Rosalynn Carter’s Lasting Impact on Mental Health

A few days ago, the nation learned that former First Lady Rosalynn Carter had died. As we all mourn her passing, I found myself reflecting on the incredible legacy that she has left behind. I had the fortune of meeting her a few times when I spent a year working at the Carter Center, the nonprofit she and former President Carter co-founded to wage peace, fight disease and build hope.

A number of obituaries have highlighted the ways in which she was a pioneering First Lady of the United States – she established the modern Office of the First Lady, sat in on cabinet meetings, and was described by former President Carter as his “equal partner in everything [he] ever accomplished.”

As First Lady, she took on issues germane to the Department of Labor, such as hosting the First Lady’s Employment Seminar in 1978. But for many, including me, her leadership on issues of mental health is one of her most important legacies.

She once described meeting an exhausted woman who worked a night-shift job at a cotton mill. The woman was going home to take care of her mentally ill daughter. The encounter stressed how the challenges of balancing the demands of work and family become exacerbated when you have an ill loved one. It was one of many impactful meetings for Mrs. Carter, who was then campaigning for her husband to become governor of Georgia. Those encounters helped to build her deep and abiding interest in mental health, which she carried through her time as the First Lady of Georgia, First Lady of the United States, and at the Carter Center.

As First Lady of Georgia, she served on a Governor’s Commission dealing with mental illness and made many recommendations that were later signed into law. As First Lady of the United States, she again made mental illness a signature issue. In her first interview as First Lady, she highlighted stigma and access to treatment as two issues of particular concern. She served as the honorary chair of the President’s Commission on Mental Health, which produced a foundational report that led to the Mental Health Systems Act of 1980. Mrs. Carter testified in support of the bill, as she later would for the Pete Domenici and Paul Wellstone Mental Health Parity and Addiction Equity Act of 2008, or MHPAEA.

At the Carter Center, Mrs. Carter’s advocacy continued. She established the mental health program, which works on public policy, supports mental health journalism, and works to reduce stigma and discrimination against those with mental illnesses. The program used to hold an annual symposium to bring together national thought leaders to discuss various issues related to mental health policy. MHPAEA was released at the 2013 symposium. The program also triggered my own interest in mental health.

Mrs. Carter was one of the softest-spoken people I have ever met. But our prioritization of mental health and substance use issues in our enforcement program, our work to address stigma, our proposal to update our mental health parity rules, and many other examples show how strongly her voice resonates throughout EBSA’s work.

Ali Khawar is the principal deputy assistant secretary of the U.S. Department of Labor’s Employee Benefits Security Administration.