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8 Oct 2005

By Marion Scher

At 78 years of age, most former First Ladies would certainly consider putting their feet up. Not the indefatigable Rosalynn Carter. Marion Scher has obtained a rare interview with this fascinating woman and discovers what fuels the burning passion she has to do work in the realm of mental health.

When Jimmy and Rosalynn Carter left the White House in 1981 after he had served just one term as president of the United States, many people thought they would never hear again of the "peanut farmer" as he had come to be known.

They couldn't have been more wrong. For though he may not be remembered for the great things he achieved during his presidency, he will certainly go down in history as the US president who did the most – both inside and outside his county – after his term of office.

And Rosalynn Carter – his wife and partner of 60 years – will be right up there with him in many halls of fame for her work in health issues, conflict resolution, human rights and the political freedoms that go with this.

She has become best known for her tireless work in the field of mental health.

"People often ask if my long-standing involvement with mental health is based on personal experience; if my family had somehow been afflicted by the diseases on which I've worked for so many years. The answer is no, although during my childhood a distant cousin of ours, Tommy, was in and out of state mental institutions in Georgia.

"When he was home I was afraid of him and would run and hide. I don't know why I had to get away; he was never violent, just very nervous and very loud. He probably wanted nothing more than friendship and recognition yet he was 'different' and, when I heard him, my impulse was to flee. Today he could be treated and lead a more normal life.

"Tommy's condition and the way he was treated made a deep impression on me as a child. Later, after we were married, Jimmy and I visited him at the state hospital several times."

But not until her husband was running for governor of Georgia in 1970 did Rosalynn's real involvement start.

"A law was passed that called for the deinstitutionalisation of mental homes, and family members of patients would ask me for help," she recalls.

"They'd ask: 'If your husband is elected, what will he do for my emotionally disturbed child, my depressed brother, my psychotic aunt?' And I also thought 'his own cousin?' One night at a rally I got in line with everybody else to shake hands with him.

"He reached out to take my hand whilst still talking to the person in front of me. Then he saw who I was, grinned and asked: 'What are you doing here?' I told him that I had come to see what he was going to do about mental health when he became governor. He told me that he would have the best system in the country and that he'd put me in charge of it.

"Well, I wasn't put in charge, of course, but I became part of a commission formed to improve services to the mentally and emotionally disturbed."

This was the start of a journey of discovery for Rosalynn. She attended every meeting of the commission, volunteered weekly at the Georgia Regional Hospital and visited other regional hospitals, reporting back to the commission and Jimmy on what she found. Most important of all, she spoke out, determined to break the stigma of mental health and make it an acceptable subject of conversation.

"I helped mentally disturbed children, planted flowers with geriatric patients and followed up with alcoholics who had been put up in the hospital to dry out. I fed some who needed help, read stories to others and watched them all respond to attention.

"But it was a struggle for me. One day after I'd spent time in a children's ward – trying to hold back tears – the superintendent took me to his office and said: 'I've watched you this morning and I have to say one thing: If you're going to help at all, you've got to get over your tears. Don't let it get the best of you. We need you.'

"He was of course right, but it was hard not to feel sorry for all these people who had been in institutions for most of their lives. Most of them never had and visitors; they were stranded.

"Over the next four years we made a lot of progress in our mental health programme, moving patents into new, small regional hospitals and a few group homes. We thought this had to be a better option. The hardest part was finding places to house people. We set un community centres where people could go for help."

By the time the Carters were living in the White House, Rosalynn knew exactly what her goal as First Lady would be. "Eleanor Roosevelt worked for social change; Jackie Kennedy restored the White House to an American showcase in which we could take pride; and Lady Bird Johnson renewed our interest in beautifying the county's highways and parks.

"My main project would be to develop a strategy for further helping the mentally ill. Jimmy signed an executive order creating the President's Commission on Mental Health and I became the honorary chairperson."

A year later, the commission presented the president with 117 recommendations. Time and again, the commission was faced with evidence of people not seeking psychiatric help because of the stigma attached to the illness – not even telling their family or friends.

"Today we know about the brain; there are new medications, new treatments. But we still have inadequate funding which holds us research projects. We felt we had come a long way during those White House years, but unfortunately the Reagan administration made cutbacks in funds for domestic programmes and these gains were short-lived. This is a great pity – shameful and so wasteful.

"How many lives could be saved, and how much expense to the taxpayers saved, with new knowledge and new cures?"

After Ronald Reagan's 1980 election triumph, the Carter family returned to Plains, Georgia, where both Jimmy and Rosalynn had grown up. In was here that the 18-year-old Rosalynn had fallen in love with the handsome young naval officer, who whisked her off her feet and into life as a naval wife, seeing America for the first time.

Seven years later, with three young sons – Jack, Chip, and Jeff – and after living in 11 different places – including Pearl Harbor, Hawaii, San Diego and the state of Connecticut – Jimmy's father died and, and Jimmy decided to return to Plains to run the family peanut-farming business.

"I was devastated," recounts Rosalynn. "The thought of going back to a small town was too much for me. I argued. I cried. I even screamed at him. I thought we'd never travel again. Little did I know … In fact Jimmy likes to tell the story of how, on our long drive back, I would only answer him through one of the boys. I don't remember that – but I guess it's true."

Ex-president Carter, who turned 81 this week, spent the first year back home in Plains, Georgia, writing his book Keeping Faith, and then, together with Rosalynn, started planning his presidential library and the Carter Center.

Opened in 1982 amid magnificent parkland, the Atlanta-based centre was formed in partnership with Emory University to "advance human rights and alleviate unnecessary human suffering."

A not-for-profit, non-governmental organization, the centre carries out its work supported by donations from individuals, foundations, corporations and even countries.

At the Carter Center, Rosalynn's work focused on mental health. She set up a taskforce that years later goes on proposing initiatives to reduce stigma and discrimination.

"The earlier you can detect it, the better chance you have of overcoming it and giving better treatment," says the former First Lady. "The NIMH [National Institute of Mental Health] recently gave a grant to a friend of ours at Columbia University to develop a list of symptoms of mental illness in young people, as it's not easy to detect in children.

"We're also working with primary care doctors and general practitioners on recognising mental illness, as well as medical schools to change their curriculum to encompass this. General doctors, heart specialists or others don't have any training in mental illness and someone who's had a heart attack, for instance, often suffers from depression."

But what really gets this dynamo steamed up is the use of insensitive language in connection with mental health. "The media are becoming more aware, but occasionally you'll still see a headline using the words 'mad', 'crazy', 'lunatic' as labels where they don't belong.

"Today we can diagnose mental illnesses and there are new treatments. Medications don't have the serious side effects they used to have, and since we left the White House I'm able to say recovery is possible. Not a total cure, perhaps, but the ability to lead a normal life.

"Unfortunately the Bush administration has made even more cuts to health funding which, when you have such as that most of the violent deaths in the world are from suicide and that depression will be the biggest illness in the world by 2020, then you must worry.

"We need to create awareness around this disease. That's one of the reasons why in 1996 we set up the Rosalynn Carter Fellowships for Mental Health Journalism. This has been our most successful program in combating the stigma associated with mental illnesses. Initially five annual fellowships were offered in the United States but in the last five years two were offered to journalists from New Zealand and this year marks the second year they've been offered to two South African journalists."

With a life so fully lived, a question that must be asked is: So what do you see as your greatest achievement? Without blinking an eye, she answers: "Eleven outstanding grandchildren, and of course the Carter Center.

"But there's still so much unfinished business. Our work in Africa is ongoing, and we're always looking to see just where we can make a difference."

Marion Scher, a freelance journalist, was awarded the 2005-06 Carter fellowship for mental health writing. The other recipient is Shandukani Mathagu, a radio journalist from Thohoyandou.

Copyright 2006. Used with permission from Marion Scher.