Why Rosalynn Carter fought for mental health reform

FFew people have passed away with as much grace and influence as Rosalynn Smith Carter, who died Sunday at the age of 96. She calls her autobiography “The First Lady of the Plains,” but to many she was also the First Lady of Mental Health Reform. . Decades ago, she took a bold stand on the topic of mental health, which is common knowledge today. Mental health is healthy, stigma is deadly, and people with mental illness have the right to be full members of society rather than hiding in overcrowded and dangerous facilities.

Her leadership on this important issue began in Georgia, where a young Jimmy Carter was elected to the state Senate, and continued for decades. She only recently retired from the Carter Center’s mental health department. She provides guidance and information, such as when Mike Hogan, chairman of President George W. Bush’s newly appointed New Freedom Commission on Mental Health, asked her to speak to the commission in 2002. , I was often asked to brainstorm. It was the first time something like that had happened. It is the first presidential agency since her husband founded it a quarter century ago.

“Twenty-five years ago, we never dreamed that one day people would actually be able to recover from mental illness. Today, it’s a very real possibility. …For as long as I have. “For someone who has struggled with mental health issues, this is a miraculous development and an answer to my prayers,” she told the committee. Working with people like Larry Fricks, a pioneer in the peer services movement, as she said when I was writing The Fight for Recovery: An Activist History of Mental Health. helped shape her understanding of recovery and its possibilities.

It was consistent with her work. She placed humanity at the center of her efforts, and she believed that society should not abandon anyone. This explains her concern for ending stigma, a powerful force that denies people who suffer from mental health problems respect and often prevents them from living fully in their communities. useful for.

Much of her spirit comes from her ability to see the personal behind conditions and situations. Jimmy’s distant cousin Tommy visited Central Georgia State Hospital in Milledgeville. These visits opened a window into the deplorable and inhuman conditions for the 13,000 Georgians packed into this state mental hospital at the time. She volunteered with her friends and colleagues to visit hospitals in Georgia, and shortly after Jimmy was elected, she attended the National Mental Health Association (now Mental Health) conference in Philadelphia in 1976. America) attended the convention. So she told her friends that her husband was forming a committee to study mental health.

As Georgia’s first lady, she said the high point of her job was mental health reform. During her husband’s gubernatorial campaign, she met distraught parents whose children suffered from developmental disabilities and mental illness, she said in her “First Lady of the Plains.” They asked her, “Will she help them if Jimmy Carter is elected governor?” She relayed her question on their behalf and he answered, “Yes.”

True to his word, after being elected in 1971, he announced the creation of a gubernatorial commission to study and implement mental health reform. And Rosalynn Carter honed her skills. She visits all 12 of her hospitals in Georgia, and at Georgia Regional Hospital she volunteers one day a week, working on every floor, where she “listens and learns” Told. She read to children, talked to adults trying to sober up, and gardened with her elders. In the end, Georgia followed the commission’s direction to downsize its aging institutions.

Another of the commission’s charges expanded the number of community mental health centers from 23 to 134, allowing people living at home to receive services. It served as a dry run for the next committee her husband would appoint, this time to serve with confidence, agility, and experience.

In 1977, one month after taking office, Carter established the Presidential Commission on Mental Health (PCMH). Due to nepotism rules, Rosalynn Carter could only become honorary president, but no one questioned who was in charge. Soon she turned her east wing into a hub for mental health reform. Twenty people were selected to serve on the committee, which held public hearings in Chicago, Tucson, Philadelphia, Nashville, and San Francisco with former patients, clinicians, service providers, and local politicians.

In October 1980, this painstaking work led to Congress passing the Mental Health Systems Act. This legislation focuses on the unmet needs of populations across the board, including minorities, the elderly, children, the poor, and rural people. America. Performance grants required contracts, which created accountability. Patient rights will be identified. The prevention program will become part of the National Institute of Mental Health (NIMH). These and many other things can be transformative.

However, the celebrations did not last long. The following month, Ronald Reagan won the presidential election in a landslide, dealing a major blow to the first lady. The new Republican president hid mental health reform after he took office. Even before his inauguration, he sent a delegation to NIMH with a message about budget cuts and service termination. This was followed by the introduction of national block grant programs, watering down the public health approach to health and replacing it with state-funded programs. Mental health became part of the block funded by Black Lung Disease, Rodent Control, and Blood Pressure Lowering programs.

Rosalynn Carter leaves politics and grief behind and returns to Plains, Georgia. Perhaps her most enduring work was produced in the years that followed. She remained steadfast in her mission of mental health reform, and when the Carter Center opened in Atlanta, mental health programs became a perpetuation of her priority. Although she can no longer influence government policy as before, her new role has allowed her to fight stigma and support the development of journalists.

It’s no surprise that stigma was a theme at the first Rosalynn Carter Symposium on Mental Health in 1985. And for the next 20 years, the annual Rosalynn Carter Mental Health Symposium became the centerpiece of staging reform. In his 1998 book, Helping People with Mental Illness, Carter wrote that his longtime goal was to “eradicate the stigma of mental illness.” She knew that people were reluctant to share their experiences with mental illness for fear of discrimination or rejection. Priscilla Allen, one of the PCMH members, said she had to fabricate her background because her landlord wouldn’t rent an apartment to people who had previously been admitted to a psychiatric hospital. had a deep influence on her.

It took knowledgeable journalists to ensure news outlets understood how it contributed to stigmatizing people with mental illness. She was furious when a 1979 Newsweek article discussing PCMH referred to patients as inmates. “The word inmate refers to criminals, not mentally ill patients,” she scolded her editor. She later heard that one journalist didn’t think the Mental Health Reform Act was a “sexy topic.” As a note to herself, she writes: “We cannot afford to give in to these opinions. Facts — the impact of m.[ental] The disease ravaging the nation is too urgent to ignore. ”

In 1996, the Carter Center announced a fellowship program. The program currently supports 220 people around the world and helps them learn about the science, treatments, and policies, especially how patients and former patients address behavioral health issues. She also believed that by using more respectful and accurate language, we might be able to slow and perhaps even stop deep-rooted prejudice. In 2015, the center published a Journalism Resource Guide on Behavioral Health, urging reporters to use words to describe people with a condition rather than the condition itself, and to perpetuate stereotypes about “mental abnormalities.” He advised people to avoid terms such as “person” and “insane person.” This is just one example of how her legacy will live on.

Peter Bourne, a psychiatrist and longtime special assistant to Rosalynn Carter, regrets leaving the country when the MHSA was signed. In a letter to his friend Rosalyn, he said: “Your years of hard work and dedicated investment in the cause of the mentally ill have paid off in a way that positively impacts the lives of every mentally ill person in this country, simply because you care. …We all owe you so much.” I couldn’t agree more.

Phyllis Vine is a historian, journalist, and author of Fighting for Recovery: An Activists’ History of Mental Health Reform (Beacon Press).

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