Rosalynn Carter believes that the stigma associated with mental illness can cause as much harm as the disease itself. Instead of shunning the victims, the wife of former President Jimmy Carter says people need to educate themselves about mental health and embrace recovery and prevention.

Carter was the lead speaker Monday at a forum on mental health, hosted by Washington University's Brown School of Social Work at Graham Chapel.

The message from the former first lady was as folksy as it was poignant. "How do you like the Georgia weather I brought you?" she asked an audience that had turned out on a pleasant, partly-sunny afternoon when the temperature had climbed above 50 degrees. She drew more applause when she mentioned that the Washington University campus was home to the nation's top-ranked school of social work.

Beyond such pleasantries, Carter delivered a serious message about how the nation is refusing to face what she said was a pervasive, yet hidden, health problem. Carter became aware of the issue when on the campaign trail in 1966, when her husband first ran for governor of Georgia. She later became an important force for reform in Georgia after her husband's election. She continued her work when he became president.

Rosalynn Carter established a mental-health unit for the Carter Center in Atlanta, which she and her husband founded in 1982. She has written two books on the subject. Her newest is titled "Within Our Reach: Ending the Mental Health Crisis." In spite of her work, Carter concedes that public perception of the problem and access to treatment haven't changed much over the years.

"People do not want to go to a mental-health professional because they don't want to be labeled mentally ill," Carter says. She stresses that recovery is now possible because researchers have learned "so much about the brain. We know what to do, and because we don't do it, millions of people suffer. "

Yet, she says it's in society's best interest to do more because mental illness affects one in four Americans.

Health reform's impact on mental health

One member of a panel discussion that followed Carter's speech was Keith Schafer, director of the Missouri Department of Mental Health. Schafer predicted that Missouri would do more to address mental health if the federal Affordable Care Act withstands legal and political challenges.

"If it goes properly, I think people with serious mental illnesses can have the same kind of insurance that I can have as a state employee," he says. "I think we'll be a lot better at serving people than we are today."

Playing on the title of Carter's book, Schafer (left) said, "The solutions are actually within our reach. And for that reason we owe a great debt to first lady Carter."

Another panelist, Jacqueline Lukitsch (right) of the St. Louis Chapter of the National Alliance on Mental Illness, said her agency was trying to do more to overcome the stigma associated with mental illness through an education campaign. An alliance-sponsored course helps caregivers learn about mental illness and support loved ones in getting treatment. She says the course has "demonstrated a reduction in the emotional burden to caregivers as well as improved outcome for loved ones."

Lukitsch says the public should demand that state lawmakers "reject the tendency to cut mental-health services and do something to make our system better."

The panel's moderator, Enola Proctor (right), director of the Brown School's Center for Mental Health Services Research, says evidence-based, mental-health treatment can be more cost effective than some treatments for physical conditions.

"But access to mental-health care remains a huge problem. How well are people with mental health (issues) served? The answer was grim 34 years ago. I'm afraid it's very grim today."

She says that about half the people with serious mental disorders get no help and that treatment reaches only 30 percent with mood or anxiety disorders.

Community response to mental disorders

Still another challenge, she says, is figuring out ways to make sure that more new treatments, produced from billions of dollars in research, move from the lab to the real world. That is one of the issues Brown researchers are trying to understand and help address, she says.

Rabbi Susan Talve (right) of Central Reform Congregation stressed that society should provide places where people can "come out and tell their stories and get help they need." She says it's important for the public, particularly members of the faith community, to help create that space.

She mentioned an incident involving a mentally unstable veteran who was "full of anger" and had a habit of dressing in fatigues, standing outside Sabbath services and complaining about "how the Jews killed Jesus."

Rather than shutting him out, she said the congregation "kept the door open, we refused to be afraid and everyone took the time to say hello to this man and smiled." Eventually, she said, "he came into services, and honest to God, he converted to Judaism and had a bar mitzvah."

She added that he's now "a wonderful member of our community. But I wonder what would have happened if we were too afraid to keep the sanctuary door open. He has helped us experience the rich benefit of valuing each and every person."

Other panelists were Kathryn Ellis a board member of Community Treatment Inc., also known as COMTREA in Jefferson County; and Diane McFarland, CEO of Behavioral Health Network of Greater St. Louis.

Carter's visit drew a crowd, filling many of the seats at Graham Chapel. Edward F. Lawlor, dean of the School of Social Work and founding director of the school's Institute for Public Health, said the turnout showed how broadly the issue affects people in the region.

After spending the day with mental-health proponents, Carter wrapped up her visit with a book signing Monday evening at Left Bank's downtown store.