness and is within six months of release, ask whether case management has been initiated to identify housing and community mental health connections.
Know the 30-day medication bridge. At release, your person is entitled to a 30-day medication supply and a 30-day prescription. Confirm this has been arranged before their release date.
Know Free Through Recovery. If your person is on parole or nearing release and has a behavioral health condition and SUD, ask whether FTR has been arranged. FTR provides peer support, care coordination, and community connection that can significantly improve outcomes during the transition period.
Ask about NDSH referral. If your person requires hospital-level inpatient psychiatric care, ask whether a referral to the North Dakota State Hospital has been made.
File a grievance. DOCR has an administrative grievance process. File formal grievances for: failure to conduct mental health screening, denial of mental health services, failure to refer to Tompkins when warranted, medication interruption, failure to initiate six-month pre-release case management, and failure to provide the 30-day medication supply at release.
Contact Disability Rights North Dakota. DRND (disabilityrightnd.org) is the federally mandated Protection and Advocacy organization for North Dakota and monitors conditions for people with mental illness and disabilities in DOCR facilities.
Seek legal help. If your person has serious mental illness and is not receiving adequate mental health care, if Tompkins referral has been denied when warranted, or if the six-month pre-release case management or 30-day medication provision has not been provided, consult a prisoner rights attorney with experience in North Dakota's federal courts (District of North Dakota).
Frequently asked questions
How does North Dakota screen prisoners for mental illness?
DOCR conducts behavioral health screening for all incoming prisoners, identifying mental health history, substance use conditions, and active psychiatric medications. At Tompkins Rehabilitation and Corrections Center, all admissions receive a full evaluation and diagnosis before the treatment team develops a customized treatment plan. Provide psychiatric documentation at intake -- prior hospitalizations, diagnoses, and active medications.
What mental health services does North Dakota DOCR provide?
DOCR's Treatment Department provides mental health services at all adult facilities: crisis intervention, suicide risk assessment, mental health evaluations, individual counseling, group programming, and pre-release case management for seriously mentally ill prisoners beginning six months before release. Tompkins Rehabilitation and Corrections Center (DHS-operated, DOCR-contracted) provides intensive SUD and mental health treatment at the State Hospital campus in Jamestown. DOCR historically employed three psychologists shared among its four prisons.
What is the Tompkins Rehabilitation and Corrections Center?
Tompkins is a 90-bed dedicated SUD and mental health treatment facility (60 male beds, 30 female beds) on the campus of North Dakota State Hospital in Jamestown. Operated by DHS under contract with DOCR, it provides 24-hour treatment services: full evaluation and diagnosis, individualized treatment planning, individual and group therapy, and cognitive behavioral programming (cognitive restructuring). It is the most intensive mental health and SUD treatment resource within the DOCR system.
What is North Dakota's Free Through Recovery program?
Free Through Recovery (FTR) is DOCR's community-based behavioral health program established by the 2017 Legislature. For justice-involved individuals with behavioral health conditions and moderate-to-severe SUD who are at risk of criminal justice involvement, FTR provides peer support, recovery services, care coordination, care planning and referrals, connection to local mental health and SUD providers, and monitoring in collaboration with probation, parole, and clinical services. FTR can be a parole term or an alternative to incarceration.
Which ND prison has a unit for seriously mentally ill?
James River Correctional Center (JRCC) in Jamestown has historically housed a unit for seriously mentally ill prisoners. JRCC is a medium-security men's facility with a 420-bed capacity. Verify current mental health unit status and capacity at JRCC at publish, as operational details may have changed. Tompkins Rehabilitation and Corrections Center -- on the State Hospital campus in Jamestown -- provides the most intensive dedicated treatment for those with co-occurring SUD and mental illness in the DOCR system.
What is North Dakota State Hospital's role in corrections?
The North Dakota State Hospital (NDSH, Jamestown) is the state's primary inpatient psychiatric hospital and serves civil commitment patients, forensic evaluation patients (IST, NGRI), and competency restoration referrals. NDSH's campus also hosts Tompkins Rehabilitation and Corrections Center, the dedicated SUD and mental health treatment center for DOCR. For DOCR prisoners requiring hospital-level inpatient psychiatric care, NDSH is the primary referral destination.
How does ND provide mental health care at release?
Pre-release case management for seriously mentally ill prisoners begins six months before release, identifying housing and connecting the person to a nearby community mental health or SUD provider. At release, DOCR provides a 30-day medication supply and a 30-day prescription. Free Through Recovery (FTR) provides post-release peer support, care coordination, and community provider connections for people with behavioral health conditions. DOCR has acknowledged that post-release follow-up for the mentally ill has been a weakness and that FTR is designed to help fill this gap.
What is the new Heart River Correctional Center?
Heart River Correctional Center (Mandan, groundbreaking April 2025, projected fall 2027 opening) is the first prison in North Dakota history specifically designed to house women. The 191,500 sq ft, 304-bed facility will replace the current Dakota Women's Correctional and Rehabilitation Center in New England (126 capacity) and will include space for employment and educational services with a rehabilitation-centered mission. The project cost is approximately $166.8 million.
What can families do if mental health care is denied in ND?
Provide psychiatric documentation at intake. Ask about Tompkins Rehabilitation and Corrections Center for intensive SUD and mental health treatment. Ask whether the JRCC mental health unit has been considered. Confirm six-month pre-release case management has begun if release is approaching. Confirm the 30-day medication supply and prescription are arranged before release. Ask about Free Through Recovery enrollment approaching and after release. File DOCR grievances for screening failures, service denials, medication interruptions, and case management failures. Contact Disability Rights North Dakota (disabilityrightnd.org) for legal advocacy.
Who oversees mental health care in North Dakota prisons?
DOCR's Treatment Department oversees mental health services at adult facilities. Tompkins Rehabilitation and Corrections Center is operated by DHS under DOCR contract. North Dakota State Hospital (NDSH) provides hospital-level inpatient care. No federal court actively exercises oversight of DOCR. Disability Rights North Dakota (DRND, disabilityrightnd.org) is the federally mandated P&A organization monitoring conditions for people with mental illness and disabilities in DOCR. ---