It sits on a corner of the Naval Air Station Joint Reserve Base in Fort Worth, Texas. Most people driving by just see fences and standard government architecture. But inside, Federal Medical Center Carswell—usually just called FMC Carswell—operates as the only facility in the entire federal prison system dedicated specifically to female inmates with significant medical and mental health needs.
It’s a strange, heavy place. Honestly, the vibe is part hospital, part high-security lockup. Unlike a typical "camp" where people might be doing time for white-collar crimes in relatively relaxed settings, Carswell handles everything. You’ve got women there for low-level drug offenses alongside some of the most notorious names in the country. They are all tied together by one thing: they are sick.
What Actually Happens Inside FMC Carswell?
The Bureau of Prisons (BOP) classifies this place as an administrative facility. That’s government-speak for "we put whoever we want here regardless of their security level." It houses roughly 1,200 inmates, though those numbers fluctuate. Most are in the medical center itself, but there’s also a separate minimum-security satellite camp on the grounds.
Medical care in prison is a lightning rod for controversy. At FMC Carswell, the stakes are higher because the women here are dealing with stage IV cancer, end-stage renal failure, and severe psychiatric disorders. The facility operates a full-scale hospital, including surgery suites, physical therapy, and a hospice program.
It’s not just about physical ailments, though. Carswell is home to a specialized unit for women with "dual diagnosis"—those struggling with both mental health crises and substance abuse. It’s one of the few places in the BOP system where a woman can get intensive psychiatric residential treatment. But don’t mistake it for a private clinic. It’s still a prison. The doors lock. The guards are armed. The rules are rigid.
The High-Profile Names You Know
You can’t talk about FMC Carswell without mentioning the roster. Because it’s the only medical hub for women, it naturally attracts the inmates the media loves to track.
Take Reality Winner, the former intelligence contractor. She served time here after leaking a report about Russian interference in the 2016 election. Then there’s Lisa Montgomery, the only woman executed by the federal government in nearly seven decades. She spent her final years in the psychiatric unit at Carswell while her lawyers argued she was too mentally ill to understand her sentence.
Even "Squeaky" Fromme, famously known for her association with the Manson Family and her attempt on President Gerald Ford’s life, spent decades here before her release in 2009. More recently, Ghislaine Maxwell was moved to the satellite camp at Carswell. It’s a bizarre cross-section of society. You might have a grandmother dying of breast cancer sharing a hallway with a domestic terrorist or a high-level cartel member.
💡 You might also like: Passive Resistance Explained: Why It Is Way More Than Just Standing Still
The Reality of Medical Care Behind Bars
Is the care actually any good? It depends on who you ask.
The BOP will tell you that Carswell provides "community-standard care." They have partnerships with local hospitals in the Dallas-Fort Worth area for procedures they can't handle in-house. They have specialists. They have a pharmacy.
But advocacy groups and family members often tell a different story. Organizations like the National Council for Incarcerated and Formerly Incarcerated Women and Girls have frequently raised alarms about delays in treatment. If you have a lump in your breast at Carswell, you aren't getting a mammogram the next day. You're putting in a "sick call" request. You're waiting. Sometimes you're waiting weeks or months.
During the height of the COVID-19 pandemic, Carswell was a flashpoint. Inmates like Andrea Circle Bear, a 30-year-old pregnant woman, died after being placed on a ventilator. She was the first federal inmate to die of the virus. That event triggered a wave of "compassionate release" filings, a legal mechanism where inmates can ask a judge to let them out early if they are terminally ill or facing "extraordinary and compelling" circumstances.
Understanding Compassionate Release at Carswell
If you have a loved one at FMC Carswell, this is the term you need to memorize.
- The inmate or their lawyer files a request with the Warden.
- The Warden has 30 days to respond.
- If they say no (which they often do), you can appeal to a U.S. District Court.
Since the First Step Act was passed in 2018, judges have more power to grant these releases even if the BOP objects. It has saved lives, but the process is notoriously slow. People often die at Carswell while their paperwork is sitting on a desk in D.C. or at the courthouse.
Life in the Satellite Camp vs. the Medical Center
There is a huge difference between being in the "Main Building" and being at the "Camp."
📖 Related: What Really Happened With the Women's Orchestra of Auschwitz
The camp is minimum security. There are no fences. It’s for women who are considered low flight risks and have relatively short sentences. They usually work jobs in the prison—landscaping, food service, or clerical work. They have more freedom of movement.
The Main Building is a different beast. Because it houses inmates of all security levels (including "High"), the movement is much more restricted. If you're there for a heart condition but you're also a "High" security inmate, you’re living under intense surveillance. The atmosphere is clinical, sterile, and often incredibly depressing. It smells like floor wax and industrial-grade disinfectant.
The Mental Health Component
Carswell’s psychiatric wing is officially called the "Life Connections Program" or the "Resolve Program," depending on the specific track. For women with trauma—and let’s be real, almost every woman in the federal system has a history of significant trauma—these programs are supposed to be a lifeline.
They offer:
- Cognitive Behavioral Therapy (CBT)
- Trauma-informed group sessions
- Medication management
- Vocational training for those stable enough to work
However, the ratio of staff to inmates is a perpetual problem. One psychologist might be responsible for hundreds of women. You do the math. It’s hard to get deep, transformative therapy when the system is just trying to keep everyone stabilized and alive.
The Controversies and the "Dumping Ground" Reputation
Some critics call Carswell a "dumping ground." It’s a harsh term, but it stems from the fact that when the BOP doesn't know what to do with a sick or mentally ill woman, they ship her to Fort Worth.
This leads to overcrowding and a massive strain on resources. In 2020 and 2021, reports surfaced of broken plumbing, moldy ceilings, and long periods without air conditioning in the Texas heat. For a facility that is supposed to be a medical center, these conditions are more than just uncomfortable—they are life-threatening for someone with a compromised immune system.
👉 See also: How Much Did Trump Add to the National Debt Explained (Simply)
There’s also the issue of sexual abuse. Like many female facilities, Carswell has not been immune to scandals involving staff misconduct. While the BOP claims a "zero-tolerance" policy under the Prison Rape Elimination Act (PREA), the power imbalance between a guard and an inmate who needs medical help is immense.
Navigating the System: What Families Need to Know
If you're trying to support someone at FMC Carswell, you’re going to hit a lot of walls. The BOP website is often out of date. The phones are rarely answered by a human who can actually help.
Sending Money: You have to use Western Union, MoneyGram, or the National Financial Lab in Des Moines. You can’t just mail a check to the prison.
Visitation: It’s strictly regulated. You have to be on the approved visitors list, which takes weeks to process. Currently, visitation is usually held on Saturdays, Sundays, and federal holidays, but that can change if the facility goes on "lockdown" for medical or security reasons.
Communication: Most women use CorrLinks, an inmate email system. It’s not "real" email—it’s monitored, delayed, and you have to pay for it. But it’s the fastest way to stay in touch.
The Future of the Facility
Is Carswell getting better? There have been some shifts. The Department of Justice has been under increased pressure to improve conditions for incarcerated women. We’re seeing more emphasis on "gender-responsive" care. This basically means acknowledging that women have different medical and psychological needs than men—something that seems obvious but was ignored by the prison system for decades.
But the infrastructure is old. The budget is always a fight. As the female prison population grows, the pressure on this single medical hub only intensifies.
Actionable Steps for Families and Advocates
If you are dealing with a situation involving Federal Medical Center Carswell, don't just wait for the system to work. It usually won't work on its own.
- Hire a Specialist Attorney: If your loved one is seriously ill, you need a lawyer who understands "Compassionate Release" and "Reduction in Sentence" (RIS) motions. Standard criminal defense isn't enough; you need someone who knows the medical side of the law.
- Contact the BOP Regional Office: If you aren't getting answers from the local Warden at Carswell, elevate your concerns to the South Central Regional Office in Grand Prairie, Texas.
- Keep a Paper Trail: Every time your loved one tells you they were denied a doctor's visit or a medication, write down the date, time, and the name of the staff member involved. This data is crucial if you ever have to file a formal grievance (a BP-9) or a lawsuit.
- Reach out to Advocacy Groups: Organizations like FAMM (Families Against Mandatory Minimums) have resources specifically for families navigating medical crises in federal prison. You don't have to do this alone.
- Monitor the Inspection Reports: Keep an eye on the DOJ Office of the Inspector General (OIG) reports. They periodically audit Carswell, and these reports contain the most honest data you'll find about the facility's actual performance and safety.
FMC Carswell remains a complex, often troubled institution. It represents the intersection of the healthcare crisis and the carceral state. For the women inside, it is a place of survival; for those on the outside, it requires constant vigilance to ensure that "medical care" isn't just a label on a gate.