FARGO, N.D. (NewsDakota.com) – The following is a letter submitted to North Dakota Governor Kelly Armstrong by Fargo State Senator Tim Mathern who serves District 11 concerning the groundbreaking ceremony of the new State Hospital in Jamestown.

Dear Governor Armstrong, Thank you for your support of increasing behavioral health services and the invitation to the event at the state hospital on August 18, 2025.

Serving in the Legislature since 1986 has me involved in many issues, you did the same as I recall from our
time together in the Senate. I try to focus on issues that directly affect the well-being of North Dakotans. In
1987, NDCC 50-06-06.5 was enacted, instructing the Department of Health and Human Services to achieve a
continuum of care for all individuals with severe and persistent mental illness—ensuring they receive treatment in the least restrictive environment within their communities. I recall your grandmother, being a leader in that effort. That need was urgent 40 years ago, and it remains urgent today. Unfortunately, the vision behind that law has not been realized. The decision to construct a new centralized state hospital undermines that goal and disregards the intent of existing law. This is not about party or politics—it is about keeping our word to those who suffer from mental illness and their families. For these reasons, I will not attend the state hospital groundbreaking ceremony next week:

1. It conflicts with professional ethics and pragmatic considerations. Attending the groundbreaking would signal support for a model history has shown to be both ineffective and harmful. The present hospital has empty beds as the smaller Jamestown community is unable to attract the professional staff needed for a facility of this size. We already spend millions of dollars each year for traveling staff. The architectural services for the facility were done with no bidding process. The costs of more than $300,000,000 for a hospital right next to a prison is not respectful to the patients served or the taxpayers.

2. It ignores modern, evidence-based practice. Research shows community-based care achieves better outcomes, stronger social integration, and lower costs than centralized institutions. People who move from
institutions to community settings make greater gains in daily living skills while centralized hospitals risk
reversing progress and reintroducing stigma. Reliance on institutional care reflects structural discrimination, not effectiveness. For example, we do not have a state hospital for cancer but integrate this care with other
illnesses. Community care can help people feel connected to local resources, social networks, family, and
community supports like churches and social service entities.

3. It contradicts state law. The 1987 legislation sought to shift care into communities, not reinvest in a
centralized institution. We made the mistake in the 60s when the federal goal was to increase local services,
but this did not happen during deinstitutionalizing, leaving persons with illness languishing in our cities.
Instead, I respectfully urge you to:

1. Fully fund all eight Certified Community Behavioral Health Clinics, fulfilling the long-promised goal of strong community-based mental health care statewide. Each Clinic to be certified, is required to have acute
psychiatric within their continuum of care. This can be offered by private providers with the resources of private insurance, Medicaid, Medicare, and private pay. The state hospital in not able to be reimbursed by Medicaid for the full array of patient ages.

2. Repurpose the current LaHaug hospital building to serve prisoners with mental health needs and others who require secure treatment relieving pressure on correctional facilities.

3. Allocate proper funding for what we have. Examples include more resources for upkeep of the State Hospital cemetery, where more than 2,000 North Dakotans are buried, as a visible promise that our state will
never again hide those it is entrusted to care for. Further, elimination of unused facilities which only detract
from positive view of care provided and contribute to the misunderstanding that all the old buildings are the
state hospital.

Essentially our state hospital campus has become a corrections facility. The numbers of inmates compared to
patients proves it. We cannot build a better mental health system by repeating the mistakes of the past. North Dakota deserves better. $300,000,000 can be spent in more productive ways. Our citizens deserve better.

Respectfully, Senator Tim Mathern

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