CONCORD, N.H. (AP) — The sun was shining in June 1979 as Rosalynn Carter made her way through an enthusiastic crowd in Laconia, New Hampshire.

“She shook my hand!” yelled one delighted participant.

The first lady was in the state for her husband’s reelection campaign, but this was no political rally. Instead, she was at a sprawling 75-year-old institution founded for “feebleminded” children that the U.S. Justice Department had deemed “a classic example of warehousing.” She was joined by Gov. Hugh Gallen, a kindred spirit who had been pushing to correct the deplorable conditions there and at the state’s psychiatric hospital.

Recalling his time as Gallen’s press secretary, Dayton Duncan remembered the rare opportunity to visit the Laconia State School and speak with individuals facing a pressing issue, rather than just voters. This type of interaction was uncommon then and even more so now.

Duncan stated that the individual could have simply delivered a successful speech regarding the administration’s goals and ended it there. However, the fact that they chose to visit the Laconia State School and engage with the staff, children, and parents there was noteworthy.

Following their time in the White House, Jimmy and Rosalynn Carter established initiatives that have, among other accomplishments, overseen elections in over 113 nations and almost completely eliminated the Guinea worm parasite in developing regions. However, the ex-president has expressed that The Carter Center would still be considered a triumph even if it had only achieved his wife’s efforts in mental health advocacy.

That’s according to Kathy Cade, vice chair of Atlanta-based center and a longtime aide to Rosalynn Carter, and others who know the couple. They spoke to The Associated Press in the months leading up to Rosalynn Carter’s death Sunday at age 96.

Cade stated that there has never been a leader in the mental health field who has had such a significant influence on mental health care, access to care, and our understanding of mental health and illness as Mrs. Carter. This is due to her deep concern for the issue and her determination over the span of 50 years.

During Carter’s run for governor in 1966, a commitment was sparked within Rosalynn to make a lasting impact. She received numerous complaints from voters about the state of overcrowding in a psychiatric hospital. One morning, she met a fatigued cotton mill worker who shared the struggle of caring for their mentally ill daughter while balancing opposite work schedules with their spouse.

Rosalynn Carter recalled in her 2010 book, “Within Our Reach: Ending the Mental Health Crisis,” that the woman’s image lingered on her mind throughout the day. That evening, she attended her husband’s campaign rally and stood in queue to greet him.

The candidate was surprised when she stated, “I am here to witness your plans for assisting individuals with mental disorders during your time as governor.”

Jimmy Carter responded by creating a state commission to improve services for those with mental illness. Then, as president, he created a national commission on mental health, which led to the passage of the Mental Health Systems Act of 1980, a major revamping of federal policy that sought to treat people with mental illness in their communities.

Rosalynn Carter served as the honorary co-chair of the commission and played a crucial role in pushing for the legislation. She traveled throughout the country, gathering input from experts and regular citizens, and presented her findings to Congress. While it was eventually overturned during the Reagan administration, supporters argue that it laid the foundation for many positive changes that have been made since then.

In 1991, at The Carter Center, she started a program focusing on mental health and later initiated fellowships for journalists covering this subject. She also pushed for a significant legislation in Congress that mandated insurance companies to offer equal coverage for mental health.

Those who collaborated with her throughout the years attest to Carter’s achievements being based on her empathy and ability to listen.

Cynthia Wainscott, a former chair of the board at Mental Health America, a nonprofit organization, described the source of her strength as stemming from her compassionate nature and attentive listening skills. Even in a bustling environment, she remains focused on the person she is speaking with, making them feel heard and valued.

According to Wainscott, she was a skilled and motivating organizer with keen intuition.

In preparation for the yearly mental health symposium, Carter proposed reaching out to a pollster to improve a crucial message: that 20% of the US population will experience a mental illness within a year. After conducting focus groups, the pollster discovered that the statistic was not believed, but when phrased as one in five Americans, it was accepted.

According to Wainscott, when the term “20%” is mentioned, one should imagine a group of 100 individuals where 20 of them are unwell. This can feel distant and complicated. On the other hand, if you say “one in five”, people tend to think about their own workplace, school, or neighborhood. Wainscott, who was also in charge of the National Mental Health Association of Georgia, stated this.

“She mentioned that had she not been present in the room, none of us would have considered consulting a pollster for guidance on how to word it. It was a brilliant idea.”

Bill Lichtenstein, a journalist, regarded Rosalynn Carter as the “patron saint” for individuals facing mental health challenges or behavioral issues.

Lichtenstein, who runs a media production company in Boston, was an investigative reporter for ABC News when he fell ill with manic depression in 1986. He went on to produce award-winning programs on recovery from mental illness, but he still remembers feeling shunned when he disclosed his own struggles. Carter’s desire to reduce such stigma is at the heart of her accomplishments, he said.

He stated that stigma is the biggest challenge in achieving goals such as increased funding for research and equal opportunities for individuals with mental health backgrounds in employment and housing.

Lichtenstein is a member of the board of advisors for The Carter Center’s fellowship program for mental health journalism. This program has assisted over 220 journalists from the United States and six other countries.

In 2005, Marion Scher, an independent journalist and writer from South Africa, received a fellowship. She had her debut piece, titled “When is it more than just a bad day?” published in a men’s health magazine, which included the contact information for a mental health organization. The reaction to this article was significant, particularly in a country where there is still a strong stigma surrounding mental health.

She reported that the phone had been constantly ringing for three weeks and additional counselors were needed to handle the influx of calls.

Scher currently provides mental health journalism opportunities in South Africa, thanks to support from local sponsors. This demonstrates the significant impact of The Carter Center’s fellowships and would not have been possible without Scher’s determination, according to Cade.

Carter was an active individual who did not settle for simply gathering experts for conversations. Instead, she actively sought ways to influence policy through shifting attitudes. Cade remembered how she would sit with her advisors and ask, “What actions can we take? What other measures can we explore?”

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Holly Ramer, a reporter for the Associated Press, was awarded the 2017-18 Rosalynn Carter Fellowship for her work in Mental Health Journalism.