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America is turning 250 years old this July, but this year is also the 50th anniversary of when we as a nation started to look at mental health differently.
Institutionalized, locked up, hidden, punished, ignored and forgotten are some of the ways those battling mental health issues were treated during our first two centuries.
While mental health treatment had evolved over time, one of its champions, Rosalynn Carter, the wife of Jimmy Carter, the then-Democratic nominee for president, told a nationwide audience on a September 1976 appearance on Meet the Press that it was going to be on her agenda.
鈥淭he thing that I want to work with is the mental health program,鈥� Rosalynn Carter said. 鈥淚鈥檝e worked with that for a very long time. I鈥檓 very concerned about that.鈥�
“Rosalynn Carter always wanted to help people. She sought out causes and people to help, whether it related to her personally or not,鈥� said Andrew Och, author of .
as she often spoke about a conversation she had while campaigning for her husband鈥檚 failed race for governor of Georgia in 1966.
While talking to a woman outside of an Atlanta cotton mill, Rosalynn heard about her mentally ill daughter and how she and her husband couldn鈥檛 afford 鈥渢o have good help for her.鈥�
Hours later, Rosalynn asked her husband, 鈥淲hat will you do about mental health in Georgia?鈥�
Jimmy Carter answered, 鈥淲e鈥檙e going to have the best program in the country and I鈥檓 going to put you in charge of it.鈥�
Jimmy didn鈥檛 win that election, but four years later, it became a reality. Once Jimmy became the 76th governor of Georgia, he created the Governor’s Commission to Improve Services for the Mentally and Emotionally Handicapped.
One of the members of the commission was Rosalynn. Over a 10-month period, she made surprise visits to the state鈥檚 dozen community mental health centers along with hospitals in Augusta and Savannah.
One of the facilities Rosalynn visited had a very long past that she knew well.
Central State Hospital, which is nearly 100 miles outside of Atlanta, opened in 1842 as the . Horrifically, its first patient, Tilman Barnett, arrived chained to an ox cart and died six months later.
By the 1960s, the institution had 12,000 patients in 200 buildings, making it the .
Jimmy and Rosalynn visited his cousin Tommy Carter at Central State Hospital. Seeing his treatment and the conditions of the hospital influenced her to make permanent changes.
The commission鈥檚 report, “Helping Troubled Georgians Solve Their Problems,” advised the expansion of community mental-health centers, moved away from long-term institutions and improved coordination between agencies, which made it easier for people to get help without being hospitalized.
Thanks to those changes, Georgia saw a 30% drop in state hospital admissions.
, Rosalynn says her 鈥渨ork with the mentally ill,鈥� was the high point.
Two years after the Carters left the governor鈥檚 mansion, they were unpacking boxes in their new home at the White House.
Now that President Carter could make changes on a national scale, he followed the same approach that worked in Georgia.
As his budget director Bert Lance liked to say, 鈥淚f it ain鈥檛 broke, don鈥檛 fix it.鈥� So Jimmy did what he had done before: created a commission and put Rosalynn in a leadership role once again.
鈥淲ith mental health issues, President Carter saw Mrs. Carter as that caregiver,鈥� Och said. 鈥淎s that person that really genuinely cared about these people and wanted them to get better and put her in charge of it.鈥�
While she couldn鈥檛 make the same type of surprise visits to mental hospitals as she had as first lady of Georgia, Rosalynn did tour them, along with mental health centers, and met with patients and families.
During her time in the role, she advocated for caregivers and made an effort to reduce the stigma for those seeking help.
鈥淲e have to get the word out that mental illnesses can be diagnosed and treated, and almost everyone suffering from mental illness can live meaningful lives in their communities,鈥� Rosalynn said.
In 1979, Rosalynn became the first first lady to address a Senate panel since Eleanor Roosevelt.
鈥淭he mental health problems facing our country are the problems of all citizens,鈥� Rosalynn said. 鈥淭he people with these problems are ourselves, our families, our neighbors and our friends.鈥�
Just one year after Carter took office, the presidential commission on mental health delivered its final report to him.
The Mental Health Systems Act of 1980 was passed only a month before Carter lost a landslide election to Ronald Reagan. The sweeping changes that had been in the “Helping Troubled Georgians Solve Their Problems” report were never fully implemented.
For the next five decades, Rosalynn continued to champion programs through the Carter Center that reminded everyone that 鈥渕ental health is health.”
The next time you watch Robin Williams in Good Will Hunting or Frasier as he listens or even Tony鈥檚 session with Dr. Melfi on The Sopranos, think about Rosalynn Carter.
She started the public conversation on mental health in a way that had never been done before and in 2026, our country is better for it.
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