Beyond Introspection: A Podcast About Neurodivergence & Identity

Intersectionality: Location, Location, Location

• BeyondPodcast • Season 3 • Episode 2

Share episode

Harvey and Pen discuss the areas they grew up in, research on mental health in those places, and the availability of resources.

Featuring: When I say small town, I mean small town; Mental health resources? In my rural area? It's about as likely as you'd think (which is to say there's none); "Oh, mental health? That's under beef."; Nobody studies suburbs; McCarthysism, moral panics, and oh shoot that's why it's called "nuclear family"; Small town accountability vs suburban teen cruelty; Four options: a history major reading an essay, a high schooler trying to pass their test,  a history buff who I really don't want to talk to, or Harvey.

Referenced Research:


Suicide Hotline & Resources for Trans People: 

https://translifeline.org/


USA Suicide Prevention: 

https://suicidepreventionlifeline.org/


International Suicide Hotlines: 

https://www.opencounseling.com/suicide-hotlines


Suicide Hotline & Resources for LGBTQ+ Young People: 

https://www.thetrevorproject.org/


Ways to support Black Lives Matter and find anti-racism resources:

https://linktr.ee/blacklivesmatte

Resources to support AAPI (Asian-American & Pacific Islander) communities:

https://www.advancingjustice-aajc.org/

https://stopaapihate.org/


Resources for US Immigrants:

https://www.informedimmigrant.com/


Resources to Support Undocumented Immigrants in the US:

https://immigrationjustice.us/

Pen:

Hello, everyone, and welcome to Beyond Introspection: A podcast about mental health, neurodivergence, and how it impacts literally every aspect of our lives.

Harvey:

All of them.

Pen:

I'm Pen.

Harvey:

And I'm Harvey.

Pen:

And this week, we are going to be talking about location as it impacts mental health, neurodivergence... specifically, like, access to resources and things.

Harvey:

Uh-huh. Mm-hmm.

Pen:

As part of our season three discussions on intersectionality.

Harvey:

Yes.

Pen:

Because I grew up in an extremely rural area.

Harvey:

And I grew up in the Chicago suburbs.

Pen:

Which are, in case y'all did not know, different.

Harvey:

And also, both awful.

Pen:

Yeah, it is different. It's a...

Harvey:

It's a different kind of awful.

Pen:

There's flaws and things...

Harvey:

And not... dislike.

Pen:

It's... honestly, like, I don't think there is an ideal scenario.

Harvey:

No.

Pen:

I - I don't. I've spent more and more time in recent months, in the past couple years, thinking about rural areas and how, like, hmm, there are certainly flaws, and also, urban Democrats? I would like to talk to you.

Harvey:

Right? It's - it's, you know, we can probably get more into that later, but the - the tendency for urban Democrats to not recognize the particular needs of people in rural areas, and the reasons why they might lean right, is, uh, exhausting, and shut up.

Pen:

Yeah, it's, like, fundamentally busted, and just the lack of access to resources. My mom has been a teacher basically my whole life, and let me tell y'all a fun thing: funding for schools in rural areas doesn't exist.

Harvey:

No.

Pen:

My mom switched to a different school district this year, which, good for her, frankly.

Harvey:

Yeah.

Pen:

I'm pretty sure they've yet to replace her.

Harvey:

Huh!

Pen:

She's one of two science - she was one of two science teachers for the entire junior high and high school.

Harvey:

Uh-oh.

Pen:

Yeah.

Harvey:

That's, uh... oops.

Pen:

Yeah, that happened during my senior year, and we were taught the whole year by sub.

Harvey:

Shiiiii... man!

Pen:

Yeah. So, I didn't learn chemistry.

Harvey:

That's... uh-oh. Did you watch Osmosis Jones?

Pen:

No!

Harvey:

Ugh!

Pen:

God, why not? I think we did one of my mom's classes.

Harvey:

I've actually never seen Osmosis Jones myself.

Pen:

I saw it a lot as a kid, because I wanted to hear stories about cells.

Harvey:

I love you. I love you so much.

Pen:

Anyway, hey, Harvey.

Harvey:

Pen.

Pen:

Tell me...

Harvey:

Yes.

Pen:

Your...

Harvey:

Yeah.

Pen:

Wahoo!

Harvey:

Yeah!

Pen:

Moment of the Week. I've never done it. It's never been me before.

Harvey:

Role reversal.

Pen:

Yeah.

Harvey:

God, that's so cool.

Pen:

So, tell me about your partners!

Harvey:

I had a different one. I had a whole different one planned out, and you come into my house, and you disrespect me-

Pen:

You are in my apartment right now.

Harvey:

Yeah, I know. Okay. So actually, this was - today, I actually have something different to talk about, because it was very poggers and epic, even. It was... so I won this award through my university - which, this actually is not the Wahoo Moment, although this is cool - I won an award through my university. And I... basically what it was for is, um... it was introduced, I believe, last year, and it's awarded to people who make some kind of effort to make my university, like, a more inclusive space.

Pen:

Just, like, generally?

Harvey:

Yeah, just in general.

Pen:

I didn't, you won this. I didn't know this existed.

Harvey:

Yeah, it's pretty new. And I... yeah, sorry, I didn't mention it.

Pen:

No, it's okay. Congratulations!

Harvey:

Why, thank you! Um, and as far as I know, all of the other people who have won it have been, like, long-standing faculty members.

Pen:

Oh-ho-ho!

Harvey:

So it's actually kind of a big deal.

Pen:

Yeah! That's rad!

Harvey:

So that was cool, and here's where I get to talk a little bit too much about my mommy issues. I wanted to tell her about it, but because my university is halfway decent, um, it's got my - my, you know, my actual name on it, like my preferred name, as opposed to my legal name.

Pen:

Yep, yep, yep.

Harvey:

And I was like, well, my mom's probably gonna, you know, pitch a fit about it if I show her, because, like, I've told her that I go by Harvey. We just don't talk about it.

Pen:

Yeah, we don't.

Harvey:

I mean, we just avoid that.

Pen:

I got you ice cream after that, right? I know that that was my promise.

Harvey:

It was a couple... like, I think it was, like, a month after but you're like, "Hey, I still owe you ice cream." And I'm like, [sniffling] yeah. But, so there's a - shockingly, this, uh, the positive parties about Reddit.

Pen:

Whoa!

Harvey:

I know, right?

Pen:

Yeah, that doesn't happen.

Harvey:

No, there was a - there's a subreddit called Mom for a Minute, wherein people post... people will, like, post things that they, like, want to say to their moms, but can't for a variety of reasons, and then, like, moms or mom-adjacent people will come in and... and say things. So I posted that, and it got something like 2000 upvotes...

Pen:

Aww!

Harvey:

...and a lot of really sweet comments from moms being like, "I'm so proud of you." And I'm like, [sniffling] yeah?

Pen:

That's so sweet!

Harvey:

So, these these very nice Reddit moms... There's a nonzero chance that one of y'all listens to this podcast, so, uh, thanks.

Pen:

Oh, that's so sweet.

Harvey:

What is your Wahoo! Moment of the Week?

Pen:

Yeah, even though I'm the one who brought it up, I realized, like, 10 seconds ago that I didn't actually have anything prepped.

Harvey:

Such is Pen.

Pen:

Yeah, yeah, su- ooh, such is Pen. But... oh! I know. Um, so I, as I mentioned, in our very first episode, I play Magic the Gathering, but I still have rights. Would you believe that? Imagine.

Harvey:

You're on thin ice.

Pen:

That's... no, that's actually - that's fair. But I really enjoy it. I have a lot of fun with it. And...

Harvey:

Heh, nerd.

Pen:

Yeah, that's fair.

Harvey:

I'm just teasing.

Pen:

Geek check at myself.

Harvey:

I support you very much, and I'm so glad you like Magic the Gathering. Truly.

Pen:

I do. Thank you. It's fun. I like doing things with it. Though, oh, my God, if I put all the money into it... ugh! You know, there are cards that cost literally $42,000?

Harvey:

What on earth? Yup. I know you're not that kind of nerd, so like... We don't. But we don't like her.

Pen:

No! Also like... meh. But I've been playing it a lot with my roommate. We average, like, three games a day. And last Not a fan. But like last night with, uh, with my night, I played with my girlfriend for the first time in girlfriend, it was, like, super fun, and we both enjoyed it a quite a while. It used to be something that, like, sometim s cause tension because I ha e stuff, but I have since sin e gotten a lot more chill wi h things. And also, playing wi h my roommate now has been h gely beneficial for that, as o posed to my former roommate. We don't need to talk about lot, and... and she's been, like, kind of stressed lately. So it was, like, a really nice time for her too. And she was like, "You know, thank you for that. I really needed it." And I was like, aw, yeah, babe! I'm glad you had a nice time! She ki- she kicked my butt. Hardcore. Her deck is very good.

Harvey:

Yeah, I don't play Magic the Gathering. But... yeah! Cool! Woohoo!

Pen:

Yeah, it was - it was nice to get to enjoy that with her again, and have it be such a positive experience.

Harvey:

That sounds really nice Pen.

Pen:

Yeah.

Harvey:

I'm glad you had that.

Pen:

Me, too. Thanks. It's a Wahoo! Will you say Wahoo?

Harvey:

Wahoo!

Pen:

Yay!

Harvey:

I'm a... I'm a verbal stim machine

Pen:

You are and I love you for it. Alright, it's time to move on to the actual topic of the podcast.

Harvey:

Which is the intersection, as we talked about earlier, of mental health and physical location, which has more of an impact than you might think.

Pen:

Yeah, if, uh, oh... God does it. So we both did separate research for it.

Harvey:

Yeah. Would you believe that? We did research.

Pen:

Yeah, we actually did. We... the reason this episode is a week delayed coming out, is because we... last weekend, we're like, "Oh, huh, it would be good to do this episode. We research it."

Harvey:

We should make sure that we actually have things to say other than our own experiences, huh?

Pen:

Hmm. we should research more this season. We were like, eh, okay, all right.

Harvey:

We'll push it back. And then we did, and now we're recording.

Pen:

Yep! But anyway, Harvey, do you wanna... are you - do - would you like to start off? Would you like me to?

Harvey:

I was gonna say, I was gonna offer it to you.

Pen:

Yeah, I mean, I've got notes. I did notes, which...

Harvey:

So did I!

Pen:

By which I mean, I copy and pasted a lot of things from different websites.

Harvey:

Well, as long as you're not uploading it to Blackboard like that.

Pen:

Oh, my God. I've been out of school for...

Harvey:

We don't have to think about it. We don't have to think about, Pen.

Pen:

Wow.

Harvey:

It's okay. It's okay.

Pen:

Anyway. Um, yeah, and I will... the different things that I referenced, I will include the links to the the relevant sites and articles and things in the podcast description. But overall, just broad strokes, I did you know, my research more on rural areas obviously.

Harvey:

That's where you lived. That's where the Pen was stored.

Pen:

It is. And for context for folks, because I don't know if I've ever mentioned it very specifically, the town that I grew up in is about 1500 people. Very, very small. The town that my parents currently live in, and they were, like, went between a little bit, and like, especially my later high school years, and then when I was in community college, the sign says 425 people, and all of the locals know that that is an exaggeration.

Harvey:

It's true.

Pen:

It is also like right near the border of Wisconsin and Illinois, which means that I, you know, I grew up with, like, a different kind of... like, Southern Illinois versus me? Very different, just extremely different. Also, it's so flat here, it's ridiculous. Like, what? Where's the typography? Why do you guys have nothing going on?

Harvey:

We live in Illinois. This is...

Pen:

This is not...

Harvey:

This is the plains, like...

Pen:

But, yeah, you know, I grew up in a super rural area, which means I'm good at driving on garbage roads. And that's one benefit.

Harvey:

Roads that put the fear of God in me.

Pen:

There aren't that many more, but the rural area I grew up in specifically was, you know, extremely tiny. Like, my school, 1) K-12 was all in one building.

Harvey:

Which is unfathomable to me.

Pen:

Yeah, but I'll talk to people and they'll be like, yeah, my graduating class was larger than your entire hometown. And I'm like, stop. Please stop. Please don't do that.

Harvey:

Like, I think the one that messes with Pen that I have to offer is that my first high school was four times larger than their entire town.

Pen:

You can't say that.

Harvey:

Okay. I am sorry.

Pen:

I don't understand. But, yeah, the area I grew up in, like, our school district encompassed three towns. Well, villages. Well, I don't actually know what one of the, counts as. But, you know

Harvey:

You should have asked me this, like, a month ago, when I was... when I was hyperfixating on city planning.

Pen:

Well, one of them doesn't even have a population sign.

Harvey:

Oh, shucks.

Pen:

Yeah, I don't know how big that place is except it's not.

Harvey:

Not large.

Pen:

The bar has good wings, though.

Harvey:

Oh, hey, that's cool.

Pen:

It has a bar, and presumably, a post office somewhere, and I think that's it.

Harvey:

It's kind of like the Indian restaurant and copy shop over in our town.

Pen:

Um, but anyway, it is... the area that I grew up, like, I'm queer, obviously. We discussed this. I was... I was safe there in a way that a lot of queer folks often aren't in rural areas. It's not to say that people understood. They didn't. There are no resources for queer people there. But I was never in any danger or anything, which is a very... a very unique thing, and absolutely impacted, like, my relative experience.

Harvey:

Right.

Pen:

I've also struggled with mental health things, uh, since I was 15, and then, you know, the undiagnosed ADHD and such. There was absolutely some stigma that existed, and also, specific to... to my area, there was, like, no - there was nothing. I had to drive, like, 30 minutes for the nearest therapist.

Harvey:

Which is wild. So if that therapist sucks, like, you're kind of SOL.

Pen:

Yeah, it was not great. But you know, all of that is to give context for my specific experience, which is not necessarily indicative of the - the average, but there are some similarities. Anyway, the overall things in my research on rural areas are 2) there is a severe lack of resources in rural areas across the entire country.

Harvey:

Which is... and in the country, we mean, the US.

Pen:

Yes, yeah. The United States.

Harvey:

And, uh, that's, unfortunately, very unsurprising.

Pen:

Yeah, it's... that includes psychiatrists, treatment possibilities, any education on mental health and neurodivergence, just hugely lacking. And also, there is research to suggest that there are more developmental disabilities in rural areas, sort of by, like, population and things, you know, relative to that.

Harvey:

That's interesting. I wonder why that is?

Pen:

That's actually - it's something that my mom and I talked about a bit, and some of it, I think, has to do with particularly... I mean, it's kind of in sync with lack of resources and things, and in particular, there is, you know, developmental disabilities and disorders are not exclusively genetic, but there are genetic components. And, you know, often when you are disadvantaged, it is harder to find jobs and things, and so, being in a lower income area where it's also somewhat less expensive to live is a thing and that people get trapped in cycles.

Harvey:

That makes sense.

Pen:

Which is not...That's not at all exclusive, or even, inherent to developmental disorders in particular, but that is like a relatively common cycle, and the unfortunate part of that is like you are stuck there, a nd part of the reason you're stuck there is because of the lack of resources to do anything to help.

Harvey:

It's a vicious, vicious, vicious cycle, it seems.

Pen:

Yep. And we continue to get fully ignored. But, yeah, so, ruralhealthinfo.org, which is a cool thing. It's fun learning things that, like, that existed.

Harvey:

Which is - hey, that's great.

Pen:

The following factors, in particular, are challenges to the provision of mental health services and rural communities: accessibility, having to travel long distance to receive any kind of service - like my 30 minute drive to get literally any therapy - also less likely to be insured for mental health services, and what providers we do have probably aren't top tier.

Harvey:

Ugh, yeah, that's a shame.

Pen:

Particularly when it comes to, like, you know, social workers and things in our schools.

Harvey:

Which play very important roles, by the way, so when you have a bad social worker, you're having a lot of kids getting hurt.

Pen:

Getting hurt, also not being recognized as having things. What is available for, like... particular, like, pulling kids out...

Harvey:

Right.

Pen:

...for classes with, like, you know, math and reading and stuff, like, that version of it isn't going to be as good. Availability, chronic shortages of mental health professionals, and also, that mental health providers are way more likely to practice in urban centers. No one wants to move out to the middle of nowhere and get paid even less. Affordability. Folks in rural areas do not make very much money, almost 100% of the time.

Harvey:

Yeah, it's... phew.

Pen:

Out of pocket costs for mental health care, especially because, like I mentioned, the insurance problem, significant. And then there's, uh, acceptability. Rural residents may be more susceptible to stigma when it comes to, like, receiving the mental health care, especially because it's not common to be able to, and so, then, it's not normalized, and so, then there's more of a stigma, and it goes on and on and on.

Harvey:

Well, and then there's also the piece that I imagine rural communities, just because they tend to be smaller, are probably a little more tight knit, so word just gets around. maybe in a way that people don't want.

Pen:

Yeah, it can be very problematic. And then there's issues of... it's not always that there is a significant, like, drug usage in rural areas, and that's also something that happens in urban areas. But there, I can tell you, at least from my experience, there's absolutely a link that gets put in, at least to the public consciousness...

Harvey:

Right.

Pen:

...between drug usage that is, like, actively detrimental drug usage, and particularly when it comes to, you know, mothers who use drugs during pregnancy, and linking that to particularly conditions like bipolar disorder. And so then there's like that public perception of those being linked, and so then it is, like, wrong and bad exclusively.

Harvey:

Right.

Pen:

It's busted.

Harvey:

Oh, yeah, it's... it's... I mean, it's very classist.

Pen:

Oh, to an extreme,

Harvey:

Like disturbingly, so. Like, and not to say that any kind of those -isms isn't disturbing, but sometimes it just reaches a level where you're like, "Holy sh..." you know?

Pen:

Yeah, yeah. The... the classism that exists, and how it exists, in rural areas is... oh, God.

Harvey:

It's very concerning.

Pen:

Here's - I have some - I have an interesting - depressing- statistic.

Harvey:

Oh?

Pen:

As of September 30 2021, so actually, a very recent one.

Harvey:

Oh!

Pen:

The HRSA, which, uh, I'm actually not entirely certain what the HRSA is, but health enroll... [mumbling] I'll find that out. Oh! Health Resources and Services Administration, the government agency.

Harvey:

Oh, okay. All right.

Pen:

Yeah. It has designated 3,426 mental health professional shortage areas in rural areas. It's estimated that it would take about 1,600 practitioners to remove that.

Harvey:

Oh, wow.

Pen:

And equalize it out a bit more.

Harvey:

And, you know, what's - what's important to note about this, is that there's just a shortage of mental health professionals in general. So, when you already have that shortage, and then it gets magnified in rural areas, that is a recipe for disaster, just straight up.

Pen:

Oh, yeah. Under the ruralhealthinfo information, one of the things that I really liked they had is, you know, FAQs, things, including, "What can rural community or healthcare facility do to, like, minimize the challenges of accessing and providing that?" Expanding the use of telehealth, please. That's way more accessible. Though also, there are issues of a lack of access to internet and things in rural areas, but still.

Harvey:

And the good news is that, now that the pandemic has had - the only good thing - not the only good thing, but one of the good things to come out of the pandemic, is some agencies are opting for telehealth only.

Pen:

Yeah, there's definitely an increase in the availability of telehealth, thank God

Harvey:

For real. And places that take insurance, unlike BetterHelp.

Pen:

Oh... there's also offering loan repayment programs and state tax waivers to recent behavioral health professions graduates and things that can help. And my favorites of the

suggestions:

providing clinical rotations in a rural setting to expose future healthcare professionals to the qualities of working in rural areas. So actually getting people in, and getting them experience in those areas, and potentially getting them, like, connections in those areas, so they're more likely to go there, ever.

Harvey:

That is really smart. That makes a lot of sense,

Pen:

Right? I saw that, and I was like, I never would have thought of that. That is a wicked good idea.

Harvey:

Uh-huh. How about that.

Pen:

Agweb.com...

Harvey:

I love that.

Pen:

And I will - I will - there's a fun fact about this particular article that I will say at the end.

Harvey:

Oh, is this one that you texted me about the other night?

Pen:

Did I? Oh, no.

Harvey:

Okay.

Pen:

Ugh, no, not that.

Harvey:

Go on.

Pen:

This one was talking about Rural Minds, which is a, I believe, relatively new nonprofit that is focusing on you know, mental health and rural areas.

Harvey:

We love a nonprofit. Well, caveat.

Pen:

We love - in theory, nonprofit, yay! This one has

some more statistics, including:

rates for depression are higher in rural America than in urban areas; suicide rates among people living in rural counties are 25% higher than major metropolitan areas.

Harvey:

Hoo!

Pen:

There is 20% fewer primary care providers than in cities, just in general. I can tell you, town where I grew up, there was one health clinic. It had a doctor and an RN, and then the doctor wasn't there anymore. Don't remember why. And so it was just an RN for a long

Harvey:

Uh-oh. time. Think it might still be. And she's, like, good at her job. Uh-huh.

Pen:

But that's not always ideal.

Harvey:

No, like, generally, it would be good - like, RNs are great, generally, it's good to have a doctor and an RN.

Pen:

Yeah. Especially, like, there are some situations in which you need a doctor, sometimes for, like, insurance purposes and things.

Harvey:

Because insurance in the United States is a nightmare. Living nightmare.

Pen:

Yeah. Lack of psychiatrist and 65% of rural counties; lack of psychiatric nurse practitioners at 81%; and also, just the general lack of access to broadband internet at home, four times more likely than for urban residents, which screws you over in a whole lot of ways.

Harvey:

Oh, yeah. It's... man, those are sobering.

Pen:

Here's the fun fact about this particular article from agweb.com. It's in/news/livestock/beef. Which, 1) I have no idea why this is listed under beef. It's funny that it's listed under beef. And also, that actually shows off, like, the prioritization in rural areas, and like, what kind of things exist, and how they're categorized and things, not that I'm saying that rural areas are like, "Oh, mental health? That's under beef." But also, like, beef is a very relevant kind of category. Like, these are the concerns of rural areas, are, you know, farming, really heavily, especially here in the Midwest, things like that. So like, that is where the concern is at. We're not thinking about more abstract situations. There's not a lot of sociology majors that come out of rural areas, you know? And that that absolutely impacts things like mental health.

Harvey:

Absolutely.

Pen:

And, like, the... how aware people are gonna be of it.

Harvey:

Right.

Pen:

And then there were some, uh, some interesting things on the other... the other point that I had, the idea of developmental disabilities and, well, disability being a legal term, disorder being medical, being more common in rural areas.

Harvey:

Yeah.

Pen:

And of course, children with developmental disorders being less likely to receive special education or early intervention services. Imagine.

Harvey:

Shocking.

Pen:

According to study from The National Center of Health Statistics, almost 20% of children ages 3 to 17 in rural areas qualified for a developmental disability.

Harvey:

Wow.

Pen:

Compared to 17% in urban areas, which is fairly close, but still, like, I think kind of interesting

Harvey:

That is. To see those kinds of differences, that is interesting.

Pen:

cdc.gov researchers found that children living in rural areas were more likely to have been diagnosed with ADHD and less likely to receive behavioral treatment.

Harvey:

Shocking.

Pen:

Yep. And then, on autism specifically, there was a TED Talk by Dr. Amy Price Azano, um, made some points specifically that non metropolitan spaces don't have access to essential human resources to address autism,including geographic isolation, population density, and poverty being the biggest impacts. The struggle of rural areas entails a lack of human resources, lack of know-how on effectively helping kids with autism...

Harvey:

Yikes.

Pen:

...and ill-equipped and underfunded educational systems. The thing that I think best sums up all of that, particularly,

like, re:

autism was the - just the title of an article from

Science Direct:

There's nothing here: Perspectives from rural parents promoting safe, active recreation for children living with autism,

Harvey:

Hmm.

Pen:

Yep.

Harvey:

Wow.

Pen:

Yep.

Harvey:

That's, uh, poignant.

Pen:

Isn't it? So, yeah, that's all of mine on just the general, like, research and some of the statistics. Again, essentially, there's no resources. The resources that we... well, I say we because I still kind of lump myself in with with rural areas a fair bit, because I spent so much time, especially in my early life there.

Harvey:

And I would consider the area that we live in, like, semi-rural.

Pen:

Ah, [laughter] comparatively, yeah, there's a lot of folks who consider it rural, but to me, it's like, that's nice. There's like, 20,000 people here? And a university? That's cute.

Harvey:

Yeah, but if you go literally, like, five miles in one direction, there's, like, nothing.

Pen:

Yeah. And that part feels proper to me.

Harvey:

Fair enough.

Pen:

People are like, "We're surrounded by corn." And I'm like, "Can you see it from your window? No? Then you're not." It's... anyway. So there's a lack of resources, the resources that do exist are not very good, or are significantly far away and more difficult to access just in general, and then the very possible prevalence - higher prevalence of developmental disorders, and specifically, like, there is a particular issue with lack of resources for that, especially for, like, children, because, if you're not receiving that help, like, that is... we need resources for dealing with, like, depression, and anxiety, and bipolar disorder, and mental health conditions, just in general.

Harvey:

Right.

Pen:

There is a level of, like, particular significance, I would say, with neurodivergence, specifically, because that is a lifetime thing, where, if there are not resources to help with that, there is a special kind of, like, disadvantage that you are just put at. Not in the least, like, you never get to learn how to best function, just for yourself,in being alive.

Harvey:

Right.

Pen:

Mm-hmm. So that's my side.

Harvey:

Yeah. And tell you what, I wish I could have been that thorough. I focused on the suburbs, because that's where I come from. The funny thing is, there's a heck of a lot of literature on mental health in urban settings and mental health in rural settings. Not a whole lot in suburban settings.

Pen:

That is... that is an unfortunate, uh, blind spot there.

Harvey:

Yeah.

Pen:

That's significant,

Harvey:

I think, in research, a lot of the time, suburban areas- because they are metropolitan, necessarily - they're lumped in as urban, but I'll tell you, as someone who grew up in the suburbs, there are major cultural differences between suburbs and urban areas.

Pen:

Yeah, totally.

Harvey:

So, I think - I think as I am, I'm going to have decidedly less to say, just because there's not a whole lot for me to go off of, but - so, some - a fair amount of it's going to be conjecture, but I like to think informed conjecture.

Pen:

You know, experiential knowledge is significant.

Harvey:

Mm-hmm. For sure.

Pen:

Especially because science is not always very good.

Harvey:

No, no. It's, um... so I think the - the - like, uh, I think a good way to start this conversation would be to discuss just the development of suburbs, because it's a) relevant and b) really interesting. Suburbs for anyone, especially in the United States. I'm talking about this in the context of the United States, it's - it's a product of the industrial - like, the post-industrial revolution.

Pen:

It's, like, racism, right?

Harvey:

Uh, partially, that's, it's not all racism, but, uh, racism is certainly a prevalent part of it.

Pen:

Imagine.

Harvey:

So suburbs, more or less were - you know, so, during the Industrial Revolution, there was this massive shift from rural settings to urban settings, because that's where job opportunities were.

Pen:

Yeah.

Harvey:

That's where industry was hence, you know, industrial revolution. So that was...

Pen:

Cough, cough, still true.

Harvey:

Still true, yes. To a different extent now, but but still true. Um, and so, you know, that was a thing. After a little while, urban centers were just getting so full, that they weren't livable...

Pen:

Yeah...

Harvey:

...in some very real ways. And some of that was also racism. When you've got a lot of people congregating in one area, all trying to make money, you're going to have Black people there- shocking! You're going to have Latino people there, you're going to have Asian people there. Immigration was booming in during the Industrial Revolution, that was huge.

Pen:

So primarily, people were going towards more urban areas, because that's where there were jobs and things.

Harvey:

Right.

Pen:

So if you're a new immigrant, why would you go to the middle of nowhere?

Harvey:

Precisely. So definitely, I would be shocked if racism wasn't at play there; that the white people got uncomfortable about the fact that people of color who were coming in, and so they wanted to move away. But it was at least partially, just because urban centers were just so full.

Pen:

Yeah.

Harvey:

So people started moving away from the urban centers, but not terribly far, because they wanted to keep their jobs. That was the groundwork for the development of suburbs. And so...

Pen:

And the development for pop-punk as a genre of music.[Laughter]

Harvey:

But I think there's a part two to this, more or less, and that's the Cold War. You'd be shocked at how many - maybe you wouldn't - I think a lot of people would be shocked at just how many things the Cold War influenced about modern American culture.

Pen:

That sounds very, very true. Like, there are some times when I look at things in Wikipedia articles, and they're like, "And then the Cold War," and I'm like "Shoot, really?"

Harvey:

Yeah. So you know, of course, and I think World War II as well, you know, set the stage to allow this kind of breeding ground for high patriotism and nationalism. But in the Cold War, it really ramped up. Particularly with McCarthyism, you start seeing these moral panics about just about everything. And the thing about World War II is that post-World War II, the United States was really pushing for, like, almost this... this, like, new beginning, like - like turning a page in a chapter book. They were really trying to, like, reestablish, you know, what they called the American dream. And the American dream was often centered in the suburbs. So we're talking nuclear- nuclear family! That makes so much sense.

Pen:

Oh! Oh...

Harvey:

Wow, that makes sense.

Pen:

Because...

Harvey:

Because Cold War.

Pen:

Oh...

Harvey:

Nuclear weapons. Oh, my God. Anyway.

Pen:

Nuclear families are like weapons.

Harvey:

I mean, yeah, that's true.

Pen:

Particularly prioritizing them as some kind of savior, I would say, is a very direct metaphor.

Harvey:

Yeah, yeah. But, so post World War II, you start seeing this, like, strong influx of, like, the American dream, and,"what does it mean to be an American?" And the ideal of that ended up being placed in the suburbs.

Pen:

White picket fence, 2.5 kids?

Harvey:

Exactly. Exactly that. And so, when you start going into the Cold War, particularly the 50s, and the 60s, and you're starting to see McCarthyism, and all of these moral panics about people who were too liberal, and communists, and people of color, and gay people, like... you start seeing this, like, really strong shift into, just, this, like, this very, like, Americanized, patriotic, nationalistic culture in the suburbs. And in many ways...

Pen:

That doesn't good for someone's brain.

Harvey:

No. So my point in bringing this up, and this is - this is the part that - that's conjecture. I think, in my personal opinion, having grown up in the suburbs, I think that that - that perspective that's very focused on the American dream, that's very heterogene - hetero - heterogenous. I've never known how to pronounce that. I think heterogenous.

Pen:

Cool.

Harvey:

That's that's very heterogenous. That's very white, frankly. You get a culture that's very assimilationist in a very unique way in the suburbs, which is fascinating from a sociological perspective. But having lived through it, it's awful. Horrible. So I think... so there's two - there's another part to this, and that's suburban spread. And there are some - there's a lot of literature, actually, on suburban spread, but not its effects on mental health, mostly on physical health.

Pen:

What is suburban spread...?

Harvey:

I was about to explain that. And so suburban spread is just the tendency for suburbs not only to become further apart, but also just to continue spreading throughout a metropolitan area.

Pen:

Okay.

Harvey:

So essentially, just, metropolitan areas get bigger, and bigger, and bigger, and also, more sparse, which leads to some issues with transportation. Some of why you see negative physical health effects in the suburbs is because, not to the same extent as rural communities, but in a different way, receiving access to those to those resources is also harder because of the travel time. You'll also find that a lot of suburbs are food deserts. There are high rates of poverty and homelessness in suburbs.

Pen:

Yeah.

Harvey:

It just- it all gets very swept away. It's... you know, mental health concerns, and any concerns, in suburban areas exist. I remember I went to a pretty wealthy high school, and most of my friends were not terribly wealthy. I was pretty well-off, I grew up upper-middle class, and now I would probably describe myself as lower-middle class, but I grew up upper-middle class, and the things that my friends would tell me were very real. It was like, you know, I'm on - I'm on, like - the - I was on a free lunch - they were like telling me like, hey, I'm on this free lunch program, but I haven't been able to get lunches this week, because I have, like, an outstanding balance on XYZ that I - we can't pay off.

Pen:

Oh, geez.

Harvey:

There's also the piece of, like, public education, especially in the suburbs, isn't actually free, even though it's supposed to be. Because there's... every time I registered for school, it was at least a couple hundred dollars, minimum. So, the problems exist, for a variety of reasons. We are spread out, it's not easy to build community in the suburbs, and no one wants to talk about mental health, because he suburbs are supposed to be this idyllic place. And actually, I'm going to... I apparently didn't write the citation down, but I will send it to you so we can link it. There's this really interesting article that I have a PDF to about LGBTQ youth trying to build space and resilience in suburban communities, and it's often in some really unusual places. Like, I'm trying to remember exactly what they said. A lot of the time, it's, like, park districts and...

Pen:

Yeah!

Harvey:

And things like that, where they're - they're carving out spaces where they do not exist.

Pen:

Yes.

Harvey:

Just to exist and just to coexist. But in terms of some of the literature that I have, and there's like two... there's two things that I can really draw on. So, um, there's... there's some information from the Center for Urban Design: Mental health, where it is true that, compared to rural and suburban areas, urban areas are more likely to have a higher proportion of people with mental health concerns. However, they suspect that some of that might be that people with mental health issues who have the mobility will move to urban centers, because that's where the resources are.

Pen:

There's, also, I would say, a much more significant likelihood of being diagnosed or receiving treatment in the first place.

Harvey:

Agreed.

Pen:

Both because there is, like, the existence of those resources, and the stigma looks very different

Harvey:

Exactly. So, the direction of causality is - is, at best, debatable. And then there was... in terms of the - in terms of, like, rural and suburban stuff, LGBTQ+ people... Israel and colleagues found that LGBTQ+ people in rural settings and suburban settings, were substantially more likely to experience poorer mental health outcomes as compared to LGBTQ people in urban settings. And that is not a surprise to us.

Pen:

Not even a little bit. God, I... it would be fascinating to talk to someone who was surprised by that.

Harvey:

And, um, this... the same is true for people of color, that people of color - I mean, on balance, they experience poorer mental health outcomes than white people. Please, sometime, look up the minority stress model. It's way too complicated for me to get into, but it's super useful.

Pen:

Yeah.

Harvey:

So marginalization comes into all of that. But I, you know, the unfortunate thing about this is that that's pretty much all I have to offer.

Pen:

That is... what - what a blind area,

Harvey:

It's - it is remarkable. And it doesn't have to be blind. There's a lot of... and thank goodness that there are some people who are doing the research, because there's a lot of, like, really rich information when you dig into it, and when you actually start looking at, you know, what's happening in the suburbs. And, you know, here's what I'll say: you were talking about how, in rural places, like, in your particular rural setting, although it wasn't perfect, and there were parts of that experience that were really painful, you generally felt safe.

Pen:

Yes. Which is, again, very specific to mine. Like, I have - my mask says they/them on it, and when I'm visiting home, I feel okay with that. Maybe a little awkward sometimes, but that's fine. If I go, like, 20 minutes out to a different town, then I'm more aware of, like, I actually don't know how it's gonna be here. But in my, like, 425 people, or 1500 people, I am not concerned about a hate crime or even being stopped and yelled at.

Harvey:

For sure. And the suburbs, for me, were very hostile. When I was going to school, when I was in middle and high school, like - and I'm gonna say some slurs here - like being called a faggot and a tranny was pretty much, like... like, that was my nickname, pretty much. It was... I was actively, like, being deadnamed in school, and when I would bring it to the staff and faculty at that school, like, a lot of the time, they said, "Oh, we'll look into it," and then they didn't, Because the suburbs, as much as they like to tout being progressive, are remarkably conservative.

Pen:

Yeah.

Harvey:

At least in my experience, and I think that ties back into the Cold War, McCarthyism, the American dream. It was a an incredibly painful experience. And I think the pain that happens in the suburbs is by virtue of the fact that it gets absorbed into urban settings. Our narratives are being left out.

Pen:

Yeah. And that's... that matters a lot.

Harvey:

Yeah, um, and I like to think that I raised some interesting things about why that might be.

Pen:

I think so. Yeah, definitely. Like, it is - it is unfair, and inaccurate, to lump in suburban areas with urban areas. Like, there are fundamental differences between the two.

Harvey:

Very different.

Pen:

And that is... and I have - I have thought about that a lot, and we've discussed it, like, how I felt pretty safe growing up. No one understood, especially when it comes to being nonbinary, like, people didn't get it. There were other queer people in my high school. It was not something that people really talked about. It... I mean, there were definitely still, like, garbage jokes and things made...

Harvey:

Of course.

Pen:

...but I wasn't concerned about being harmed in any way. And actually, like, my peers were really cool about it, even if they didn't always understand. And then you've talked about your experiences, and I'm like, I - that never would have happened.

Harvey:

Yeah, I was... I mean, some of it is, like, the - the setting is just so large that there's a degree of anonymity with just being a jerk. But my experience was, not only did people not understand, they didn't care to understand.

Pen:

Yeah.

Harvey:

They held often - and, look, I don't think that there's anything wrong with being religious. I was very directly harmed by Christianity.

Pen:

Yeah.

Harvey:

They held their Christian fundamentalism so dear, that they were just convinced that I was going to hell,that I was corrupting people, that I was going to harm children... and they didn't want to hear anything different, so...

Pen:

And that's... I mean, that's hellish.

Harvey:

And that's so far - so far removed from what it's like in urban settings.

Pen:

Yeah. And - and rural settings, because there is a closer-knit community, even if you are not, like, closely-knit with things, like, my mom and I, and - like, we've never been very social or anything, so we don't have, you know, some of the... tight, close-knit, everyone knows their neighbors, and everyone's friends, which is also just notrural areas are actually like. Stop romanticizing them. That's not... that's not real. But there's also a level of accountability that just exists. Like part of the reason that I'm quite certain that I was fairly safe was because my mom was a teacher, my adopted dad was very social and things. My stepdad, also well-known figure. Being their kid, meant, like, anything that happened to me was going to be known. And even if there wasn't, like... even if none of those people, none of my parents held, like, super high social status, it was still gonna be, like, a recognized thing. And there was still going to be backlash for people just on a social level. Like, hey, why were you horrible to that kid? Like, what do you think you're doing? And it was going to be known.

Harvey:

And I didn't have that kind of collateral?.

Pen:

Yeah.

Harvey:

I was that fag. And my dad was that fag's dad,

Pen:

Which is... ugh. I think it's a very worthwhile thing for people to consider, especially because I don't think it's a very common thing for people to consider. Like, all of these factors that go into it, and how that impacts like, obviously, literally every aspect of your life. And especially, like, there are advantages and different - and disadvantages to every setting that you grow up in.

Harvey:

Nothing's perfect.

Pen:

No, no. And I certainly think it's definitely worthwhile to look at all of them and be like, yeah, it's not actually inherently better to be in a more metropolitan area. And also, resources in every area are just... there is always going to be a way that it's lacking, and a way that that matters.

Harvey:

Yeah. So, we should start wrapping up. But I do want to ask you, Pen, if you have any closing thoughts.

Pen:

Um, I think it's worthwhile to think about where you grew up, and to think about the ways that you were impacted by it. The different ways that the stigma could have looked, and to consider like, I imagine a fair few of our listeners do have mental health concerns, or neurodivergence, and to consider like, hey, did you have access growing up? Do you have access now? What does it look like? Because I find that can be a very eye-opening experience and can also matter quite a bit in what you personally do, and how you expect to be treated.

Harvey:

Yeah.

Pen:

And, like, hey, you know, as always, if you're pushing through, like, if you're in a rural area, and there's no resources, and no one who understands you, you are enough, and you are doing enough, and things can still improve, I promise. I did the dang thing.

Harvey:

And if you're a kid growing up in the suburbs, you're not just being whiny and you're not being melodramatic. It sucked to grow up there. I see you. Last closing thought and, like, I don't know, like, insert the Jeopardy theme song

here:

Harvey's Googling list, post this episode.

Pen:

Yay!

Harvey:

The Minority Stress model. McCarthyism. The American Dream. Manifest Destiny. The Cold War. That is all.

Pen:

So that's either a history major reading an essay, a high schooler trying to pass their test, or the history buff who I really don't want to talk to.

Harvey:

Or Harvey!

Pen:

Or Harvey.

Harvey:

So with that being said, Google those things if you've got some time. Stick around and we'll tell you a little bit more about how this podcast is run.

Pen:

Bye.

Harvey:

Bye.

Pen:

Bye.

Harvey:

Beyond Introspection is an independently-run podcast by Pen Novus and Harvey LaFord. Music by Girl Lloyd. You can find us on Twitter and Instagram at ByndPodcast, or you can email us at beyonddot - that's D-O-T - podcast@gmail.com. We publish on Buzzsprout, iTunes, Spotify, or wherever you get your podcasts. You can find the links to our social media and email in the podcast description. Got feedback for us? Feel free to reach out on social media, or via email. We'd love to hear from everyone. Take care of yourselves.