My Q&A with FLOTUS Pioneer: Mental Health 2013

Former First Lady Carter has spent over 40 years addressing mental health

Posted May 13, 2013

A rare opportunity: In February I met former United States President Jimmy Carter. He was kind enough to facilitate my being able to ask former First Lady Rosalynn Carter about her pioneer work with mental health awareness, her ongoing activities, and mental health issues in the US and abroad.

In consideration of May--National Mental Health Awareness Month--from the comfort of her office at The Carter Center in Atlanta, GA, here is a portion of the Q&A as former First Lady Rosalynn Carter, Mental Health Pioneer, Addresses Mental Health 2013 in the US and Abroad:

MTM: For more than 40 years, you have been a pioneer for increasing mental health awareness and working to reduce the stigma associated with mental illness. What initiated your interest in mental illness?

RSC: When my husband was running for governor of Georgia, one woman particularly stands out in my memory because I met her at 4:30 a.m. as she was leaving a long shift at the cotton mill in Atlanta. She looked exhausted, and her hair and clothes were covered with lint. She explained that she and her husband rotated shifts working and taking care of their daughter who suffered from a mental illness. It did not sound like either of them got much rest.

The image of that woman continues to haunt me even decades later. There are many families who face the same challenges trying to care for a seriously ill loved one in the absence of adequate mental health services.

MTM: Mental illness was such a taboo topic in the 1970s. Was it initially scary to speak out so boldly about this? Did you get any pushback from public or elected officials?

RSC: I didn't find it scary. When I announced my focus on mental health as first lady of Georgia in 1971, none but five mental health advocates in the state wanted to be involved with the issue. Today, many are devoted to the cause. Many politicians, celebrities, businessmen and women, and community leaders now are open about their struggles with mental illnesses, something almost unheard of when I began. Together, we are spreading the word that mental health affects all of us and deserves our support and attention.

MTM: In addition to your work in the United States, you have done mental health work in South Africa and Romania, and even as far away as New Zealand. Why these countries in particular?

RSC: In New Zealand we were familiar with the head of the mental health program at one of the universities. The others developed as we tried to reach different geographical regions in the world.

We also partner with nongovernmental organizations in countries that have a mature journalism corps but face serious challenges when it comes to raising awareness about mental illnesses. We just launched the Rosalynn Carter Fellowships for Mental Health Journalism with a Colombia partner, Universidad de la Sabana.

MTM: How do other nations handle the issue of mental illness? Are they ahead of us, lagging behind us or do they handle the issue the same as the United States, with the same challenges and stigmas? Are any of the other countries doing things to advance mental health awareness and care that we are not doing?

RSC: Around the world, even in wealthy nations like the United States, stigma and misperceptions about mental illnesses cause mental health issues to be among the least recognized and most neglected public health problems. Some nations are making groundbreaking progress.

A number of countries have improved mental health services particularly in increasing community based care and deemphasizing long-stay state hospitals.

The Australians have developed a national strategy of social inclusion that is designed to remove barriers to community life for people living with disabilities.

Regions of Italy have led in psychosocial rehabilitation for several decades, and Great Britain is addressing seriously the issue of stigma, which can inhibit people from seeking services.

Less developed and less wealthy nations also set important examples for positive change. Liberia views mental health as critical to the country’s recovery from its long, brutal civil war. We work to help Liberia improve mental health services despite limited resources and infrastructure. Two years into our work in partnership with the Ministry of Health and Social Welfare, 79 local mental health clinicians have been trained and credentialed, and are treating patients in all 15 counties across the nation.

MTM: As a physician/surgeon, I know that many people rely on family traditions, old wives’ tales, and for sure, there is a major reliance on faith and prayer, saying “I have God!” or “I'll just pray about it,” to the exclusion of seeking professional medical care. This is especially true concerning mental health and psychiatric disorders. What do you say about balancing psychological/psychiatric conditions with the promise of faith and the availability of prayer?

RSC: Prayer is always helpful, and God works in wondrous ways. One of the most important messages is that thanks to effective treatments and a better understanding of the brain, almost anyone with a mental illness can recover.

The more people talk about how they have overcome a mental illness, the more hope we have for others that they too can live in recovery. If we spread this message, and if we increase access to mental health care and end the shame and stigma associated with mental illnesses, more people will seek and find the help they need.

MTM: Lately we have heard a lot about mental health issues in the news, in Washington, D.C., and at medical centers: traumatic brain injury and athletes; PTSD and other disorders in our military, including high suicide rates, gun violence, and mass shootings. What are your thoughts about the current national discussions? What would you like to see Congress, the White House, the medical community, and health insurers do?

RSC: As a nation, we are aware of our obligation to provide the best care for our service members returning from these two long wars and to address specifically their complex mental health needs. We also need much more attention and research in overcoming the stigma that is still pervasive.

The Affordable Care Act requires mental health coverage as part of the basic package. We're going to be watching the implementation carefully to be sure that it provides the coverage we worked so hard to achieve.

It is also important to keep mental health stories in the news and in the national discussion because they are so neglected, even today. One in four Americans will experience a mental illness each year and continue to live meaningful lives within their communities.

It is not surprising that many people associate mental illness with violence because they have seen movies or watched news stories that make this connection. But the truth is that someone with a mental illness is more likely to be a victim of violence than commit violent acts. Sadly, such myths continue to persist and can result in someone’s being denied a job or housing because of their illness.

MTM: Anything else you'd like to add, or you want people to know?

RSC: Just a note: We don’t use the expression “the mentally ill.” People don’t like to be identified by their illnesses. The correct terminology to use is “people with mental illness” or “people living with mental illnesses.”

On the personal side, Mrs. Carter cooks regularly; is very active in her church; and, this July, she and President Carter, age 88, will have been married for 67 years. According to Pres. Carter, they never go to bed angry and "have the same love and affection [as] when first married."

I'd like to thank Mrs. Carter and her staff for making this interview possible. I appreciate her taking the time to provide me her thoughts on mental health issues. I additionally thank former President Jimmy Carter for being so generous to, without hesitation, facilitate this unique opportunityHe and Mrs. Carter are going strong and are untiring, constant champions for human rights for all.

Copyright © 2013 Dr. Melody T. McCloud. All rights reserved. Feel free to share this on your social network pages, with author credit and link to this page: Twitter: @DrMelodyMcCloud.

See the latest E-Book: First Do No Harm: How to Heal Your Relationships Using the Wisdom of Professional Caregivers, and, in print and e-book: Living Well...: The Woman's Guide to Health, Sex and Happiness.

Photos courtesy of the Carter Center: 

Mrs. Carter's work with mental health: 

About the Author

Melody T. McCloud, M.D., is an obstetrician-gynecologist and the author of First Do No Harm: How to Heal Your Relationships Using the Wisdom of Professional Caregivers.

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