Page 1 of 27

Jimmy Carter Presidential Library and Museum

Rosalynn and Mental Health | Gallery Talk Extended Outline
Sarah Grace Rogers | 5 December 2023

Rosalynn’s Mental Health Themes

Photos: NAID 181493 & 177696

➢ Hope and Recovery

o “...change can take place…” (Remarks as Honorary Chair of the Last Acts 1997)
➢ Respect (“Everything is respect.”)
o “...now we realize they are human beings with hopes and dreams and thoughts just like everybody else.”
(Putnam Interview)
➢ Stigma (the greatest barrier)
o “But I want everybody to know what I know, so we can get over the stigma and go on to do what is good and
right for people with mental illnesses.” (Putnam Interview)
➢ Prevention
o Caregiving: courage, compassion, and empathy
▪ “We preach human rights and civil rights and yet
we let people suffer because of an illness they
didn’t ask for and for which there is sound
treatment.” (Paul Wellstone Mental Health and
Education Equity Act 2007)
o Community Support
▪ “The mental health problems facing our country
are the problems of all citizens. The people with
these problems are ourselves, our families, our
neighbors and our friends.” (Putnam Interview)
o Children as our Legacy
▪ “We don’t take care of children in our country as
we should and then when they get in trouble, we
punish them severely.” (Pro Bono Luncheon
Address 2002)
o Unserved and underserved
▪ “...at the heart of all these problems are serious
deficiencies in our public defender systems.”
(Pro Bono Luncheon Address 2002) Object: JC 80.1270
➢ Access
o “...they got what was left over after everything else was funded, everything else in health, which was nothing
almost. It was tragic.” (Putnam Interview)
➢ Learning
o “You don’t say ‘the mentally ill’ anymore. You said, ‘The person with mental illness.’ So every time I look at
that, I think how wrong we were and how little I knew back then about mental health.” (Putnam Interview)
 Page 2 of 27

About Rosalynn Carter

➢ Rosalynn’s Life
o Born August 18, 1927 in Plains; Passed away November 19, 2023
o Married Jimmy Carter on July 7, 1946
o Graduated from Georgia Southwestern College, now Georgia Southwestern State University, in 1946
o Children (4): Amy Carter, Jack Carter, James Earl Carter III, Donnel Jeffrey Carter

Photo: NAID 593564; Objects, Left to Right: JC 77.233, JC 80.61.2

➢ Overview of Rosalynn’s Work

o Started during Jimmy’s campaign for governor in January 1971
▪ Served on Governor’s Commission to improve services to the mentally and emotionally
handicapped
o “Steel magnolia” nickname by the press because of her “sweetness and drive”
o Honorary chair of the President’s Commission on Mental Health and testified before the Senate
▪ Led to passage of Mental Health Systems Act 1979
o Friends with Margaret Mead (cultural anthropologist and women’s rights advocate)
▪ Quotes her as “She said if we’d become interested and take the most vulnerable among us…then
we humanize our culture.”
o First First Lady to establish an office in the east wing of the White House and have a projects staff
o Advocate for the hospice movement, against the death penalty, advocated for passing legislation requiring
schoolchildren to have vaccines
o Advocate for women’s rights and the Equal Rights Amendment (ERA)
o Published Helping Someone with Mental Illness: A Compassionate Guide for Family, Friends, and
Caregivers. with Golant - 1998
o Published Within Our Reach: Ending the Mental Health Crisis (with Susan Golant and Kathryn Cade) in
2010

Objects, Left to Right: JC 78.960, JC 84.7.303, JC 84.7.525, JC 2002.57.2.1

 Page 3 of 27

Early Statement on Mental Health: 1976

➢ Carter, Rosalynn. Statement. Kern View Community Mental Health Center. Bakersfield, California. October 15, 1976.
o “If we are not well, it is hard to care very much about good roads, the ozone layer, national parks…being sick
doesn’t leave much room for other considerations.”
o “Health has a decided influence on almost every other domestic issue from unemployment and human
productivity to the very spirit of our society. It has been my experience, working with the mental health
program in Georgia, that health is one of the matters that public officials can do something about.”
o JFK 1963 quote on “Special Message on Mental Illness and Mental Retardation”
▪ Special Message on mental illness and mental retardation, 5 February 1963 | JFK Library
o Specifies that Rosalynn would like to see
▪ The immediate establishment of a presidential commission on mental health
▪ Expanded research into the basic causes of mental disabilities
▪ Applying what we know to those who need help
▪ A national health insurance program which includes coverage for mental illness
▪ Movement toward a more caring society

Carter, Rosalynn. Statement. Kern View Community Mental Health Center. Bakersfield, California. October 15,
1976.
(First Lady’s Social Office: Speeches – Mental Health)
 Page 4 of 27

Origin Story – Mental Health

➢ Mrs. Carter began caregiving at a young age when her father was diagnosed with cancer.
➢ Lillian Carter
o Lillian was a registered nurse in South Georgia (Plains) and helped care for Rosalynn’s father (Wilburn
Edgar Smith) before he died of leukemia at 44 (1940)
o “I was deeply influenced by how chronic illness affected and shaped my family and by the heroic and selfless
efforts of health care providers, including Jimmy's mother, Lillian Carter. She was among the most dedicated
and skilled nurses imaginable and I was in awe of her as I observed the expert care she provided. The type of
assistance that Lillian provided as a nurse is increasingly being provided today by family members.”
▪ Carter, Rosalynn. “Addressing the Caregiving Crisis.” Preventing Chronic Disease 5, no. 1
(December 2007): A02.
o Rosalynn was also inspired by her.

Objects on Lillian Carter: 78.1238.1-.2

Photos: NAID Photo 6340631, 173724

➢ “I got more and more concerned about what was happening after seeing the institutions.” (Putnam Interview)

Photo”: NAID 179020

 Page 5 of 27

Mental Health Speech Files: Origin Story.

(First Lady’s Project Office: Speech
Material: Mental Health [3])

Carter, Rosalynn. Remarks. Milwaukee Mental Health Complex. March 27, 1980.
(Frist Lady’s Social Office: Speeches, Mental Health)
 Page 6 of 27

Timeline of Events

➢ Carter Presidency: January 20, 1977 – January 20, 1981

➢ Adapted from NARA Catalog Photos and The Carter Center. “Honoring 50 Plus Years of Mental Health Leadership:
Timeline.”

Date Event

May 1971 Rosalynn Carter was a member of the Governor’s Commission to Improve Services for Mentally and
Emotionally Handicapped Georgians (created by Gov. Jimmy Carter)

October 29, Final report ("Helping Troubled Georgians Solve Their Problems") for Governor’s Commission to Improve
1971 Services for Mentally and Emotionally Handicapped Georgians

February 1977 Rosalynn was named honorary chair of the President's Commission on Mental Health

March 29, World Federation for Mental Health Speech

1977

April 1, 1977 Mental Health Association April 1, 1977

30 second television spot
“Let’s help each other. This is Rosalynn Carter. Won't you join me in creating a new national philosophy about
mental illness? I’m a member of the Mental Health Association. Join your local Mental Health Association.”

April 20, 1977 President’s Commission on Mental Health – Chicago

Photos: NAID 174466, 5730827

June 22, 1977 Rosalynn Carter at a meeting for the President's Commission on Mental Health in San Francisco, CA

Photo: NAID 175291

July 11, 1977 Rosalynn’s Meeting on Mental Health

August 3, 1977 Rosalynn’s Group Meeting on Mental Health

August 27, Rosalynn’s Remarks for World Federation for Mental Health in Vancouver, British Columbia, Canada
1977
 Page 7 of 27

September 15, Rosalynn’s Remarks at the Washington Press Club

1977

October 27, Mental Health Luncheon

1977

January 16, President’s Commission on Mental Health

1978

January 17, Rosalynn chairs mental health hearings

1978

Photo: NAID 177628

January 20, Mental Health Association Meeting in Atlanta

1978 Carter, Rosalynn. Remarks at “Mental Health Association Meeting.”
Atlanta. January 20, 1978
(Social Office: Speeches – Mental Health)

April 27, 1978 Presentation of the final report of President Commission on Mental Health

Photos: NAID 179116, 179117, 179112

April 28, 1978 Reception for Mental Health Commissioners

February 7, Rosalynn testified for the President’s Committee on Mental Health

1979
 Page 8 of 27

Photos: NAID 183382, 183383, 183385, 183387

May 1979 Rosalynn testified before Congress for the Mental Health Systems Act

Rosalynn became the first sitting U.S. First Lady to address the WHO’s World Health Assembly about the
President’s Commission on Mental Health topics - she continued to fight stigma, work to improve health care,
and argue mental health as a basic human right

May 7, 1979 Rosalynn’s Remarks to the Medical Society of the World Health Organization in Geneva

May 16, 1979 Rosalynn’s Remarks at the American Psychiatric Association in Chicago, Illinois

June 7, 1979 Rosalynn hosted a reunion for the members of the President’s Commission on Mental Health - involved
presentation by several organizations - Rosalynn urged them not to lose momentum from the last few years -
encouraged them to mobilize a nationwide campaign to ensure the new Mental Health Systems Act passes

June 31, 1979 Rosalynn encouraged a group of women’s and minority group representatives to speak up in support of the
Mental Health Systems Act.
Rosalynn argues the act is the best way for the federal government, working with local governments, to realize
the goal of making appropriate mental health services accessible to all who need them.
“I am convinced that we can make 1979 the year in which a new national commitment is made to the proper care
and treatment of the mentally ill in this country.”

November Rosalynn urged Hollywood leaders to tell stories that diminish mental illness stigmas (LA)
1979

March 27, Rosalynn’s Remarks at the Milwaukee Mental Health Complex

1980

October 7, Jimmy Carter and Rosalynn Carter - Signing ceremony for the Mental Health Systems Act (S. 1177) at the
1980 Woodburn Mental Health Center in Annandale, VA

1982 Rosalynn received the American Psychological Association’s Presidential Citation from President William
Bevan, Ph.D.

November First Rosalynn Carter Symposium on Mental Health Policy ("Stigma and the Mentally Ill") held at Emory
1985 University School of Medicine, with the Department of Psychiatry

June 1990 Rosalynn met with Hollywood producers on improving mental illness portrayal in media

September Rosalynn established the Carter Center Mental Health Program

1991

March 1994 Rosalyn and Betty Ford testify before Congress, supporting inclusion of mental healthcare and substance abuse
benefits in national health care reform

October 2, First Rosalynn Carter Georgia Mental Health Forum, "Within Community," held at the Carter Center
1995

September First Committee of International Women Leaders for Mental Health meeting held - 8 first ladies and 9 personal
1996 representatives signed a joint statement committing to advance mental health

1997 Rosalynn served as Honorary Chair of the Last Acts

 Page 9 of 27

April 1997 The Rosalynn Carter Fellowships for Mental Health Journalism established at the Carter Center

1998 "Helping Someone with Mental Illness: A Compassionate Guide for Family, Friends, and Caregivers” book by
Rosalynn published

August 1999 Mr. and Mrs. Carter awarded Presidential Medal of Freedom

November The Rosalynn Carter Symposium on Mental Health Policy previewed the first Surgeon General’s Report on
1999 Mental Health

December The first Surgeon General’s Report on Mental Health released

1999

2000 "Helping Someone with Mental Illness" translated into several Eastern European languages to advance mental
health services ( Lithuania, Ukraine, and Georgia)

November Rosalynn awarded Surgeon General’s Medallion

2000

2002 Pro Bono Luncheon Address by Rosalynn Carter

February 2003 Rosalynn argues that significant change has occurred with mental health illness recovery since the Carter’s
Presidential Commission- told at the New Freedom Commission on Mental Health convened by President Bush

May 2004 Address to the World Health Assembly: President Carter argues too few people lack treatment for mental health

2007 Paul Wellstone Mental Health and Education Equity Act

July 2007 Rosalynn testified before the House Committee on Education and Labor Subcommittee on Health, Employment,
Labor, and Pensions - argued for insurance coverage of mental health and substance use disorders

April 2010 Rosalynn Carter wrote "Within Our Reach: Ending the Mental Health Crisis."

August 2010 Liberia Mental Health Initiative launched to improve access to mental health services and decrease stigma

October 2010 Carter Center named as amicus curiae to a settlement agreement addressing the public mental health system
(signed by the state of Georgia and U.S. Department of Justice)

May 2017 Rosalynn awarded second American Psychological Association Presidential Citation by American Psychological
Association President Antonio Puente

September Carter Center’s Mental Health Program launched a School-based Behavioral Health Initiative in Georgia in
2018 efforts to make mental health services more common - directed by Rosalynn

January 2020 Carter Center’s Mental Health Program began leading the Georgia Parity Collaborative to achieve parity via
policy change

May 2021 Rosalynn received the WHO Director-General’s Award for Global Health during the opening ceremonies of the
74th World Health assembly
 Page 10 of 27

Legacy

Brown, Joe. “Rosalynn Vows to Play “Testimony Makes Rosalynn Wince.”

Role on Health Panel.” Constitution Atlanta Constitution. May 26, 1977.
Washington Bureau. n.d. (First Lady’s Press Office: Mental Health
Commission [2])

➢ White House Executive Order 11973. February 17, 1977.

(President’s Commission)
o Section 1: Establishes the Commission - will have 20
people, a chairperson and vice chairperson
o Section 2: Research, role of education, cost of programs-
Submit a report to the President addressing national
needs and priority
o Section 3: Preliminary report by 9/1/77 and final by
4/1/78
o Section 4: Authorized Chairperson (Chairperson holds
meetings and hearings as they deem necessary)
o Section 5: Commission is authorized to request
information needed to carry out the order
o Section 6: General Services Administration as
administrative service
Object: JC 81.4.3
o Section 7: Expenses paid from “Unanticipated Needs” of
Executive Office Appropriations Act 1977; authority to
seek and receive other than government funds
o Section 8: Functions of President under Federal Advisory Committee Act performed by Secretary of Health,
Education, and Welfare
o Section 9: The Commission shall terminate 60 days after delivering final report to president
 Page 11 of 27

White House Executive Order 11973. February 17, 1977.

(President’s Commission on Mental Health Press: Releases Files: Box 25)

o Commission Personnel
▪ Thomas E. Bryant, M.D., J.D. = Chairman
▪ Rosalynn Carter = Honorary Chairperson
▪ Ruth B. Love (Superintendent of Oakland Schools) - Vice Chairperson
▪ 20 people - 8 women and 12 men, 1 person from AA and one former patient serving on the National
Patients Rights Committee of the Mental Health Association
▪ Task Panels Announced June 16, 1977
• Made of over 200 volunteers
• Mental Health - Problems, Scope and Boundaries
o Service Delivery Task Area
• Organization and Structure of Mental Health Services
• Assessment of Community Mental Health Centers Program
• Planning and Review Mechanisms
• Access and Barriers to Care
• Deinstitutionalization, Rehabilitation, Long-Term Care
• Cost and Financing
• Manpower and Personnel
• Research
• Prevention
• Legal and Ethical Issues
• Public Attention and Media Promotion of Mental Health
• Rural Mental Health
o Sub-Panel: Mental Health Needs of Migrants and Seasonal Farmworkers
• Mental Health and the Family
o Sub-Panel: The Elderly
o Sub-Panel: Children’s Mental Health
• Special Populations - Minorities, Women, Physically Handicapped
• Community Support Systems
• Alcohol and Drug Abuse
o Liaison Task Panel: Alcohol-Related Problems
• Mental Retardation
• The Arts and Mental Health
• November 15, 1977
o Dr. Thomas Bryant announced two new task panels: Task Panel on Cost and
Financing & Task Panel on Deinstitutionalization, Rehabilitation and Long-Term
Care
• December 23, 1977
o The Drug Panel was formalized
o Funding
▪ President provided $100,000 of his funds as startup money
 Page 12 of 27

▪ Additional money from the Department of Health, Education, and Welfare (not new appropriations but
reprogramming of available funds)
▪ Also planned to raise money in the private sector
▪ Preliminary Report September 1977 - recommended a sizable increase in research funding - $25 million
o Preliminary Report September 1977
▪ Scope of the nation’s mental health problems
▪ Scope of the nation’s response to mental health problems
▪ Focus of future work and initial recommendations
• Providing needed mental health services - sets goals for improvement and coordination of
services
• Financing needed mental health services - addresses the issue of national health insurance
coverage, examines other forms of financing and recommends further study of several
alternatives
• Expanding the base of knowledge about mental illness and mental health - addresses the need
to increase research funding
• Identifying strategies that may help prevent mental disorder and disability - addresses the need
for a preventative care strategy and outlines existing approaches
▪ Public Statements
• “The discrimination that persists against mental illness is a national disgrace.” (First Lady
Outlines Mental Health Commission Findings September 15, 1977)
• “Mental health is much more than just the absence of mental illness. It is the quality of life we
lead.” “Our problem is that we are still locked to the past by the stigma that is attached to
mental illness. Negative public attitudes hold back our progress.” (Washington Press Club
September 15, 1977 - Mrs. Carter’s Remarks)
o Research from Commission
▪ Mental Health Scope. Preliminary Report Also Covers Alcohol and Drugs “MH Commission Wants $40
Million More For Research.” Volume XI Number 16. September 19, 1977.
• For Fiscal 1979 - for the alcohol, drug abuse and mental health institutes
• President Carter was “responsive” to research recommendations
• Research recommended increases around $23.4 million for the National Institute of Mental
Health, $11.9 million for the National Institute on Drug Abuse, and $4.8 million for the
National Institute on Alcohol Abuse and Alcoholism
• Little funding “places in jeopardy the development of new knowledge and the promise of
more effective means of prevention and services”
• Mental health research
o New understandings of the role of neurotransmitters and chemical imbalances - can
help treat schizophrenia and depression
o More studies on the psychological, social, and biological factors affecting mental
health in certain populations (especially children and elderly)
• Drug abuse research
o Understanding the receptors in the brain can help understand the addictive process
and allow better treatments to develop
o Understanding how social and situational stress affect drug use in different age
groups will help to plan more effective treatments
• Alcohol research
o Understand biochemical and psychological factors related to alcohol dependence
o Needed follow-up studies on recent findings about how a predisposition to alcohol
might be inherited and how alcohol consumption by pregnant women increases the
child’s risk for mental and physical abnormalities
• New research shows that an increase from 10 to 15% of the American population needs some
kind of mental health care (between 20 and 32 million people) - ranging from counseling to
long term care
o At any given time 25% of people are experiencing emotional stress that can result in
depression or anxiety
o Service and continuity of care is lacking with little attention given to basic needs
(food, clothing) in communities
o “America’s mental health problem is not limited to those individuals with disabling
mental illness and identified psychiatric disorders. It also includes those people who
suffer the effects of a variety of societal ills which directly affect their everyday
lives. Vast numbers of Americans experience the alienation and fear, the depression
 Page 13 of 27

and anger associated with unrelenting poverty and institutionalized discrimination

that occurs on the basis of race, sex, class, age, and mental and physical handicaps.
o “In addition, the Nation’s mental health problems include conditions that involve
significant psychological and emotional distress but do not fit neatly into customary
categories of mental disorder. These include some physical handicaps, many
learning disabilities, certain types of organic brain disease, the misuse of alcohol and
other drugs, and the social isolation experienced by chronically disabled persons.”
• Recommendations to the president
o Funding priority to training professionals, state and county staff, and primary care
practitioners
▪ Aldo priority to train minority, bicultural, and bilingual mental health
workers and researchers
o Designate a health manpower shortage state and county mental hospitals that are
inadequately staffed by physicians
o Change federal law so the Health Systems Agencies and State Health Planning and
Development Agencies plans align with the State Mental Health Plans - and have at
least 2 mental health representatives sit on the National Council on Health Planning
and Development
o Explore the possibility of requiring a specified level of mental health benefits be
included in private health insurance policies - it is possible that expanded mental
health benefits may allow more patients to be treated outside state hospitals
o There are also intentions to begin a study on current costs of providing specific
mental health services in various settings and facilities

Mental Health Scope. Preliminary Report Also Covers Alcohol and Drugs “MH Commission Wants $40
Million More For Research.” Volume XI Number 16. September 19, 1977.
(President’s Commission on Mental Health Press Releases Files: Box 25)

▪ Carter, Rosalynn, and Thomas E. Bryant. “Mental Illness in America: Community Supports a
Responsive Service System Insurance for the Future New Directions for Personnel Protecting Basic
Rights Expanding the Base of Knowledge a Strategy for Prevention Improving Public Understanding.”
• 20 pages
o Can pull from President’s Commission on Mental Health Press Releases Files
(National Archives Identifier 136748) Box 25
▪ Introduction
• Estimated cost of mental illness was $17 billion and counting - 12% of all
health care expenditures
• Dramatic increased in child and you adult suicide, drinking, emotional
problems, self-destructive behavior, and teen pregnancy
▪ Schizophrenia
• Repeated disability and lifetime stress
▪ Depression and Affective Disorders
• Higher rates in women, non-white, separated and divorced people, poor, and
less educated
• Psychological intervention is need in addition to drug use
• Continuing care is necessary
▪ Emotional Distress and Other Mental Disorders
• Physician care is often inadequate, and 70% of suicide victims had sought care
shortly before death
▪ Drug Use and Alcoholism
▪ Mental Disorders in Childhood
▪ Mental Problems of the Elderly
 Page 14 of 27

• So much is unknown about the aging brain

o Treatment is ineffective
• Little attention given to affiliative and supportive structures
• “Integration of health and social services and new models of service are
desperately needed.”
▪ Treatment of the Mentally Ill
• Availability of new drugs spurred development of new therapies
• Shift from institutional to community care
▪ Community Supports
• “The personal and social supports found in our neighborhoods and
communities are one of the great resources in American society for maintaining
mental health and preventing serious mental and emotional disabilities.”
• Schools, workplace, justice system, and general health care providers =
important as community supports, as well as drop-in centers, runaway houses,
free clinics and hotlines
• The Commission recommends improvements to the link between community
support and formal mental health services
o Also recommends research to increase knowledge of community
support systems and networks
▪ A Responsive Service System
• Introduction
o “Appropriate services should be available to all Americans in need of
mental health care.”
o Though services are already available, we need the creation of new
services
o The Commission Report to the President states that the long-range
goal for mental health services should be an integrated system of care
with a variety of programs and facilities staffed by trained personnel
▪ It must be “accessible to all”
▪ Responsive to populations with special needs
▪ Adaptive to changing circumstances
▪ Coordinated services and assured continued care
▪ “...we can no longer afford a fragmented system that leaves
many people unserved…”
▪ Need money and planning and support
▪ “...we must…establish a national priority to meet the
needs…”
▪ The Commission has several recommendations—
• New Federal grant program for community mental health services
• Strengthening of Existing Programs and Service
• Services Responsive to Populations with Special Needs
o Notably minorities
• A National Plan
o “An adequate, humane system of mental health care cannot exist until
the special needs of Americans with long-term and severe mental
disabilities are met, and until Federal, Sate, and local governments
share the responsibility for meeting this goal.”
o Federal incentives are recommended to help states accomplish goals -
$50 million a year over the period of five years
• Developing Resources in the Community
o There is a notable lack of continued care after discharge from a
hospital
o Long-Term 24-Hour Care
▪ Creation of Intermediate Care Facilities - Mental Health
(ICF-MH) within Medicaid programs
o Employment and Employability
▪ Development of tax credits to employers as an incentive to
hire as well as a broader range of vocational rehabilitation
and sheltered employment opportunities
• Planning for Mental Health Services
 Page 15 of 27

o Also requires accreditation and licensing procedures, peer review,

and program evaluation procedures
▪ Insurance for the Future
• Introduction
o Many who need mental health care can’t afford it
o The Commission calls for strategies to finance mental health services
- payment based on need for care, not the diagnosis, and the
appropriateness of care, not the discipline of the provider
o A national health insurance program = most effective way to provide
financing for all Americans, regardless of income
• Principles for Financing Care
o Array of coverage
o Reimbursement
o Patient-borne cost-sharing should be no greater than for a physical
illness.
o Consumer choice of provider and procedures - ensure they have all
necessary information to make an informed decision
• Medicare
o Needs to be updated
• Medicaid
o Correct deficiencies by improving programs
• Private Health Insurance
o Strengthen requirements of insurance plans, introduce legislation that
requires employers to include plans, increase research on costs
• Basic Support for People with Chronic Disabilities
o Need housing, nutrition, and services - people need income support
for a range of needs
o Increase qualified personnel - with the appropriate skills - and put
them where they are needed
o Need more research on who is needed
▪ Mental Health Personnel
• Still inadequate staffing - minorities are underrepresented, few are
knowledgeable about children, adolescents, and the elderly
▪ Protecting Basic Rights
• Advocacy
o Need advocacy programs
• Discrimination
o Recommend all Federal agencies enforce laws and regulations
prohibiting discrimination and equalize opportunities
o Vulnerable groups - children, elderly, minorities, involuntarily
detained, chronically mentally disabled, and prisoners
• Commitment and Guardianship
o Protect the rights of individuals
• The Rights of Those Receiving Care
o Recommend each state develop a Bill of Rights for the mentally
disabled:
▪ A right to treatment and habilitation and to protection from
harm for all involuntarily confined mentally and
developmentally disabled patients
▪ A right to treatment in the least restrictive setting
▪ A right to refuse treatment with attention to the
circumstances and procedures under which the right may be
qualified
▪ A right to due process when community placement is
considered
• Privacy
• The Criminal Justice System
o Needed service within jails and prisons
▪ Expanding the Base of Knowledge
• There has been development of drugs and a reduction in hospitalizations but
mental health research eroded while other research funding has grown.
 Page 16 of 27

• Research priority needs to be restored

• The Commission proposes increases for fiscal year 1980
o National Institute of Mental Health increase $30 = $165 million
o National Institute on Alcohol Abuse and Alcoholism increase $9 =
$30 million
o National Institute on Drug Abuse increase $9 = $55 million
o NIMH training budget increase $6.3 million = total of $25 million
• Key areas of research
o Reliable data on the incidence of mental health problems and the
utilization of services
o Studies to produce greater understanding of the needs and problems
of the underserved
o Research on the ways mental health services are delivered
o Research on the major mental illnesses, mental retardation, and basic
psychological, sociological, biological, and developmental processor
▪ Prevention
• Introduction
o The focus cannot be placed solely on treatment but should also be
looking at prevention - promoting strengths, resources, and
competencies of people, families, and communities
o Programs should be developed for the entire life span
o Children should be the priority
• Prenatal and Perinatal Care
o Increased care
• Child Health Assessment and Development Review
o Develop programs for screening and care
• Developmental Day Care Programs
o Increases in Project Headstart and developmental day care programs -
child care that focuses on emotional and cognitive development to
promote positive mental health
• Foster Care and Out-of Home Care for Children
o Need for evaluation
• Center for Prevention
o Recommended to be established in the NIMH to prioritize prevention
▪ Improving Public Understanding
• “But many who need help do not seek it, and many who have received help do
not admit it.” - Commission
• “...so that people eventually are as willing to use mental health services as they
are to use the emergency room in the local hospital.” - Commission
• Shift from non-community to community-based care
o But has brought new problems of acceptance after hospital discharge
• Need to increase public acceptance
o “This Commission does not know how to end discrimination…We do
know, however, that the quality of information available to the
American people may help curb the fears and anxieties which lead to
thoughtless, even cruel, responses to those who need help and
understanding…”
o Media can play an important role
▪ Pattern of portraying mentally ill as violent on television
when they are more likely to be withdrawn and fearful
▪ Need more accurate portrayals
o Commission’s recommendations
▪ Research to obtain better information about how people
actually view the mentally ill and illness and develop
public education programs
▪ Establish Collaborative Media Resource Center by private
mental health organizations
▪ Establishment of a DHEW Task Force on Stigma and
Public Understanding, composed of members from the
public and private sectors, including former patients
 Page 17 of 27

▪ “Our task now is to begin to understand that the causes of mental health problems are as
varied as their manifestations. Some are physical. Some are emotional. Some are rooted
in social and environmental conditions. Most are complex combinations of these and
other factors, some of which are unknown.”
▪ “In this way we may begin to understand that none of us is immune from mental illness
or emotional problems, and that the fear, the anxiety, and even the anger we feel about
people who suffer these problems may merely reflect some of our own deepest fears and
anxieties.”
o Press Release. April 24, 1978.
▪ RC presented to the President a Report of the Commission that calls for changes in how mental
health services are provided and funded
• Based on a review of the Nation’s mental health needs and resources
• Included public hearings over which RC resided across the country - citizens from all
walks of life
▪ Commission’s goal to make quality care affordable and accessible to all Americans as well as…
• A new federal grant program for community mental health services to create services
where none exist, supplement existing services that are inadequate, and increase ways
that communities can develop a comprehensive network of services
• A new national priority to end neglect of the chronically mentally ill by providing federal
incentives - $50 million a year for five years – to phase down further large state mental
hospitals, upgrade care in remaining smaller hospitals and develop the needed
community-based services
• Inclusion of appropriate coverage for mental health care in any plan for national health
insurance and improved mental health coverage in Medicare and Medicaid
• A concerted national effort to prevent mental disabilities, chiefly through increased
availability of maternal and infant care and early childhood development assistance
• Increased federal investments in research on the causes and treatment of mental illness,
mental retardation, drug abuse and alcoholism
▪ Commission recommended give priority to unserved and underserved: children, adolescents,
elderly, racial and ethnic minorities, and people with chronic mental illness
• Recommended a funding level of $75 million in the first year and $100 million for each
of the following two years - this would be in addition to funds required to support the
Nation’s existing Community Mental Health Centers
▪ Commission also recommended
• Increased links between existing community supports (families, schools, churches, self-
help groups) and formal mental health services
• New directions for the federal support of training, to promote better distribution of mental
health personnel throughout the country, and more personnel trained to meet the special
needs of minorities, children, adolescents and the elderly
• Stronger protection for the basic rights of the mentally disabled, and establishment of
advocacy systems for the mentally ill
• Adoption by each state of a “Bill of Rights: for the mentally disabled
• Specific steps to improve public understanding and acceptance of the mentally ill and
mental illness
▪ 20 Commission members representing fields of interest in addition to mental health, 450 additional
individuals serving on 32 task panels (study groups prepared reports on a variety of topics for the
Commission)
 Page 18 of 27

Press Release. April 24, 1978.

(President’s Commission on Mental Health Press Releases Files: Box 25)

“Remarks of the President upon Receiving Final Report of the President’s

Commission on Mental Health.” April 27, 1978.
(President’s Commission on Mental Health Press Releases Files: Box 25)

o Published Commission Report

• The President’s Commission on Mental Health
o The Commission was established by Executive Order No. 11973, signed by President Carter
February 17, 1977, to review the mental health needs of the Nation and to make recommendations
to the President as to how the Nation might best meet these needs.
o The Commission held public hearings across the country, and received the assistance of hundreds
of individuals who comprised special fact-finding task panels.
o These task panels, made up of the Nation’s foremost mental health authorities and other volunteers
interested in mental health, produced and submitted to the Commission the reports which are
contained in the Appendices to the Commission’s Report.
o Volume I = the Commission’s Report and Recommendations to the President
o Volumes II, III, and IV are Appendices to the Report - contain reports of task panels comprised of
approximately 450 individuals throughout the country who offered expertise, perceptions ,and
assessments of the Nation’s mental health needs and resources
o The President’s Commission on Mental Health
▪ Rosalynn Carter, Honorary Chairperson
▪ Thomas E. Bryant, Chairperson
 Page 19 of 27

▪ Ruth B. Love, Vice-Chairperson

▪ Priscilla Allen
▪ Allan Beigel
▪ Jose A. Cabranes
▪ John J. Conger
▪ Thomas Conlan
▪ Virginia Dayton
▪ LaDonna Harris
▪ Beverly Long
▪ Florence Mahoney
▪ Martha L. Mitchell
▪ Mildred Mitchell-Bateman
▪ Harold Richman
▪ Julius B. Richmond, Ex-Officio
▪ Reymundo Rodriguez
▪ George Tarjan
▪ Franklin E. Vilas, Jr.
▪ Glenn E. Watts
▪ Charles V. Willie
• Acknowledgements
o Acknowledgement to the people who served on task panels to collect data and information
o Acknowledgement who many people who gave testimony across the country
o Congressional committees and federal and state departments
o Public and private organizations
• Contents
o Volume I
▪ Recommendations
• Community supports
• A responsive service system
• Insurance for the future
• New directions for personnel
• Protecting basic rights
• Expanding the base of knowledge
• A strategy for prevention
• Improving public understanding
▪ Annotations
▪ Staff
▪ Task panels and other contributors
▪ Letter of Transmittal by Bryant
o Volume II
▪ Task panel reports
• Mental health - nature and scope of the problems
• Community support systems
• Mental health service delivery
• Alternative services - a special study
• Mental health personnel
• Cost and financing
o Volume III
▪ Mental health of American families
• General issues and adult years
• Infants, children, adolescents
▪ Learning and unused learning potential
▪ Special populations: mental health of minorities, women, physically handicapped
• Asian-Pacific Americans
• Black Americans
• Americans of Euro-Ethnic Origin
• Hispanic Americans
• American Indians and Alaska Natives
• Physically Handicapped American
• Women
▪ Mental health of the elderly
 Page 20 of 27

▪ Rural mental health

▪ Migrant and seasonal farmworkers
▪ Mental health problems of Vietnam Era veterans - a study
o Volume IV
▪ Task panel reports
• Legal and ethical issues
• Research
• Prevention
• Public attitudes and use of media for promotion of mental health
• Arts in therapy and environment
• State mental health issues
• Liaison task panels
o Mental retardation
o Alcohol-related problems
o Psychoactive drug use-misuse

Report to the US President from The President’s Commission on Mental Health, Volumes I-IV. 1978.
(President’s Commission on Mental Health Press Releases Files: Box 25-26)

➢ Mental Health Systems Act

o Signed into law on October 7, 1980 at the Woodburn Center for Community Mental Health in
Annandale, Virginia
o Continuation of the Community Mental Health Act of 1963 (JFK)
o Emphasized “care and treatment of chronic mental illness to ensure that mental health support and
aftercare services are available at the community level.”
o Strengthened services to the poor in rural and urban center areas
o Allowed for federal grant money for the commission’s target demographic: children, adolescents, and
the elderly
o Still included the rape prevention and control section added in the House in 1979
o The Patients’ Bill of Rights, Section 501: laid out what a person undergoing treatment could expect of
their medical team, why it was appropriate, and what rights they had (accessibility, confidentiality,
and the right to assert grievances)
 Page 21 of 27

“Carter Submits Mental Health Care
Bill.” Los Angeles Times. May 16,
1979.
(First Lady’s Press Office: Mental
Health Commission [1]: Articles)
White, Ronald D. “Carter Signs Mental
Health Bill In 2nd Recent N. Virginia
Visit.” Washington Post. October 8,
1980.
(First Lady’s Press Office: Mental Health
Systems Act Signing 10/7/80: Articles)

Carter, Rosalynn. Signing Ceremony. “Mental Health Systems Act of 1980.” October 7, 1980.
(First Lady’s Social Office: Speeches – Mental Health)

➢ World Federation for Mental Health

o “Meeting of the President’s Commission on Mental Health.” World Federation for Mental Health Speech.
3/29/77.
(First Lady’s Press Office: World Federation for Mental Health Speech)
▪ President Carter
▪ Notes that there was more competitions to get on the Commission that to serve on the Supreme
Court
▪ A lot has already been done - go at it from that perspective because “we could waste a lot of time
just reinventing the wheel.”
▪ Rosalynn was prevented by law from being an official Chairman
▪ “The other point is that when you make a report to me, I intend to act on it… It will be something
that is alive and something to be used as a guide for all of us. Rosalynn just wrote a note, ‘not
disbanded in September.’”
o Rosalynn
▪ Introductions from all the attendees
▪ “I do think we can do some meaningful work between now and the first of September.”
▪ “We want to encourage cooperation…”
 Page 22 of 27

o Tom Bryant
▪ Commission will be based at the White House - staff members external to the agencies and the
departments
▪ Logistics, stressing short on time
o Julius Richmond - Focus on higher risk groups and prevention
o Ruth Love - Education should foster good mental health
o Multiple perspectives from members
➢ Carter, Rosalynn. “Remarks for World Federation for Mental Health.” Vancouver, British Columbia, Canada. August
25, 1977.
o “Dr. Mead tells me she believes that if we select for first consideration the most vulnerable among us - the
emotionally disturbed child, the institutionalized psychotic, the street addict - then our whole culture is
humanized. She believes that our value as individuals, our success as a society, can be measured by our
compassion for the vulnerable.”
o “What is holding us back is the stigma that is attached to mental illness… And this self-feeding cycle of fear,
discrimination, and lack of understanding about mental illness is more than a vague uneasiness we detect
from time to time. It is a troubling fact.”
o “The data our Commission had gathered shows that the public continues to be repelled by the notion of
mental illness - although it is becoming less socially acceptable to say so!”
o “We cannot impose the Euro-American standard of treatment on everyone, especially on those who are
already alienated and excluded from the mainstream. We need to tailor services to ethnic and racial
minorities, and we need to launch a broad attack against stigma in communities where these citizens live.”
o “We need to care and to be cared for.”
o “So it is not that mental illness is less prevalent than other major diseases; it is that mental illness is simply
not an acceptable condition people want to talk about or deal with.”
o “We must create a climate in which our most vulnerable are accepted.”

Carter, Rosalynn. “Remarks for World Federation for Mental Health.” Vancouver, British Columbia, Canada. August 25,
1977.
(First Lady’s Social Office: World Federation for MH Speech)
 Page 23 of 27

Objects of Achievement, Left to Right: 77.1304, 78.1157, 80

Objects of Achievement, Left to Right: 80.1305, 80.425.1, 80.972a-b

 Page 24 of 27

Rosalynn’s Statements

“The Future of Mental Health: Statement By Rosalynn Carter, Honorary Chairperson - The President’s
Commission on Mental Health Before the Senate Subcommittee on Health and Scientific Research.” February 7,
1979.
(First Lady’s Press Office: Mental Health Commission [2]: 79.02.07: Statement on Future)

Organizations

➢ The Rosalynn Carter Institute for Caregivers, based in Americus, Ga. has focused on providing support for caregivers
since the late 1980s.
o GPB News
➢ Carter Center (Carter Center Leadership page)
o The Carter Center, based in Atlanta, was co-founded by Jimmy and Rosalynn Carter in 1982. Rosalynn
Carter has a 50-year legacy of advocating for and de-stigmatizing mental health and substance use disorders.
▪ Continued her leadership at the Carter Center (founded by the Carters in 1982) - dedicated to
improving the quality of life for people at home and in the developing world through peace and
health programs
• Carter Center
o The Center also works with journalists through its U.S. and global Rosalynn Carter Fellowships for Mental
Health Journalism.
▪ GPB News
➢ Initiated the Rosalynn Carter Symposium on Mental Health Policy in 1985 - brought in representatives from
nationwide mental health organizations to coordinate efforts on key issues
o Held for 32 years
o Focuses on mental illness, the elderly, children and adolescents, family coping, financing mental health
services, research, treatment, and stigma
o Archived Presentations: https://www.cartercenter.org/health/mental_health/symposium/archived-webcast-
presentations.html
➢ Instituted the 1996 annual Georgia Mental Health Forum
o Focused on developing solutions to build a healthier mental health care system
o 27th Forum (May 2023): https://www.cartercenter.org/health/mental_health/forum/index.html
o “Helping Georgia Build a Health Mental Health Care System,” Carter Center, accessed November 11, 2023,
https://www.cartercenter.org/health/mental_health/forum/georgia-crisis.html
▪ 2008 - the Carter Center’s Mental Health Program began mobilizing the statewide mental health
community to identify solutions to the crisis in hospitals and devoted 4 (2009-2012) of the annual
Rosalynn Carter Georgia Mental Health Forums to the Georgia mental health crisis
➢ Carter Center Mental Health Task Force - chaired by Mrs. Carter and made up of people that can affect public policy
o Meets quarterly
o Goals: to identity policy initiative and the the agenda for the program and annual symposia
o https://www.cartercenter.org/health/mental_health/taskforce.html
➢ Launched the Rosalynn Carter Fellowships for Mental Health Journalism in 1996 - one of the most successful
international programs in combating the stigmas associated with mental illness
o https://www.cartercenter.org/health/mental_health/fellowships/index.html
▪ Our Goals
• 1. Increase effective and accurate reporting on behavioral health issues
• 2. Equip journalists with the tools needed to produce high-quality work that reflects an
understanding of behavioral health
• 3. Develop a diverse cohort of better-informed journalists who can more effectively
report on behavioral health across evolving and emerging platforms
 Page 25 of 27

➢ Rosalynn Carter Institute for Caregivers (RCI) - established at her alma mater (Georgia Southwestern State University
in Americus, GA - 1987
o Rosalynn addresses concerns of those who take care of people suffering from mental and chronic illness and
long-term disabilities
o Research, education, and training - promotes the mental health of people, families, and caregivers, builds
public awareness, advanced policies to enhance caring communities
o Research resulted in her book Helping Yourself Help Others: A Book for Caregivers co-authored with Susan
Golant (1994)
o https://rosalynncarter.org/

Personal Speech Material Notes

➢ Social Office: World Federation for Mental Health Speech – Personal Notes

Other Relevant Articles

1. Billington, Joy. “Carter Mental Health Panel Calls for Stepped-up Effort.” Washington Star. September 15, 1977.
2. Lyons, Richard D. “20 Million People or More Need Mental Care, U.S. Panel Assets. New York Times. September 16,
1977.
3. Carter, Rosalynn. “Removing the Mental-Illness Stigma. New York Times. November 18, 1977.
4. “Completing the Mental Care Revolution.” New York Times. November 1, 1977.
5. Tyrrell, R. Emmett. “’Everybocy Has a Mental Problem’ – Rosalynn.” No Apologies. March 27, 197
6. Gregg, Susan. “Rosalynn: the woman behind the man.” Cavalier Daily. October 3, 1980.
7. Carter, Rosalynn. “Helpig Children to Hope.”

Jimmy Carter Library Archives

Record Group 220: President's Commission on Mental Health. ACC # 80—01. National Archives Identifier 547. February
1977-December 1978.
President’s Commission on Mental Health Press Releases Files (National Archives Identifier 136748) Container 25 (2/17/77-
4/27/78)
President’s Commission on Mental Health Published Reports Files (National Archives Identifier 136750) Container 25: Report to
the President from the President's Commission on Mental Health, 1978, Volume I, II, & III.
President’s Commission on Mental Health Published Reports Files (National Archives Identifier 136750) Container 26: Task
Panel Reports Submitted to the President's Commission on Mental Health, 1978, Volume IV.

Records of the First Lady’s Office. ACC # 80-1. ARC ID 561326. 1977-1981.
First Lady’s Press Office: Mary Hoyt’s Press Releases and Speeches Files Scope and Content (Series ID (ARC) 596812)
Container 2 (World Federation Speech and MHA)
First Lady’s Press Office: Mary Hoyt’s Press Clippings Files (Series ID (ARC) 596819) Container 51 (Mental Health Act Signing
and Commission)
First Lady’s Social Office: Gretchen Poston’s Administration Office Files (Series ID (ARC) 720265) Container 59 (Speech
Material)
First Lady’s Projects Office: Kathy Cade’s Project Files (Series ID (ARC) 5968811) Containers 30-31 (Speech Material)
 Page 26 of 27

Sources

Carter, Rosalynn. “Addressing the Caregiving Crisis.” Preventing Chronic Disease 5, no. 1 (December 2007): A02.

Carter, Rosalynn, and Thomas E. Bryant. “Mental Illness in America: Community Supports a Responsive Service System
Insurance for the Future New Directions for Personnel Protecting Basic Rights Expanding the Base of Knowledge a
Strategy for Prevention Improving Public Understanding.”

Willard, Fran Roberts. “Lillian Carter, Rosalynn Carter, and Caregiving.” Proceedings: Baylor University Medical Center 24, no.
3 (July 2011): 249-250.

“Preliminary Report Also Covers Alcohol and Drugs ‘MH Commission Wants $40 Million More For Research.’” Mental Health
Scope XI, No. 16 (September 1977).

Carter, Rosalynn. “Removing the Mental Health Stigma.” New York Times, November 18, 1977.
.https://www.nytimes.com/1977/11/18/archives/removing-the-mentalillness-stigma.html?searchResultPosition=1

Putnam, Tom. Interview. “Rosalynn Carter on the Mental Health Crisis,” JFK Library, accessed November 11, 2023,
https://www.jfklibrary.org/events-and-awards/kennedy-library-forums/past-forums/transcripts/rosalynn-carter-on-the-
mental-health-crisis.

“Helping Georgia Build a Health Mental Health Care System,” Carter Center, accessed November 11, 2023,
https://www.cartercenter.org/health/mental_health/forum/georgia-crisis.html

“Honoring 50 Plus Years of Mental Health Leadership,” Carter Center, accessed November 11, 2023,
https://www.cartercenter.org/health/mental_health/honoring-50-years-of-mental-health.html.

“Political Rewind: Rosalynn Carter's legacy on mental healthcare and support for caregivers,” GPB News, accessed November
11, 2023, https://www.gpb.org/news/2023/06/09/political-rewind-rosalynn-carters-legacy-on-mental-healthcare-and-
support-for.

“Rosalynn Carter,” Carter Center, accessed November 11,

2023, https://www.cartercenter.org/about/experts/rosalynn_carter.html.

“Rosalynn Carter’s Leadership in Mental Health,” Carter Center, accessed November 11, 2023,
https://www.cartercenter.org/health/mental_health/rosalynn-carter-mental-health-leadership.html.

“24 Fun Facts about First Lady Rosalynn Carter,” Carter Center, accessed November 11, 2023,
https://www.cartercenter.org/news/features/blogs/2021/her-secret-service-code-name-and-other-lesser-known-facts-
about-first-lady-rosalynn-carter.html.

“Rosalynn Carter Speeches,” Iowa State University: Archives of Women’s Political Communication, accessed November 11,
2023, https://awpc.cattcenter.iastate.edu/directory/rosalynn-carter/.

“How Rosalynn Carter reduced stigma around mental health and caregiving,” PBS Newshour, accessed November 11, 2023,
https://www.pbs.org/newshour/show/how-rosalynn-carter-reduced-stigma-around-mental-health-and-caregiving.

Mental Health System Act, S 1177, 96th Cong., introduced in the Senate May 17, 1979. Government Printing Office,
1980. https://www.congress.gov/96/statute/STATUTE-94/STATUTE-94-Pg1564.pdf.
Page 27 of 27