Former First Lady Rosalynn Carter is known worldwide as a leader in the field of mental health. From serving on governmental commissions to advance mental health services during her husband's terms as Georgia governor and U.S. president to her current work leading Carter Center projects to improve mental health policies and reduce stigma, Mrs. Carter has worked tirelessly for more than 35 years to help those living with mental illnesses and their families. In light of the recent passage of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008, Mrs. Carter sat down to discuss what has changed since she began her advocacy work and what still can be done for people living with mental illnesses.
Q: How did you first get involved with mental health issues?
My involvement with mental health began in 1970, when I was working in Jimmy's campaign for governor of Georgia. My interest was piqued by the many people who asked me what Jimmy would do for a relative of theirs who had a mental illness. One day, when Jimmy was speaking at a rally, I got in line with everybody else to shake hands with him. He saw who I was, grinned, and asked, "What are you doing here?" "I came to see what you are going to do about mental health when you are governor," I replied. Since then, I continue to meet so many people with mental illnesses who inspire me and encourage me to keep fighting against stigma and discrimination.
Q: How has understanding of mental health changed over the years?
Thirty-five years ago, we never dreamed mental illnesses could be controlled. There was very little knowledge about how to treat these illnesses. Few people even spoke the words "mental health." Mental health referred only to mental illnesses, and mental illnesses were shrouded in shame and stigma. Today, because of research and our new knowledge of the brain, mental illnesses can be diagnosed and treated effectively, and the overwhelming majority of people with these disorders can live normal lives in their communities and be contributing citizens.
Q: What can be done to combat stigma and discrimination against people with mental illnesses?
One in four Americans will have a mental illness this year. I think that if people realized how common mental illnesses are and how effective treatments are, people would be less afraid to talk about them. And if more people talk about these disorders, the stigma and misunderstandings about mental illnesses slowly will disappear.
At The Carter Center, our Mental Health Program has worked since 1991 to achieve four basic goals: to reduce stigma and discrimination against people with mental illnesses; to achieve equity for mental health care comparable to other health care; to advance promotion, prevention, and early intervention services for children and their families; and to increase public awareness worldwide about mental health and mental illness to stimulate local actions to address those issues.
Q: Why is mental health parity important?
I often have said that if insurance covers an illness, than people will think it's OK to have that condition. When insurance denies coverage for mental illnesses, people incorrectly think that mental illnesses are different from other conditions like diabetes and cancer. If someone does not have insurance coverage for mental health care, they may not be able to afford doctors visits or other treatment. As a result, the cost for untreated illnesses is shifted to the public sector and our economy. Major mental disorders cost the nation at least $193 billion annually in lost wages, and the cost of alcohol and drug problems in the United States is more than $400 billion. We also pay the price for the inequality of mental health care in the number of homeless, lives lost to suicide, and families torn apart.
Q: How will the new parity legislation help people living with mental illnesses?
By passing mental health and addiction parity legislation, Congress has made an important statement that these diseases should be treated like any other physical illness. This new law will help people like Jerome Lawrence, an artist who has schizophrenia and works at an advocacy organization. Jerome will no longer have to worry about whether the cost of his care will make him dependent on Supplemental Security Income. Members of the mental health and substance use communities collaborated to make mental health parity a reality and deserve great credit for their hard-won victory.
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