ATLANTA (AP) - Standing outside an Atlanta cotton mill campaigning for her husband's bid to become governor of Georgia, Rosalynn Carter came upon a stooped and weary woman heading home to care for a mentally ill daughter.
The pre-dawn encounter in 1966 would help launch a crusade that has lasted to this day. As her husband's political career catapulted him to the White House, Mrs. Carter worked to bring mental health to the fore. Her advocacy has continued long after the couple left the nation's capital and established the Carter Center in Atlanta.
The former first lady details that 1966 meeting and her work since in a new book, "Within Our Reach: Ending the Mental Health Crisis." It is Mrs. Carter's fifth book and her second dealing with mental health.
Mrs. Carter, 82, says that while there have been dramatic advances to treat those who suffer from mental illness, the stigma still lingers.
"That's really been frustrating to me," Mrs. Carter said in a recent interview with The Associated Press. "The one thing that holds progress back more than anything else is the stigma."
Popular crime dramas on television, she said, still portray the mentally ill as violent and reinforces the mindset that they should be feared. She said the mentally ill are far more likely to be victims of crime then perpetrators.
And the treatment of Hurricane Katrina victims and veterans returning from the wars in Afghanistan and Iraq show there is still much that's misunderstood about mental illness, she said.
"There should be no more shame or stigma attached to mental illness than any other illness," she said.
In the book, Mrs. Carter discusses how she heard repeatedly during her husband's two campaigns for governor about conditions at Georgia's largest mental health hospital. At her urging, her husband created a state panel to tackle the issue of mental health care. And he continued that campaign when he reached the White House.
As first lady, Mrs. Carter served as the honorary chair of the President's Commission on Mental Health. It ultimately pushed through the passage of the 1980 Mental Health Systems Act, which boosted funding for mental illnesses.
When the Carters returned to Georgia and established the Carter Center, she created a program devoted solely to mental health and eventually established fellowships for journalists who cover the issue. And she lobbied in Washington to help push a landmark bill in Congress requiring insurers to provide equality in mental health coverage.
"She's done a terrific job of putting everyone in the same room together and keeping the issue in the spotlight," said Michael Fitzpatrick, executive director of the National Alliance on Mental Illness.
Mrs. Carter is the first to acknowledge more work must be done. Funding for mental health has seesawed over the years and still lags behind what's needed to provide treatment and community support services, she said. And Mrs. Carter worries the economy will slash already scarce funding for mental illness.
She praised the recently enacted federal health care law saying the provision preventing insurers from denying coverage for pre-existing conditions is a major victory in the mental health field.
Her new book is sometimes deeply personal, describing her father's death and an automobile accident that flipped the car carrying her son, Jeff, then 2 years old. For some time afterward she said her heart would race when reading newspaper accounts of car crashes, leaving her a small understanding of what it might be like to suffer from post-traumatic stress disorder.
As a girl growing up in Plains, Mrs. Carter recalls in the book that she was frightened by a nervous young man who could be found wandering the streets. When he would grow agitated, the sheriff would haul him away, sometimes in a straitjacket, to a mental health hospital. She would learn years later that the man was the cousin of her future husband.
Mrs. Carter said she has a particular affinity with the elderly who suffer from depression because of isolation and a sense of being useless after decades in the work force. Her mother, she said, wept when at age 70 she was forced to retire from her job at the U.S. Post Office in Plains.
Even as Mrs. Carter says the mental health system remains in shambles, she argues there is reason to be optimistic.
She said when she took on the issue of mental illness, "I never dreamed that people could receive treatment, that recovery could be possible."
Today, she said, those suffering from schizophrenia can take medicine that effectively erases symptoms.
And in Georgia, which the Carters still call home, recent news is cause for celebration - and worry.
After decades of turmoil, state officials have decided to stop admitting new patients to the Central State Hospital, the facility that first attracted Mrs. Carter's interest.
"To me, it's symbolic," she said. "But I worry about what is going to happen when people go out in the community and there aren't enough services? What will happen to those who leave?"