March 25, 2022 • 32 mins
Join Denesha Snell and Dr. Eric Shult, psychologist for University Health, as they discuss racist historical systems and their impact on mental health treatment, trauma, and toxic stress and how to move forward.
Read the Show Notes (PDF)
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Denesha Snell (00:00):
Did the onset of COVID-19 and a racial awakening
create the perfect atmospherefor our city to face its
history.
This is Anatomy of a Crisis (00:10):
The Impact of Racism on Public
Health in America.
I'm your host, Denesha Snell.
Join me as we explore thehistory, systems, and people
that have shaped where we live,work and play.
(00:34):
So we have with us today Dr.
Eric Schult from Truman MedicalCenters.
So thank you for joining us forAnatomy of a Crisis: The Impact
of Racism on Public Health inAmerica.
I'm excited to have thisconversation with you because we
know that mental health is oneof the drivers behind the health
of a community, but before wejump into our topic, tell us a
(00:56):
little bit about yourself.
Dr. Eric Schult (00:58):
Hi, thank you for having me.
Yeah, so I I've been apsychologist at Truman medical
centers since the beginning of2013.
And I.
We've been focusing primarilyon, on inpatient psychiatric
care.
So I tend to work with peoplewho are kind of in high crisis,
high, acute sort of situations.
And in addition to that, I'vedone a lot of multicultural
work.
I've taught classes for master'slevel students focusing on
(01:19):
multiculturalism and then theresearch I have done focuses on
sort of subtle racist attitudesof white Americans.
So yeah, that's kind of the, themain sort of bullet points for
me.
Denesha Snell (01:29):
Okay, sweet, so, I love history.
And part of what we're doing onthis podcast is really talking
about how have we gotten to thisplace where we are, right.
COVID we talk about COVID beingthe great revealer, although
there were, these were thingsthat were already happening.
You know, COVID seemed toamplify those things that we
already knew were happening inplace.
(01:51):
So whether it's mental healthissues or housing, et cetera.
As humans, I know that we're allinterconnected and we can try to
heal ourselves by facing ourhistory.
So what I want to do is talkabout mental health, racism, and
the historical systems that haveled us to where we are today.
So can we talk a bit about someof the systems and the systemic
(02:12):
issues that you've seen,especially when it comes to
mental healthcare?
Dr. Eric Schult (02:16):
Yeah, I like how you phrased that, I think it
does reveal where we are, when apandemic happens it reveals
where we are at a given time.
And so we know that the peoplewho are dying from COVID tend to
have pre-existing health issues.
The question is, well, how didthat come to be?
And so when we're talking abouthistorical systems and it's
specifically within Kansas City,one of the things that pops up
(02:38):
is that we basically have what'scalled a Troost wall.
Right?
And so how did an arbitrarystreet that doesn't really mean
anything become this dividingline between the haves and the
have-nots and, you know, withoutspending too much time on this.
So this deals with things likeredlining, blockbusting, racial
steering in terms of, you know,someone who is qualified to have
(03:01):
a home, but a person of color isqualified to buy a home, but
they get steered into a sort ofneighborhood.
I think what's interesting, youknow, we know that that
redlining and a lot of these,racially discriminatory
practices have been outlawed bythe fair housing act since the
late sixties.
And for over 50 years, ourcommunity is still pretty
divided.
And when that happens, peopleare going to suffer, right?
(03:25):
So like we have a pandemic.
So, the people who arestruggling are the ones that
don't have the time to go gettested.
They can't do remote work.
They're already struggling withwith other health issues.
They don't have the resourcesthat help them get in to receive
those health crisis.
And I think what peoplesometimes struggle to realize
it's almost like a lack ofknowledge of history it's that
(03:47):
they didn't choose to be there.
They found themselves in asystem that locked them in to
that point in time.
Denesha Snell (03:55):
Right.
Absolutely.
So to carry people from, youknow, historically, and when
we're talking about mentalhealth and we look at these
systems and they all worktogether.
So whether that's housing,healthcare, just the segregation
in itself, so separate but equalwas never equal.
How did that look in the pastfor mental health and how has
that played out kind of over theyears?
(04:17):
Both systemically and on acommunity level.
Dr. Eric Schult (04:20):
Well, I mean to say that you're separate but
equal drives in this sort ofmentality, that I'm not good as
people that are different fromme.
And we even know this because,you know, one of the things that
undid Brown V Board of Educationis the doll study where children
of color looked at dolls ofdifferent racial backgrounds and
(04:41):
adults that look like them.
They thought that they wereugly.
And so I think, and so it'salmost.
If I live in a segregatedsystem, it's almost going to be
like the air I breathe in.
Denesha Snell (04:52):
Right.
Dr. Eric Schult (04:53):
So it's gonna, it's going to change how I think
about myself.
It's gonna change how I thinkabout my environment.
It's also going to change mybelief that if I am struggling,
there's someone who can help me.
Denesha Snell (05:03):
Right.
Dr. Eric Schult (05:03):
And part of that is the belief, but the
other part of that is that itmeans sort of, you know, if I
grew up in this sort ofresidential segregated community
there also just maybe a dearthor no places for me to go
anyways.
Denesha Snell (05:16):
Right.
Dr. Eric Schult (05:16):
So now the only thing I have to me, you know, is
probably my family or my sort ofextended support network to the
extent that that is kind ofaround me.
And so these are things thathappen, you know, decades,
centuries ago, and it still cankind of create this belief that
I don't know who I am.
If I do experience some sort oftraumatic event, who's going to
(05:37):
be there to help me because ofanything, what that sort of
segregation is going to show isthat, or it's going to send this
implicit and explicit message islike, we don't care.
Denesha Snell (05:47):
Right.
Dr. Eric Schult (05:47):
We you don't care what you're going through.
Or something even far morenefarious in that is I don't
believe you.
Denesha Snell (05:55):
Absolutely.
Dr. Eric Schult (05:56):
Right.
That's how that stuff can kindof seep in.
Denesha Snell (05:59):
Okay.
So we examine the socialdeterminants of health and the
centers for disease control theydefine the social determinants
of health as the conditions andthe environments where people
are born, live, learn, work,play, and worship that affect a
wide range of health functioningand quality of life, outcomes,
(06:21):
and risks.
So one of those determinants ishealth access, and we tend to
pile everything into healthaccess, mental health access,
and people will say, but youhave access to mental health.
You have these places likeTruman Medical Center and other
places that where you can go getmental health, but I want to dig
a bit deeper and talk not aboutthe access to mental health, but
(06:43):
how dealing with thesehistorical and present day
factors of racism affect themental health of a community.
So can we start by talkingabout, you can really talk about
whatever you want.
I was going to start withtrauma, but we can tell the
whole story if you, like.
Dr. Eric Schult (06:59):
I think if you want to look at trauma like
what's trauma, right?
So it's this emotional responseto a variety of events ranging
from a naturally occurringdisaster, or a car crash,
violence, sexual violence,things like that.
You know, it involves shock,terror.
It changes how you think itmesses with your emotions.
It changes your behaviors and itkind of ultimately really makes
(07:20):
you question the belief inyourself that this world is
predictable, fair, and just.
And so I think how thatintersects with race is that we
know if I'm living in asituation where from early
childhood and on I'm exposed toneglect, I'm exposed to abuse of
a variety of different kinds.
(07:41):
I grew up in a neighborhood thatisn't safe, there's inadequate
food resources, inadequateschool resources, all these sort
of come together to increase thelikelihood that I might
experience trauma and alsoincreases the likelihood that
how I deal with that traumamight not be particularly
healthy.
Denesha Snell (07:57):
Right.
So let's explore that a littlebit.
I mean, how does somebody knowif they've been traumatized?
I worked at public health for along time and people would say,
oh, we're fine, we're justgoing, you know, going through
life things happen.
How do you know if you've beentraumatized, even though to seek
help.
Dr. Eric Schult (08:12):
Yeah, well, I mean, there's definitely,
there's definitely resilienceand this can exist in sort of
like genetic as well as sort ofsocial conditions can also help
us sort of be resilient.
Right?
I think the thing that I'd wantto pay attention to, if I was
worried about trauma was how isthis impacting my thoughts,
emotions, and behaviors.
Right?
Am I having these intrusivesymptoms where I constantly
(08:35):
think about the event or theseries of events, I dwell on it?
I can't get out of my.
My emotions are all over theplace, you know, one a minute
and I'm fine, but the nextminute I might be anxious or
agitated, or just experiencing abunch of different emotions.
My behavior changes.
I try and avoid going out intothe environment or in the
specific part of the environmentwhere maybe that trauma happen.
(08:56):
And I think that sometimes whathappens with that behavior it's
like that avoidanceovergeneralizes.
So I've learned not to go tothis one space.
And now I'm starting to avoidother things.
And where that becomes reallybad is the avoidance keeps me
safe in my mind, although it'sdoing lots of other things, but
maybe I'm also during thosethings that could help me
recover.
(09:17):
I'm not seeking treatment, I'mnot spending time with my
friends or family, I'm not goingto work.
I'm not doing those things thatare naturally rewarding that are
valued and growing, and so thatcan kind of come together and
just cause many differentproblems.
Denesha Snell (09:30):
So let me ask you this.
When dealing with community andespecially communities of color
and the black community, what doyou see as a trend?
For mental health and seekingthat mental health access and
seeking services.
So maybe I have the access, butI feel like I'm okay.
Or I have this spiritual life,because I will tell you, as
(09:52):
black folks, descendants frompeople who were enslaved,
religion held a bigger peace toour wellbeing than anything
else.
So what do you find in thecommunities that you work.
Dr. Eric Schult (10:09):
Well, I think some of the things I've noticed
is that of the people that Iwork with, because they're
struggling and because they haveto survive economically, it's
almost like, I don't believethere's a time and place for me
to take time for myself.
And so, because of that, thestress of that might already
compound what I'm already goingthrough.
(10:29):
I think the other thing, and Ithink that this is like, what
makes a good multiculturalpsychologist is that I also
don't want to be likehistorically myopic, right?
There are reasons why a personof color may not trust me right
away.
And that's okay.
I mean, I may not share the samebehaviors and attributes as for
other people that they'veencountered, but I might look
(10:52):
like someone, you know, and so Ican understand how they're
distrust to me might be bakedinto their, into the culture or
growing up because of realthings that happened.
I mean, psychology unfortunatelyhas a lot of things to account
for.
And so likely now, you know, aswe're developing evidence-based
treatments for trauma, for othermental health issues, there's
(11:13):
also a much greater emphasis onmulticulturalism working with
people that are different fromus because as more people gained
access.
It's one thing to have theaccess.
It's another thing to seek itout.
And so we have to makeourselves, you know, be
available in a way to wheresomeone's going to want to come
back to us.
Denesha Snell (11:33):
Right.
And so not even just, you know,mental health, but as far as the
distrust of the medicalcommunity period.
Cause I think about things likethe Tuskegee experiment and
that's just the biggest one thatsticks out in my head.
But we also know that blackwomen had been experimented on
with OBGYNs, et cetera, etcetera had been sterilized when
(11:54):
they didn't ask to besterilized.
And so I think that there's awhole history there that even
sometimes, if we don't knowexactly and we can't pinpoint,
it's been passed down.
So what have you all done inyour field to say, hey, we
understand historically theseare the things that have
happened.
Dr. Eric Schult (12:12):
Well, I think for, I know in my training, the
big emphasis is justacknowledging the problem.
Racism is a real thing.
It's not something that's,make-believe only impact certain
people experiences with everydaysort of racist things, changes
your health.
It changes the trajectory ofyour health.
It also changes the trust levelof that you have in
(12:33):
professionals, right?
Like I might have the initialsand the certificates and all
that stuff, but that doesn'tmean you're going to trust me.
And so we focus a lot oninterpersonal skills, rapport
development, conceptualizingsomeone's mental health issues,
not in a vacuum, but in theworld that they live in.
Denesha Snell (12:49):
Okay.
Dr. Eric Schult (12:50):
And so I think utilizing that then helps us
deliver evidence-basedtreatments so that people can
get better and then return totheir communities and live safer
and better lives.
Denesha Snell (13:02):
Excellent.
So we talk about COVID as thisgreat revealer, right?
COVID revealed all this stuffthat was going on.
But 2020 was some kind of year.
I mean, it almost seemed like itwas the perfect storm between
our political climate.
The murders of George Floyd,Brianna Taylor, Ahmaud Arbery.
(13:22):
We know there's historicaltrauma.
Okay.
And I know that we carry some ofthat with us in our DNA, but is
there a such thing as like avicarious or secondary trauma
that we've been experiencing,especially as, as black people
are witnessing and seeing thingslike the murder of George Floyd.
Dr. Eric Schult (13:41):
So like, if I see racialized murder on TV does
that change how I feel about itor does it seem closer to me?
Denesha Snell (13:49):
Yes.
Dr. Eric Schult (13:50):
And I would say, yeah.
And I think part of it is, youknow, for white Americans from
people of color.
There are, there could be someshared experiences, dealing with
poverty, dealing withtransphobia homophobia, but
what's different are theseeveryday racial sort of
experiences.
And I think sometimes also wesort of associate that with
poverty, but I think whatresearch and research and
(14:11):
scholarship and this personalpandemic as shown us is that
people of all economic regionsof the ladder can experience
racism.
And so I think for a person ofcolor who sees that event and it
gets replayed and people talkabout it at work and there's all
these things that are going on.
I think it's almost like if thismakes sense, it's like it
shortens the distance from thatevent to you.
(14:34):
And it makes you more stressedout for yourself or for the
people that you care about.
And so then that's where some ofthose experiences we talked
about before of like, you know,your thinking, your behavior,
your emotions, you know, and,and also really another one is
physiology.
Denesha Snell (14:48):
Right?
Dr. Eric Schult (14:49):
Heart rate goes up, you know what I mean?
Like you're on, you have astartle response.
You're physically tense.
That's going to make a dent atsome point or another.
And so I guess, ultimately tocome back to your question, I
think because of the frequencyof experiencing everyday racial
events for people at alleconomic runs of the ladder,
then when a big event happens,it might just seem closer to
(15:12):
you, which then might activatesome of those sort of that
secondary or sort of traumaresponses that we were talking
about before.
Denesha Snell (15:17):
Absolutely.
I love the fact that you broughtthat up because it seems like no
matter where you sit, especiallyas a black person on the
socioeconomic, you know whereveryou sit on that ladder, We are
having the same conversationwith our kids.
Right?
And we could go to work withpeople say, but you're not those
(15:38):
people, but it doesn't matterbecause we have a shared
experiences and we know that wehave to educate our kids.
We have to teach them how to besafe.
And a lot of that came out ofhistorical.
Right?
There were things that my mothertaught me that her mother taught
her, that her mother taught her.
That was meant to keep them safeas they were living in the deep
(15:58):
south.
Right?
And even not even in Missouri,that's not considered the deep
south, but we know the historyof Missouri.
So I want to talk about thetoxic stress because that's
ultimately what it seems like tome is that it's it's living with
this toxic stress that getspassed on and passed on and
passed on and how that affectsour mental health.
Dr. Eric Schult (16:21):
Well, so I guess how I would define toxic
stress is it's the activation ofyour body's stress response
system without any sort ofprotection.
And so where this becomesimportant is especially in
childhood, I mean, this can be aproblem that I don't at all, you
(16:43):
know, aspects of one's life, butthis is really bad for
childhood.
If I experienced these sort ofongoing traumatic events and it
activates my stress responsesystem in this way.
It impacts brain development.
It literally changes our brainsarchitecture.
It impacts organ development.
And so for kids that are goingthrough this sort of ongoing
stress now it changes at leadsto cognitive impairment, it
(17:06):
leads to behavior problems, itleads to emotional issues.
If this keeps going throughone's lifetime, it also leaves
the wear and tear on your body.
Right?
Which puts you at risk forearlier death.
The other thing we know though,that there are racial
disparities and toxic stress.
And so I have to think about mysafety or my children's safety,
(17:28):
because I've had this encounteror there's the threat of this
encounter.
And I want to make sure that myloved ones don't go through
that, but that also stresses meout like no one's business.
And the cost of that is thatwe're not supposed to live in
fight or flight.
Now, don't get me wrong, in somerespects, we have to experience
(17:49):
stress.
It helps us problem solve, ithelps us develop resistance, but
we're not talking aboutadversity here and there.
This is like every single daybecause of something about me or
an experience I've had, my brainis on high alert.
And you're right, it's also truethat people of color they're
(18:11):
attaining education and economicmobility in a way that maybe
previous generations did not.
Denesha Snell (18:18):
Right.
Dr. Eric Schult (18:19):
Nevertheless, they can still have some of
those stressful.
And so I think maybe connectingthat to your point earlier,
that's like why maybe someonewith a college degree, solidly
middle-class, maybe evenupper-middle-class is still
telling their children to bewary of how you interact with
cops.
Denesha Snell (18:35):
Absolutely.
Absolutely.
So let's think about thisconsidering systemic, and often
cultural, historical roots ofracism.
What can institutional leadersdo, if anything, to change our
trajectory?
So that could be institutionalas far as government in the
political sphere, policy, oreven just our everyday corporate
(18:58):
life.
Dr. Eric Schult (19:00):
I think the main thing that maybe a starting
point, and this is what somecities and localities and
counties have done, which isjust this declare racism, a
public health problem.
Right?
And so this is what the KansasCity council did.
This is what Douglas county didin Kansas.
And I think part of it is.
(19:20):
There's no reason for us toaspire, to be racially
colorblind when we don't live ina society that looks like that.
So we have to be truthful and wehave to be straightforward.
And so it's almost like a moreadvantageous perspective might
be like racially colorconscious.
I know that there aredisparities that, they interact
with other parts of life, butthere are racial disparities.
(19:43):
And so part of that is thenrealizing we have a problem.
And so then we can kind ofmarshal our resources and sort
of come together to do somethingabout that problem.
So like on a federal level,that's probably something like
the ACA.
And so that's also Medicaidexpansion in various states.
When they don't have to worryabout their insurance, then
(20:03):
they're probably going to seekout preventative healthcare in a
way that they wouldn't if theygo to the ER and they're
constantly worried, how much isthis going to cost?
Denesha Snell (20:11):
Right.
Dr. Eric Schult (20:12):
There are definitely other local things.
Truman, we do have a programthat looks at social
determinants of health.
And they do that screening andkind of various clinics
throughout the hospital.
And that helps people affordtheir medications, it helps
people with transportation, ithelps people with access to
food, and so on and so forth.
And I, and I know that there aredifferent programs.
Built around, but it just seemslike there is a way that we can
(20:34):
do this federally and I'm surethere's a way that we do this
locally.
It just engender such strongresentment and, and strong
emotions.
Denesha Snell (20:43):
So, as Douglas county and as the city of Kansas
City has done saying racism is apublic health issue and they've
made these declarations and manypeople are saying, okay, you've
made this declaration.
So what, does that mean for us?
Dr. Eric Schult (20:59):
If that was the only thing that I would say that
that's not enough.
I think that that is justacknowledging the problem and
then hopefully marshalingresources to help intervene and
provide access to care in a waythat can do something about
that.
Now I know at least in Missouri,we did vote to expand Medicaid.
Denesha Snell (21:19):
Absolutely.
Dr. Eric Schult (21:20):
Right?
And that saves lives that helpsdeal with the toxic stress that
we're looking at before, causethat toxic stress can definitely
make dents and impacts on ourdevelopment, but there are also
things that we can do about it.
And so that it's not permanentand doesn't disable some of our
citizens.
And so I think by declaring itwe got to move to the next step
(21:43):
and then use policies thatactually make a real difference
for people such as giving themhealth insurance.
Denesha Snell (21:49):
Absolutely.
So I want to talk a little bitabout life expectancy and we
know what life expectancy lookslike in Kansas City.
We know that there are starkdifferences depending on the zip
code you live in.
I was reading earlier aboutdeaths for deaths of despair and
deaths from things like drugsand alcohol and suicide, but
(22:12):
with COVID and the people notbeing as connected, I would like
to talk a little bit about that.
Like, what does that lifeexpectancy look like and mean?
And especially when we'retalking about mental health and
your zip codes, let's talk a bitabout that.
Dr. Eric Schult (22:25):
So, I mean, there's kind of a lot unpack
with that.
Deaths that have been despairhave looked specifically at the
opiod epidemic.
That's sort of targeted kind ofwhite, rural communities.
And I think that's necessary.
It's creating health conditions,not only related to deaths and
other things, but that's alsonot the only crisis sort of
going on.
(22:46):
I think what COVID revealed iswhat are people supposed to do
if they can't work from home,they don't have time to go get
tested, and they're trying to beas financially responsible and
financially accrued as they can,they're gonna go, and they're
going to put them in cells instressful situations that also
(23:07):
might expose them to likeillness and death.
And then if they don't have theresources to work against some
of those factors, they're goingto struggle and they're going to
do the best they can, but it'salmost like you're working with
like one hand tied behind yourback.
We already knew, I mean evenbefore 2020, life expectancy had
sort of stalled.
(23:28):
Which is really crazy if youthink about it because of how
powerful, and how rich, and howinnovative our country is in
terms of developing strategiesto help people live.
But I think that's the power ofopioids, but it's also the power
of not looking into othercommunities that have probably
had other issues.
Denesha Snell (23:44):
Right.
So what would you say to thosewho say, you know, again, you
have these resources just go outand use them.
Like, I think it's hard, youknow, I hate the term, pull
yourself up by your bootstraps.
Right?
But you still, you still havepeople who, who believe that
that people could just go outand just change the trajectory
(24:06):
of their life.
But I want to talk a bit about.
Because I, in my eyes, and I'mnot a mental health
professional, but we look at howthe intersection of your social
economics, race, all of thosethings affect your trauma
response.
Can you dig a little deeper intothat?
Dr. Eric Schult (24:27):
So I think anyone in that situation whether
they're white Americans orpeople of color that stacks the
deck against them.
Right?
But as we talked about before,there are still racial
disparities.
And I think it's almost likemultiple things can be true at
the same time.
So anyone in those conditionscan struggle and racism is a
(24:47):
chronic stressor and it seems tobe a chronic stressor that isn't
only tied to poverty.
Right?
I mean, there is still racialdifferences.
As we said before, people areattaining education and economic
mobility in ways they hadn'tpreviously.
They're still having a hard timebuying homes.
The race that your name mightimply impacts the likelihood
that you get a call back for ajob offer.
Denesha Snell (25:06):
Right.
Dr. Eric Schult (25:07):
We're talking about trauma.
There's probably nothing moredifficult than a parent would
have to deal with is infantmortality.
And so the data is very clearthat African-Americans, for
example, are more likely to havehealth issues going in, which
then creates complications.
And so we know African-Americanwoman with a college education
(25:28):
and moderate, you know, SES isjust as likely to experience
infant mortality as a whiteAmerican woman who doesn't have
a high school diploma and haslow SES.
STS doesn't explain thatdifference.
Denesha Snell (25:42):
Right.
Dr. Eric Schult (25:43):
And so I think that we look at the intersection
of all that stuff.
Multiple groups of people canstruggle with poverty,
homophobia, transphobia,ableism, and things like that.
That is a commonality that Iwish we could sort of see in
each other and work to help witheach other.
And racism also interacts withall those things as well.
Denesha Snell (26:05):
Absolutely.
Absolutely.
Dr. Eric Schult (26:06):
It impacts the likelihood that I would want to
seek help from people that don'tlook like me.
Denesha Snell (26:11):
Absolutely.
So more and more, you know, wehear progressive politicians
talk about the history of racismand race relations as a root
cause of poverty and racializedtrauma.
What more can be learned fromthat history as it relates to
mental health?
Dr. Eric Schult (26:28):
Well, I think more that we can learn.
So again, you know, I've saidlike, I don't want us to not
know our history.
And so if we're thinkingspecifically about Kansas City.
This is everything from youknow, the homeowners loan
corporation.
This is what JC Nichols did.
Now the interesting thing aboutJC Nichols is like, he's also
been dead since the 1950s andour city still looks like this.
(26:51):
And so I think it's fundamentalthat we understand the history
of sort of disparate outcomes,right?
And unfortunately, part of thosedisparate outcomes is probably
related to psychologist sort ofmaybe not doing the right thing.
And this is everything fromeugenics to classify
homosexuality as a mentalillness.
As I said before, there's a lotfor us to atone for, and we're
(27:13):
doing that now, but I alsounderstand that there can be
like a residue or a legacyleftover from that and therefore
people may not be initiallyinclined to want to come see me
or another psychologist forthose reasons, even though
they've never met me.
And I think that's also againwhere the training on dealing
with people that are differentfrom us becomes so important.
Because someone's going to comewith that baggage.
(27:35):
It's part of my job, then buildrapport and help that person
feel more comfortable so theycan tell me what's really going
on with them.
Denesha Snell (27:41):
Right.
So would it be advantageous forthe medical community or those
professionals in the mentalhealth community to advocate for
more people of color in theprofession?
Would that make a difference?
Dr. Eric Schult (27:56):
Yeah.
I mean, this is something so APAor the American psychological
association, they talked aboutthis last year and one of their
initiatives was to get morepeople of color.
And I think, I mean, we know theresearch is clear when people
want mental health treatment,they want to work with someone
who looks like that.
Right?
Now it's more complicated as, asto what degree they do view that
(28:19):
as being effective.
So I might be more comfortablewith someone who looks like me
and my experience may not begreat with that.
So it's kind of like multiplethings that have to happen at
the same time.
We need better representation,so that, that might not sort of
trigger that initial hesitancyin the first place.
And in addition to that, we needthe multicultural training that
(28:39):
we've been focusing on for thepast 20 or 30 years, so that
ultimately people can work withpeople that are different from
them and provide quality care.
Denesha Snell (28:47):
So, for your average person, your average
Kansas Citian, how did weadvance this conversation?
And, you know, so what do I doas just an everyday person?
How do I help advance the needs?
Or, you know, what can I do asjust an everyday citizen that
maybe is not in this field?
(29:08):
What can I do to help advancethis conversation?
Dr. Eric Schult (29:11):
I guess the initial thing that comes to mind
is how can I help?
I'd wonder what are those sortof epicenters within different
communities?
Can I volunteer to help at afood kitchen?
Can I volunteer in a specificchurch community?
Are there other things, youknow, can I donate, food,
clothing, whatever it might be.
I guess I would look for forways to donate my time and
(29:33):
energy to people that need themost, because we also know that
food pantries, job training,things like that, those are also
things that help limit or helpreduce, you know, toxic stress.
And so I guess as like aneveryday sort of Kansas Citian
and I would just sort of maybelook to those as like, in terms
of behavior here and maybethings I could do.
Denesha Snell (29:53):
Okay.
And as we close thisconversation out, what would you
like to say maybe that youhaven't said yet?
Dr. Eric Schult (30:02):
Oh boy.
Well, I guess, you know, thereare ways that we can cope with
stress.
Whether you choose to see apsychologist, or you choose to
go to a counselor, you choose togo to not go to any one of those
groups.
And I guess the ultimate thingis if you're going for the,
through the type of stress thatwe're talking about, there are
(30:23):
different things that we can do.
And so one thing is it might bejust turning off the TV, right?
Give yourselves a littledistance from the kind of
ongoing media.
You know, loop that that's goingon a break from that may not be
so bad.
In addition to that, we talkedabout before that, like
behavioral avoidance is a majorissue with trauma.
(30:45):
Well, who are those people thatI can reconnect with?
I may be hesitant.
I may not enjoy it as much as Inormally would, but I'm still
getting out of my house or I'mgetting out of that place where
I'm trying to avoid others.
And I think repetition of thatcan help people.
Relaxation, this is anythingfrom deep breathing to
mindfulness activities,something that targets that
physiological Problems that wetalked about before trauma.
(31:08):
So that I can lower my heartrate, ease some of that tension,
and not put myself in a positionwhere my brain is going to shut
off because I'm constantly infight or flight.
For those of you that arereligious, seeking out spiritual
guidance, talking to a pastor,going to the church, and maybe
the message isn't somethingspecific to you, but just the
act of being around people andgetting out of that spot that
(31:31):
feels lonely and dark might bereally helpful too.
And so I guess those are justsort of the things that are kind
of on my mind about, you know,things that, that people can do.
Denesha Snell (31:39):
Excellent.
Well, Dr.
Eric Schult, thank you so muchfor joining us today on the
podcast.
I've enjoyed the conversation, Ilook forward to hearing more
from you in the future.
Dr. Eric Schult (31:50):
Thank you.
Denesha Snell (31:50):
I thank you.
Thank you for joining us foranother episode of Anatomy of a
Crisis to learn more about theservices offered at University
Health Behavioral Health.
Visit their website atuniversityhealthkc.org.
Announcer (32:07):
Thank you for joining us for Anatomy of a Crisis
Impact of Racism on PublicHealth in America.
This podcast is a production ofthe Kansas City Public Library
in partnership with the KansasCity Health Department.
We hope you enjoyed theconversation and until next
time, be well.
Did the onset of COVID-19 and a racial awakening
create the perfect atmospherefor our city to face its
history.
This is Anatomy of a Crisis (00:10):
The Impact of Racism on Public
Health in America.
I'm your host, Denesha Snell.
Join me as we explore thehistory, systems, and people
that have shaped where we live,work and play.
(00:34):
So we have with us today Dr.
Eric Schult from Truman MedicalCenters.
So thank you for joining us forAnatomy of a Crisis: The Impact
of Racism on Public Health inAmerica.
I'm excited to have thisconversation with you because we
know that mental health is oneof the drivers behind the health
of a community, but before wejump into our topic, tell us a
(00:56):
little bit about yourself.
Dr. Eric Schult (00:58):
Hi, thank you for having me.
Yeah, so I I've been apsychologist at Truman medical
centers since the beginning of2013.
And I.
We've been focusing primarilyon, on inpatient psychiatric
care.
So I tend to work with peoplewho are kind of in high crisis,
high, acute sort of situations.
And in addition to that, I'vedone a lot of multicultural
work.
I've taught classes for master'slevel students focusing on
(01:19):
multiculturalism and then theresearch I have done focuses on
sort of subtle racist attitudesof white Americans.
So yeah, that's kind of the, themain sort of bullet points for
me.
Denesha Snell (01:29):
Okay, sweet, so, I love history.
And part of what we're doing onthis podcast is really talking
about how have we gotten to thisplace where we are, right.
COVID we talk about COVID beingthe great revealer, although
there were, these were thingsthat were already happening.
You know, COVID seemed toamplify those things that we
already knew were happening inplace.
(01:51):
So whether it's mental healthissues or housing, et cetera.
As humans, I know that we're allinterconnected and we can try to
heal ourselves by facing ourhistory.
So what I want to do is talkabout mental health, racism, and
the historical systems that haveled us to where we are today.
So can we talk a bit about someof the systems and the systemic
(02:12):
issues that you've seen,especially when it comes to
mental healthcare?
Dr. Eric Schult (02:16):
Yeah, I like how you phrased that, I think it
does reveal where we are, when apandemic happens it reveals
where we are at a given time.
And so we know that the peoplewho are dying from COVID tend to
have pre-existing health issues.
The question is, well, how didthat come to be?
And so when we're talking abouthistorical systems and it's
specifically within Kansas City,one of the things that pops up
(02:38):
is that we basically have what'scalled a Troost wall.
Right?
And so how did an arbitrarystreet that doesn't really mean
anything become this dividingline between the haves and the
have-nots and, you know, withoutspending too much time on this.
So this deals with things likeredlining, blockbusting, racial
steering in terms of, you know,someone who is qualified to have
(03:01):
a home, but a person of color isqualified to buy a home, but
they get steered into a sort ofneighborhood.
I think what's interesting, youknow, we know that that
redlining and a lot of these,racially discriminatory
practices have been outlawed bythe fair housing act since the
late sixties.
And for over 50 years, ourcommunity is still pretty
divided.
And when that happens, peopleare going to suffer, right?
(03:25):
So like we have a pandemic.
So, the people who arestruggling are the ones that
don't have the time to go gettested.
They can't do remote work.
They're already struggling withwith other health issues.
They don't have the resourcesthat help them get in to receive
those health crisis.
And I think what peoplesometimes struggle to realize
it's almost like a lack ofknowledge of history it's that
(03:47):
they didn't choose to be there.
They found themselves in asystem that locked them in to
that point in time.
Denesha Snell (03:55):
Right.
Absolutely.
So to carry people from, youknow, historically, and when
we're talking about mentalhealth and we look at these
systems and they all worktogether.
So whether that's housing,healthcare, just the segregation
in itself, so separate but equalwas never equal.
How did that look in the pastfor mental health and how has
that played out kind of over theyears?
(04:17):
Both systemically and on acommunity level.
Dr. Eric Schult (04:20):
Well, I mean to say that you're separate but
equal drives in this sort ofmentality, that I'm not good as
people that are different fromme.
And we even know this because,you know, one of the things that
undid Brown V Board of Educationis the doll study where children
of color looked at dolls ofdifferent racial backgrounds and
(04:41):
adults that look like them.
They thought that they wereugly.
And so I think, and so it'salmost.
If I live in a segregatedsystem, it's almost going to be
like the air I breathe in.
Denesha Snell (04:52):
Right.
Dr. Eric Schult (04:53):
So it's gonna, it's going to change how I think
about myself.
It's gonna change how I thinkabout my environment.
It's also going to change mybelief that if I am struggling,
there's someone who can help me.
Denesha Snell (05:03):
Right.
Dr. Eric Schult (05:03):
And part of that is the belief, but the
other part of that is that itmeans sort of, you know, if I
grew up in this sort ofresidential segregated community
there also just maybe a dearthor no places for me to go
anyways.
Denesha Snell (05:16):
Right.
Dr. Eric Schult (05:16):
So now the only thing I have to me, you know, is
probably my family or my sort ofextended support network to the
extent that that is kind ofaround me.
And so these are things thathappen, you know, decades,
centuries ago, and it still cankind of create this belief that
I don't know who I am.
If I do experience some sort oftraumatic event, who's going to
(05:37):
be there to help me because ofanything, what that sort of
segregation is going to show isthat, or it's going to send this
implicit and explicit message islike, we don't care.
Denesha Snell (05:47):
Right.
Dr. Eric Schult (05:47):
We you don't care what you're going through.
Or something even far morenefarious in that is I don't
believe you.
Denesha Snell (05:55):
Absolutely.
Dr. Eric Schult (05:56):
Right.
That's how that stuff can kindof seep in.
Denesha Snell (05:59):
Okay.
So we examine the socialdeterminants of health and the
centers for disease control theydefine the social determinants
of health as the conditions andthe environments where people
are born, live, learn, work,play, and worship that affect a
wide range of health functioningand quality of life, outcomes,
(06:21):
and risks.
So one of those determinants ishealth access, and we tend to
pile everything into healthaccess, mental health access,
and people will say, but youhave access to mental health.
You have these places likeTruman Medical Center and other
places that where you can go getmental health, but I want to dig
a bit deeper and talk not aboutthe access to mental health, but
(06:43):
how dealing with thesehistorical and present day
factors of racism affect themental health of a community.
So can we start by talkingabout, you can really talk about
whatever you want.
I was going to start withtrauma, but we can tell the
whole story if you, like.
Dr. Eric Schult (06:59):
I think if you want to look at trauma like
what's trauma, right?
So it's this emotional responseto a variety of events ranging
from a naturally occurringdisaster, or a car crash,
violence, sexual violence,things like that.
You know, it involves shock,terror.
It changes how you think itmesses with your emotions.
It changes your behaviors and itkind of ultimately really makes
(07:20):
you question the belief inyourself that this world is
predictable, fair, and just.
And so I think how thatintersects with race is that we
know if I'm living in asituation where from early
childhood and on I'm exposed toneglect, I'm exposed to abuse of
a variety of different kinds.
(07:41):
I grew up in a neighborhood thatisn't safe, there's inadequate
food resources, inadequateschool resources, all these sort
of come together to increase thelikelihood that I might
experience trauma and alsoincreases the likelihood that
how I deal with that traumamight not be particularly
healthy.
Denesha Snell (07:57):
Right.
So let's explore that a littlebit.
I mean, how does somebody knowif they've been traumatized?
I worked at public health for along time and people would say,
oh, we're fine, we're justgoing, you know, going through
life things happen.
How do you know if you've beentraumatized, even though to seek
help.
Dr. Eric Schult (08:12):
Yeah, well, I mean, there's definitely,
there's definitely resilienceand this can exist in sort of
like genetic as well as sort ofsocial conditions can also help
us sort of be resilient.
Right?
I think the thing that I'd wantto pay attention to, if I was
worried about trauma was how isthis impacting my thoughts,
emotions, and behaviors.
Right?
Am I having these intrusivesymptoms where I constantly
(08:35):
think about the event or theseries of events, I dwell on it?
I can't get out of my.
My emotions are all over theplace, you know, one a minute
and I'm fine, but the nextminute I might be anxious or
agitated, or just experiencing abunch of different emotions.
My behavior changes.
I try and avoid going out intothe environment or in the
specific part of the environmentwhere maybe that trauma happen.
(08:56):
And I think that sometimes whathappens with that behavior it's
like that avoidanceovergeneralizes.
So I've learned not to go tothis one space.
And now I'm starting to avoidother things.
And where that becomes reallybad is the avoidance keeps me
safe in my mind, although it'sdoing lots of other things, but
maybe I'm also during thosethings that could help me
recover.
(09:17):
I'm not seeking treatment, I'mnot spending time with my
friends or family, I'm not goingto work.
I'm not doing those things thatare naturally rewarding that are
valued and growing, and so thatcan kind of come together and
just cause many differentproblems.
Denesha Snell (09:30):
So let me ask you this.
When dealing with community andespecially communities of color
and the black community, what doyou see as a trend?
For mental health and seekingthat mental health access and
seeking services.
So maybe I have the access, butI feel like I'm okay.
Or I have this spiritual life,because I will tell you, as
(09:52):
black folks, descendants frompeople who were enslaved,
religion held a bigger peace toour wellbeing than anything
else.
So what do you find in thecommunities that you work.
Dr. Eric Schult (10:09):
Well, I think some of the things I've noticed
is that of the people that Iwork with, because they're
struggling and because they haveto survive economically, it's
almost like, I don't believethere's a time and place for me
to take time for myself.
And so, because of that, thestress of that might already
compound what I'm already goingthrough.
(10:29):
I think the other thing, and Ithink that this is like, what
makes a good multiculturalpsychologist is that I also
don't want to be likehistorically myopic, right?
There are reasons why a personof color may not trust me right
away.
And that's okay.
I mean, I may not share the samebehaviors and attributes as for
other people that they'veencountered, but I might look
(10:52):
like someone, you know, and so Ican understand how they're
distrust to me might be bakedinto their, into the culture or
growing up because of realthings that happened.
I mean, psychology unfortunatelyhas a lot of things to account
for.
And so likely now, you know, aswe're developing evidence-based
treatments for trauma, for othermental health issues, there's
(11:13):
also a much greater emphasis onmulticulturalism working with
people that are different fromus because as more people gained
access.
It's one thing to have theaccess.
It's another thing to seek itout.
And so we have to makeourselves, you know, be
available in a way to wheresomeone's going to want to come
back to us.
Denesha Snell (11:33):
Right.
And so not even just, you know,mental health, but as far as the
distrust of the medicalcommunity period.
Cause I think about things likethe Tuskegee experiment and
that's just the biggest one thatsticks out in my head.
But we also know that blackwomen had been experimented on
with OBGYNs, et cetera, etcetera had been sterilized when
(11:54):
they didn't ask to besterilized.
And so I think that there's awhole history there that even
sometimes, if we don't knowexactly and we can't pinpoint,
it's been passed down.
So what have you all done inyour field to say, hey, we
understand historically theseare the things that have
happened.
Dr. Eric Schult (12:12):
Well, I think for, I know in my training, the
big emphasis is justacknowledging the problem.
Racism is a real thing.
It's not something that's,make-believe only impact certain
people experiences with everydaysort of racist things, changes
your health.
It changes the trajectory ofyour health.
It also changes the trust levelof that you have in
(12:33):
professionals, right?
Like I might have the initialsand the certificates and all
that stuff, but that doesn'tmean you're going to trust me.
And so we focus a lot oninterpersonal skills, rapport
development, conceptualizingsomeone's mental health issues,
not in a vacuum, but in theworld that they live in.
Denesha Snell (12:49):
Okay.
Dr. Eric Schult (12:50):
And so I think utilizing that then helps us
deliver evidence-basedtreatments so that people can
get better and then return totheir communities and live safer
and better lives.
Denesha Snell (13:02):
Excellent.
So we talk about COVID as thisgreat revealer, right?
COVID revealed all this stuffthat was going on.
But 2020 was some kind of year.
I mean, it almost seemed like itwas the perfect storm between
our political climate.
The murders of George Floyd,Brianna Taylor, Ahmaud Arbery.
(13:22):
We know there's historicaltrauma.
Okay.
And I know that we carry some ofthat with us in our DNA, but is
there a such thing as like avicarious or secondary trauma
that we've been experiencing,especially as, as black people
are witnessing and seeing thingslike the murder of George Floyd.
Dr. Eric Schult (13:41):
So like, if I see racialized murder on TV does
that change how I feel about itor does it seem closer to me?
Denesha Snell (13:49):
Yes.
Dr. Eric Schult (13:50):
And I would say, yeah.
And I think part of it is, youknow, for white Americans from
people of color.
There are, there could be someshared experiences, dealing with
poverty, dealing withtransphobia homophobia, but
what's different are theseeveryday racial sort of
experiences.
And I think sometimes also wesort of associate that with
poverty, but I think whatresearch and research and
(14:11):
scholarship and this personalpandemic as shown us is that
people of all economic regionsof the ladder can experience
racism.
And so I think for a person ofcolor who sees that event and it
gets replayed and people talkabout it at work and there's all
these things that are going on.
I think it's almost like if thismakes sense, it's like it
shortens the distance from thatevent to you.
(14:34):
And it makes you more stressedout for yourself or for the
people that you care about.
And so then that's where some ofthose experiences we talked
about before of like, you know,your thinking, your behavior,
your emotions, you know, and,and also really another one is
physiology.
Denesha Snell (14:48):
Right?
Dr. Eric Schult (14:49):
Heart rate goes up, you know what I mean?
Like you're on, you have astartle response.
You're physically tense.
That's going to make a dent atsome point or another.
And so I guess, ultimately tocome back to your question, I
think because of the frequencyof experiencing everyday racial
events for people at alleconomic runs of the ladder,
then when a big event happens,it might just seem closer to
(15:12):
you, which then might activatesome of those sort of that
secondary or sort of traumaresponses that we were talking
about before.
Denesha Snell (15:17):
Absolutely.
I love the fact that you broughtthat up because it seems like no
matter where you sit, especiallyas a black person on the
socioeconomic, you know whereveryou sit on that ladder, We are
having the same conversationwith our kids.
Right?
And we could go to work withpeople say, but you're not those
(15:38):
people, but it doesn't matterbecause we have a shared
experiences and we know that wehave to educate our kids.
We have to teach them how to besafe.
And a lot of that came out ofhistorical.
Right?
There were things that my mothertaught me that her mother taught
her, that her mother taught her.
That was meant to keep them safeas they were living in the deep
(15:58):
south.
Right?
And even not even in Missouri,that's not considered the deep
south, but we know the historyof Missouri.
So I want to talk about thetoxic stress because that's
ultimately what it seems like tome is that it's it's living with
this toxic stress that getspassed on and passed on and
passed on and how that affectsour mental health.
Dr. Eric Schult (16:21):
Well, so I guess how I would define toxic
stress is it's the activation ofyour body's stress response
system without any sort ofprotection.
And so where this becomesimportant is especially in
childhood, I mean, this can be aproblem that I don't at all, you
(16:43):
know, aspects of one's life, butthis is really bad for
childhood.
If I experienced these sort ofongoing traumatic events and it
activates my stress responsesystem in this way.
It impacts brain development.
It literally changes our brainsarchitecture.
It impacts organ development.
And so for kids that are goingthrough this sort of ongoing
stress now it changes at leadsto cognitive impairment, it
(17:06):
leads to behavior problems, itleads to emotional issues.
If this keeps going throughone's lifetime, it also leaves
the wear and tear on your body.
Right?
Which puts you at risk forearlier death.
The other thing we know though,that there are racial
disparities and toxic stress.
And so I have to think about mysafety or my children's safety,
(17:28):
because I've had this encounteror there's the threat of this
encounter.
And I want to make sure that myloved ones don't go through
that, but that also stresses meout like no one's business.
And the cost of that is thatwe're not supposed to live in
fight or flight.
Now, don't get me wrong, in somerespects, we have to experience
(17:49):
stress.
It helps us problem solve, ithelps us develop resistance, but
we're not talking aboutadversity here and there.
This is like every single daybecause of something about me or
an experience I've had, my brainis on high alert.
And you're right, it's also truethat people of color they're
(18:11):
attaining education and economicmobility in a way that maybe
previous generations did not.
Denesha Snell (18:18):
Right.
Dr. Eric Schult (18:19):
Nevertheless, they can still have some of
those stressful.
And so I think maybe connectingthat to your point earlier,
that's like why maybe someonewith a college degree, solidly
middle-class, maybe evenupper-middle-class is still
telling their children to bewary of how you interact with
cops.
Denesha Snell (18:35):
Absolutely.
Absolutely.
So let's think about thisconsidering systemic, and often
cultural, historical roots ofracism.
What can institutional leadersdo, if anything, to change our
trajectory?
So that could be institutionalas far as government in the
political sphere, policy, oreven just our everyday corporate
(18:58):
life.
Dr. Eric Schult (19:00):
I think the main thing that maybe a starting
point, and this is what somecities and localities and
counties have done, which isjust this declare racism, a
public health problem.
Right?
And so this is what the KansasCity council did.
This is what Douglas county didin Kansas.
And I think part of it is.
(19:20):
There's no reason for us toaspire, to be racially
colorblind when we don't live ina society that looks like that.
So we have to be truthful and wehave to be straightforward.
And so it's almost like a moreadvantageous perspective might
be like racially colorconscious.
I know that there aredisparities that, they interact
with other parts of life, butthere are racial disparities.
(19:43):
And so part of that is thenrealizing we have a problem.
And so then we can kind ofmarshal our resources and sort
of come together to do somethingabout that problem.
So like on a federal level,that's probably something like
the ACA.
And so that's also Medicaidexpansion in various states.
When they don't have to worryabout their insurance, then
(20:03):
they're probably going to seekout preventative healthcare in a
way that they wouldn't if theygo to the ER and they're
constantly worried, how much isthis going to cost?
Denesha Snell (20:11):
Right.
Dr. Eric Schult (20:12):
There are definitely other local things.
Truman, we do have a programthat looks at social
determinants of health.
And they do that screening andkind of various clinics
throughout the hospital.
And that helps people affordtheir medications, it helps
people with transportation, ithelps people with access to
food, and so on and so forth.
And I, and I know that there aredifferent programs.
Built around, but it just seemslike there is a way that we can
(20:34):
do this federally and I'm surethere's a way that we do this
locally.
It just engender such strongresentment and, and strong
emotions.
Denesha Snell (20:43):
So, as Douglas county and as the city of Kansas
City has done saying racism is apublic health issue and they've
made these declarations and manypeople are saying, okay, you've
made this declaration.
So what, does that mean for us?
Dr. Eric Schult (20:59):
If that was the only thing that I would say that
that's not enough.
I think that that is justacknowledging the problem and
then hopefully marshalingresources to help intervene and
provide access to care in a waythat can do something about
that.
Now I know at least in Missouri,we did vote to expand Medicaid.
Denesha Snell (21:19):
Absolutely.
Dr. Eric Schult (21:20):
Right?
And that saves lives that helpsdeal with the toxic stress that
we're looking at before, causethat toxic stress can definitely
make dents and impacts on ourdevelopment, but there are also
things that we can do about it.
And so that it's not permanentand doesn't disable some of our
citizens.
And so I think by declaring itwe got to move to the next step
(21:43):
and then use policies thatactually make a real difference
for people such as giving themhealth insurance.
Denesha Snell (21:49):
Absolutely.
So I want to talk a little bitabout life expectancy and we
know what life expectancy lookslike in Kansas City.
We know that there are starkdifferences depending on the zip
code you live in.
I was reading earlier aboutdeaths for deaths of despair and
deaths from things like drugsand alcohol and suicide, but
(22:12):
with COVID and the people notbeing as connected, I would like
to talk a little bit about that.
Like, what does that lifeexpectancy look like and mean?
And especially when we'retalking about mental health and
your zip codes, let's talk a bitabout that.
Dr. Eric Schult (22:25):
So, I mean, there's kind of a lot unpack
with that.
Deaths that have been despairhave looked specifically at the
opiod epidemic.
That's sort of targeted kind ofwhite, rural communities.
And I think that's necessary.
It's creating health conditions,not only related to deaths and
other things, but that's alsonot the only crisis sort of
going on.
(22:46):
I think what COVID revealed iswhat are people supposed to do
if they can't work from home,they don't have time to go get
tested, and they're trying to beas financially responsible and
financially accrued as they can,they're gonna go, and they're
going to put them in cells instressful situations that also
(23:07):
might expose them to likeillness and death.
And then if they don't have theresources to work against some
of those factors, they're goingto struggle and they're going to
do the best they can, but it'salmost like you're working with
like one hand tied behind yourback.
We already knew, I mean evenbefore 2020, life expectancy had
sort of stalled.
(23:28):
Which is really crazy if youthink about it because of how
powerful, and how rich, and howinnovative our country is in
terms of developing strategiesto help people live.
But I think that's the power ofopioids, but it's also the power
of not looking into othercommunities that have probably
had other issues.
Denesha Snell (23:44):
Right.
So what would you say to thosewho say, you know, again, you
have these resources just go outand use them.
Like, I think it's hard, youknow, I hate the term, pull
yourself up by your bootstraps.
Right?
But you still, you still havepeople who, who believe that
that people could just go outand just change the trajectory
(24:06):
of their life.
But I want to talk a bit about.
Because I, in my eyes, and I'mnot a mental health
professional, but we look at howthe intersection of your social
economics, race, all of thosethings affect your trauma
response.
Can you dig a little deeper intothat?
Dr. Eric Schult (24:27):
So I think anyone in that situation whether
they're white Americans orpeople of color that stacks the
deck against them.
Right?
But as we talked about before,there are still racial
disparities.
And I think it's almost likemultiple things can be true at
the same time.
So anyone in those conditionscan struggle and racism is a
(24:47):
chronic stressor and it seems tobe a chronic stressor that isn't
only tied to poverty.
Right?
I mean, there is still racialdifferences.
As we said before, people areattaining education and economic
mobility in ways they hadn'tpreviously.
They're still having a hard timebuying homes.
The race that your name mightimply impacts the likelihood
that you get a call back for ajob offer.
Denesha Snell (25:06):
Right.
Dr. Eric Schult (25:07):
We're talking about trauma.
There's probably nothing moredifficult than a parent would
have to deal with is infantmortality.
And so the data is very clearthat African-Americans, for
example, are more likely to havehealth issues going in, which
then creates complications.
And so we know African-Americanwoman with a college education
(25:28):
and moderate, you know, SES isjust as likely to experience
infant mortality as a whiteAmerican woman who doesn't have
a high school diploma and haslow SES.
STS doesn't explain thatdifference.
Denesha Snell (25:42):
Right.
Dr. Eric Schult (25:43):
And so I think that we look at the intersection
of all that stuff.
Multiple groups of people canstruggle with poverty,
homophobia, transphobia,ableism, and things like that.
That is a commonality that Iwish we could sort of see in
each other and work to help witheach other.
And racism also interacts withall those things as well.
Denesha Snell (26:05):
Absolutely.
Absolutely.
Dr. Eric Schult (26:06):
It impacts the likelihood that I would want to
seek help from people that don'tlook like me.
Denesha Snell (26:11):
Absolutely.
So more and more, you know, wehear progressive politicians
talk about the history of racismand race relations as a root
cause of poverty and racializedtrauma.
What more can be learned fromthat history as it relates to
mental health?
Dr. Eric Schult (26:28):
Well, I think more that we can learn.
So again, you know, I've saidlike, I don't want us to not
know our history.
And so if we're thinkingspecifically about Kansas City.
This is everything from youknow, the homeowners loan
corporation.
This is what JC Nichols did.
Now the interesting thing aboutJC Nichols is like, he's also
been dead since the 1950s andour city still looks like this.
(26:51):
And so I think it's fundamentalthat we understand the history
of sort of disparate outcomes,right?
And unfortunately, part of thosedisparate outcomes is probably
related to psychologist sort ofmaybe not doing the right thing.
And this is everything fromeugenics to classify
homosexuality as a mentalillness.
As I said before, there's a lotfor us to atone for, and we're
(27:13):
doing that now, but I alsounderstand that there can be
like a residue or a legacyleftover from that and therefore
people may not be initiallyinclined to want to come see me
or another psychologist forthose reasons, even though
they've never met me.
And I think that's also againwhere the training on dealing
with people that are differentfrom us becomes so important.
Because someone's going to comewith that baggage.
(27:35):
It's part of my job, then buildrapport and help that person
feel more comfortable so theycan tell me what's really going
on with them.
Denesha Snell (27:41):
Right.
So would it be advantageous forthe medical community or those
professionals in the mentalhealth community to advocate for
more people of color in theprofession?
Would that make a difference?
Dr. Eric Schult (27:56):
Yeah.
I mean, this is something so APAor the American psychological
association, they talked aboutthis last year and one of their
initiatives was to get morepeople of color.
And I think, I mean, we know theresearch is clear when people
want mental health treatment,they want to work with someone
who looks like that.
Right?
Now it's more complicated as, asto what degree they do view that
(28:19):
as being effective.
So I might be more comfortablewith someone who looks like me
and my experience may not begreat with that.
So it's kind of like multiplethings that have to happen at
the same time.
We need better representation,so that, that might not sort of
trigger that initial hesitancyin the first place.
And in addition to that, we needthe multicultural training that
(28:39):
we've been focusing on for thepast 20 or 30 years, so that
ultimately people can work withpeople that are different from
them and provide quality care.
Denesha Snell (28:47):
So, for your average person, your average
Kansas Citian, how did weadvance this conversation?
And, you know, so what do I doas just an everyday person?
How do I help advance the needs?
Or, you know, what can I do asjust an everyday citizen that
maybe is not in this field?
(29:08):
What can I do to help advancethis conversation?
Dr. Eric Schult (29:11):
I guess the initial thing that comes to mind
is how can I help?
I'd wonder what are those sortof epicenters within different
communities?
Can I volunteer to help at afood kitchen?
Can I volunteer in a specificchurch community?
Are there other things, youknow, can I donate, food,
clothing, whatever it might be.
I guess I would look for forways to donate my time and
(29:33):
energy to people that need themost, because we also know that
food pantries, job training,things like that, those are also
things that help limit or helpreduce, you know, toxic stress.
And so I guess as like aneveryday sort of Kansas Citian
and I would just sort of maybelook to those as like, in terms
of behavior here and maybethings I could do.
Denesha Snell (29:53):
Okay.
And as we close thisconversation out, what would you
like to say maybe that youhaven't said yet?
Dr. Eric Schult (30:02):
Oh boy.
Well, I guess, you know, thereare ways that we can cope with
stress.
Whether you choose to see apsychologist, or you choose to
go to a counselor, you choose togo to not go to any one of those
groups.
And I guess the ultimate thingis if you're going for the,
through the type of stress thatwe're talking about, there are
(30:23):
different things that we can do.
And so one thing is it might bejust turning off the TV, right?
Give yourselves a littledistance from the kind of
ongoing media.
You know, loop that that's goingon a break from that may not be
so bad.
In addition to that, we talkedabout before that, like
behavioral avoidance is a majorissue with trauma.
(30:45):
Well, who are those people thatI can reconnect with?
I may be hesitant.
I may not enjoy it as much as Inormally would, but I'm still
getting out of my house or I'mgetting out of that place where
I'm trying to avoid others.
And I think repetition of thatcan help people.
Relaxation, this is anythingfrom deep breathing to
mindfulness activities,something that targets that
physiological Problems that wetalked about before trauma.
(31:08):
So that I can lower my heartrate, ease some of that tension,
and not put myself in a positionwhere my brain is going to shut
off because I'm constantly infight or flight.
For those of you that arereligious, seeking out spiritual
guidance, talking to a pastor,going to the church, and maybe
the message isn't somethingspecific to you, but just the
act of being around people andgetting out of that spot that
(31:31):
feels lonely and dark might bereally helpful too.
And so I guess those are justsort of the things that are kind
of on my mind about, you know,things that, that people can do.
Denesha Snell (31:39):
Excellent.
Well, Dr.
Eric Schult, thank you so muchfor joining us today on the
podcast.
I've enjoyed the conversation, Ilook forward to hearing more
from you in the future.
Dr. Eric Schult (31:50):
Thank you.
Denesha Snell (31:50):
I thank you.
Thank you for joining us foranother episode of Anatomy of a
Crisis to learn more about theservices offered at University
Health Behavioral Health.
Visit their website atuniversityhealthkc.org.
Announcer (32:07):
Thank you for joining us for Anatomy of a Crisis
Impact of Racism on PublicHealth in America.
This podcast is a production ofthe Kansas City Public Library
in partnership with the KansasCity Health Department.
We hope you enjoyed theconversation and until next
time, be well.
Popular Podcasts
On Purpose with Jay Shetty
I’m Jay Shetty host of On Purpose the worlds #1 Mental Health podcast and I’m so grateful you found us. I started this podcast 5 years ago to invite you into conversations and workshops that are designed to help make you happier, healthier and more healed. I believe that when you (yes you) feel seen, heard and understood you’re able to deal with relationship struggles, work challenges and life’s ups and downs with more ease and grace. I interview experts, celebrities, thought leaders and athletes so that we can grow our mindset, build better habits and uncover a side of them we’ve never seen before. New episodes every Monday and Friday. Your support means the world to me and I don’t take it for granted — click the follow button and leave a review to help us spread the love with On Purpose. I can’t wait for you to listen to your first or 500th episode!
Dateline NBC
Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations. Follow now to get the latest episodes of Dateline NBC completely free, or subscribe to Dateline Premium for ad-free listening and exclusive bonus content: DatelinePremium.com
Cold Case Files: Miami
Joyce Sapp, 76; Bryan Herrera, 16; and Laurance Webb, 32—three Miami residents whose lives were stolen in brutal, unsolved homicides.  Cold Case Files: Miami follows award‑winning radio host and City of Miami Police reserve officer  Enrique Santos as he partners with the department’s Cold Case Homicide Unit, determined family members, and the advocates who spend their lives fighting for justice for the victims who can no longer fight for themselves.