The first superintendent was Dr. O. Wellington Archibald, who had previously worked for the US Army at Fort Abraham Lincoln near Mandan, North Dakota.

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 1949 Fargo Forum article detailed a report from the American Psychiatric Association complaining of overcrowding, poorly qualified staff, and a general lack of organization.

The extent of his reforms can be seen in a quote from his 1956 annual report[2] "Gone are the cages, strait jackets, leg irons, stern guards, malnutrition, windowless seclusion rooms, unorganized departments, the sixty-hour work week, the naked despondent patient on a back ward, the odors from wards crammed with untidy and helpless men and women, the tuberculosis patients in disorganized treatment areas, the neglected surgical problems and the bedlam of disturbed units".

By the late 1970s, long-term in-patient placement was being downplayed in favor of treating the mentally ill at home through local and regional human service organizations.