Former President Jimmy Carter Leaves Behind a Legacy of Mental Health Advocacy

Jimmy and Rosalynn Carter were lifelong activists for improving and expanding mental health care access for Americans.

Former President Jimmy Carter, accompanied by his wife, Rosalynn, waves to journalists after he crosses over the border into North Korea on June 15, 1994. Some of the Carter Center's achievements in global conflict mediation include work in the countries and regions of Ethiopia (1989), North Korea (1994), Liberia (1994), Haiti (1994), Sudan (1999), Uganda (1999), Venezuela (2002-2003), Colombia (2008), and the Middle East (2003-present). Choo Youn-Kong/AFP via Getty Images

Former President Jimmy Carter, who died at the age of 100 on Dec. 29, charted a more than 70-year legacy that began with his Navy service and continued into the present day with his international conflict resolution group, the Carter Center.

While Carter is famously remembered for his decades of work with Habitat for Humanity and for pursuing global peace with his center, the 39th president also leaves behind a history of advocating for mental health care, often spearheaded by his wife of 77 years, Rosalynn, who died in 2023 at age 96.

This work includes pushing for Community Mental Health Centers (CMHCs) in Georgia as governor, creating the Presidential Commission for Mental Health (PCMH) in 1977, signing the Mental Health Systems Act (MHSA) in 1980, and working with the Carter Center, which won the American Psychiatric Association’s (APA) Organizational Distinguished Service award in 2001.

“President Carter’s impact on mental health in this country touched the lives of millions of people, and his humanitarian efforts changed the world. The APA honors his record and will work to carry out his legacy in its efforts to promote universal and equitable access to the highest quality care for all people affected by mental health disorders,” the APA wrote in a Monday statement honoring Carter’s life and achievements.

Here are some of the ways in which Carter and his wife fought for mental health throughout their decades-long careers.

Rosalynn’s Early Inspiration

Years before the Carters moved into the White House, Rosalynn had an experience with a mentally ill distant cousin that set the stage for her lifetime advocacy. She recalled being frightened in the man’s presence.

“He probably wanted nothing more than friendship and recognition, yet he was different, and when I heard him, my impulse was to flee,” she wrote in her memoir.

The experience made Rosalynn empathetic towards those suffering from mental health issues and inspired her to spend much of her time during her husband’s presidency advocating for mental health care. As governor of Georgia, Carter created the Governor’s Commission to Improve Services to the Mentally and Emotionally Handicapped and made Rosalynn a member.

While in the governor’s mansion, Carter and his wife were champions of “deinstitutionalization” and supported creating numerous CMHCs in the state, which lowered the number of mentally ill patients institutionalized in hospitals.

Presidential Achievements

Once Carter entered the White House, his work in mental health advocacy continued. His presidential commission was an attempt to continue the work of CMHCs at the national level, and Rosalynn was named honorary chair of the commission upon its creation in 1977.

The PCMH spent a year studying the nation’s health care needs before submitting its results in 1978. Two years later, it influenced the MHSA, which was backed by Sen. Ted Kennedy (D-Mass.) and Rep. Henry Waxman (D-Calif.).

The commission’s final report determined that there was a notable lack of mental health services in rural areas, inadequate care for children, adolescents, seniors, and those with chronic conditions, and diminished support for those with different cultural traditions and languages.

In May 1979, Rosalynn became the first sitting U.S. First Lady to speak before the World Health Assembly about the PCMH’s findings and her ongoing work to reduce stigma toward mental health care in the United States. Later that year, she urged Hollywood leaders in Los Angeles to tell positive stories about mental health to reduce stigma against those who suffer.

In 1980, Carter signed the MHSA, which created grants for CMHCs, mental health care authorities, and other entities that offered care and education for those suffering from mental illness. It was intended to create a safety net for anyone who was unable to seek mental health services, particularly for those who lacked local facilities for care. The act was largely dismantled by the Omnibus Budget Reconciliation Act of 1981 during the Reagan administration, which retained the MHSA’s patients’ bill of rights.

After the Presidency

In addition to resolving global conflict, the creation of the Carter Center in 1982 continued the Carters’ commitment to improving mental health care. That same year, the American Psychological Association President William Bevan awarded Rosalynn its Presidential Citation. In 2017, on the association’s 125th Anniversary, she received another Presidential Citation from President Antonio E. Puente.

In 1985, the Emory University School of Medicine in Atlanta hosted the first Rosalynn Carter Symposium on Mental Health Policy called “Stigma and the Mentally Ill.” She then established the Carter Center Mental Health Program in 1991 before writing a book titled, “Helping Someone with Mental Illness: A Compassionate Guide for Family, Friends, and Caregivers” in 1998.

Both Jimmy and Rosalynn Carter won the APA’s Organizational Distinguished Service Award in 2001.

“Jimmy Carter, 39th President of the United States, Nobel Peace Prize winner, [was a] staunch proponent of mental health awareness and access. Along with First Lady Rosalynn Carter, an Honorary Fellow of the APA, his advocacy changed lives,” the APA wrote in a statement.