Rosalynn Carter, Transformative First Lady and Mental Health Advocate, Dies

Rosalynn Carter, the pioneering First Lady who worked tirelessly to raise awareness for those with mental health illness, died on Sunday. She was 96 years old.

“Rosalynn was my equal partner in everything I ever accomplished,” her husband, former President Jimmy Carter, said in a statement confirming the news. “She gave me wise guidance and encouragement when I needed it. As long as Rosalynn was in the world, I always knew somebody loved and supported me.”

Carter displayed a fiery intellect and motivation to help those on the fringes of society long before she moved into the White House after her husband won the 1976 presidential election. She approached her role as First Lady with the same hands-on spirit—quietly rewriting the rules with her steely determination and steadfast support from her husband, who considered her his closest advisor and “a very equal partner.”

In an interview from the Jan. 10, 1977 issue of TIME, Carter said she was prepared for her role as First Lady to mean something substantial, and to create meaningful changes: "Jimmy will let me assume as much responsibility as I will. These last two years, I have seen the problems, and I feel that I can help with some of them.”

Carter would go on to play an important role in her husband’s presidency. Known to have sat in on her husband’s Cabinet meetings, Carter is famously considered one of the most involved First Ladies the Oval Office has ever seen. MaryAnne Borrelli, a professor of government at Connecticut College whose research largely focuses on gender in politics and the presidency, tells TIME that Carter changed the role of First Lady permanently. She was also the first to formally claim office space in the East Wing for herself and her staff—an arrangement that has largely endured for all the first ladies who followed.

“She really took that formalization to the next step by bringing in the expertise and departmentalization of the office so that the First Lady could do more," Borrelli says. “Her contributions were first.”

In the third year of her husband's presidency, TIME declared Carter the “second most powerful person in the United States.”

Her early years

Born Eleanor Rosalynn Smith on Aug. 18, 1927, Carter was the eldest of four children born to Wilburn Edgar Smith, an auto mechanic and farmer, and Frances Allethea “Allie” Murray Smith, a dressmaker. Together they were a religious, hardworking family from the small town of Plains, Ga.

Like many women of her time, Carter aspired to graduate college and leave her small-town life, but family obligations initially complicated her dreams. After her father died when she was 13, Carter helped rear her three younger siblings while assisting her mother with sewing work. Even so, she managed to graduate high school as valedictorian and enroll in Georgia Southwestern College.

Overall, Carter credited her mother with inspiring her own bootstrapping nature. “My mother had an enormous impact on me to become very independent,” she told the Chicago Tribune in 2002. “I learned from my mother you can do what you have to do.”

Marrying the future president

Rosalynn grew up near her future husband in Plains, and grew closer to him through her friend Ruth Carter—Jimmy's sister. The pair began dating in 1945 while the future president was enrolled in the U.S. Naval Academy in Annapolis, Md., and were married on July 7, 1946—when she was just 18. She and her husband lived in several states during the first years of their marriage, including Hawaii, Virginia and Connecticut, due to his military duties.

In 1953, when Jimmy Carter’s father died, the family—which at that point included three children—moved back to their hometown of Plains, Ga., to take over the Carter family’s peanut business. Although Rosalynn initially opposed moving back home—causing a brief crisis in their otherwise close, solid marriage—she took control of the peanut company’s finances.

The business soon prospered, and their roots in the community grew. In 1955, Jimmy Carter successfully ran for office for the first time, earning a seat on the Sumter County Board of Education. He later served two terms in the Georgia State Senate before an unsuccessful run for Governor in 1966. That campaign prompted an incident Carter described as “the worst political experience of my life” in her autobiography, when she recalled being spat on by a supporter of her opponent.

In 1970, Jimmy Carter ran for governor again—and this time won. Although a primary responsibility of the First Lady of Georgia was to host various events and ceremonies at the Georgia Governor’s Mansion, the gig did not require the kind of intellect and curiosity that were at Carter’s core. In a preview to her influential role as First Lady of the United States, Carter used her position to elevate a cause she would continue to champion for decades: mental health.

Her mental health work

Carter told TIME in 2010 she first became interested in mental health reform during her husband’s first run for governor in 1966. “One day I made a remark that I might work with people with mental illness and somebody in the press heard it and it was in the paper. And the more I thought about it and found out about it, the more I thought it was just a terrible situation with no attention. And I've been working on it ever since.”

Carter also grew her work on behalf of those who live with mental illness while occupying the White House, serving as honorary chair of the President's Commission on Mental Health. But Carter's work was more than a vanity cause—she pushed for policy change.

"In four years, [the President's Commission on Mental Health] went from a commission to a full-blown legislative reworking of the entire mental health system in the United States," Borrelli says. Carter was also one of the only first ladies to testify before Congress. In 1979, she and others shared the work of the Commission on Mental Health in support of the scientific research that would become a part of the Mental Health Systems Act of 1980.

Carter continued to advocate for mental health care after she and her husband left the White House following his defeat in the 1980 election.

Together, they founded The Carter Center in 1982, a nongovernmental organization that implements worldwide initiatives to fight for peace and health. In 1985, she initiated the annual Rosalynn Carter Symposium on Mental Health Policy, and for years chaired the Carter Center Mental Health Task Force. In 1996 she launched the Rosalynn Carter Fellowships for Mental Health Journalism, aimed at eliminating the stigma surrounding mental health.

Her dedication to the cause never waned, and in a 2010 interview with TIME she lamented the severe dearth of resources for Americans suffering from mental illness.

“We know what to do for [the mentally ill] yet we don't do it. We know how to treat depression, we know how to treat mental illness, and we have not had the political will in our country to make it happen. People are homeless, sleeping on the streets. Yet today, with what we know about the brain, [we can help people] can recover. Even those who are disabled for years can recover with proper help. I'm really frustrated. For me it's a moral issue.”

Advocating for women and minorities

Throughout her life, Carter also advocated for other issues that spoke to her sense of morality and justice. She and her husband had a long but imperfect history of supporting civil rights—an issue that put them at odds with many of the more conservative members of their Georgia community and church. In 1965, Carter family members cast five of the six dissenting votes opposing a resolution barring African Americans from entering their church in Plains.

“There were times when I went to church and nobody would speak to me and we just knew that everybody was mad,” she later reflected.

Carter and her husband continued to support underprivileged African Americans in ways large and small throughout their political rise. As Kate Andersen Brower recounts in her book The Residence, the pair symbolically welcomed Mary Prince, a black woman who was eventually pardoned of her murder conviction, to work in the Governor's Mansion in Georgia as part of a rehabilitation program while she served a life sentence. Prince—who developed a close bond with their youngest child, Amy—returned to prison after Carter's term as governor ended, but the relationship didn't stop there. In a 1977 interview with People, Prince said that Carter would visit her in jail before inviting her to move to the White House to return to her post as the Carter family nanny. Eventually, Prince was proven innocent and pardoned of her crime. Both the President and First Lady insisted over the years that had Prince been white, she never would have been charged with the crime in the first place.

Carter also used her political influence to support the Equal Rights Amendment (ERA). As she lobbied for the ERA in the 1970s, she encouraged her husband to voice his support as well. In a 1977 interview, she told the New York Times that President Carter never had to inquire about her opinions. “I tell him what I think,” she said. Her work in fighting for the amendment earned her the Award of Merit for Support of the Equal Rights Amendment from the National Organization for Women.

Carter's advocacy also lives on with The Rosalynn Carter Institute for Caregivers (RCI) at Georgia Southwestern State University, which she founded in 1987. The RCI’s mission is to promote “the health, strength, and resilience of all caregivers at every stage of their journey."

This advocacy continued with ongoing volunteer work through Habitat for Humanity, which Rosalynn and Jimmy Carter first became involved with in 1984. The Carter Work Project, a weeklong volunteer effort to assist the organization's mission through creating safe and affordable housing for those in need, continues annually.

At the age of 90, and nearly four decades after her time in the White House, Carter continued to speak out for issues she was passionate about. In June 2018 she united with other former first ladies to condemn U.S. President Trump’s zero-tolerance immigration policy that separated children from their parents at the U.S.-Mexico border, calling it “a shame to our country.”

Rosalynn Carter is survived by her husband as well as four children—John William "Jack" Carter, James Earl "Chip" Carter III, Donnel Jeffrey "Jeff" Carter and Amy Lynn Carter—and numerous grandchildren and great-grandchildren.