Cindy Crusto, PhD, has always been interested in children’s health and well-being. As a high schooler in New Orleans, she worked at her mother’s Montessori early care and education center and ran afterschool programs, but when she took her first psychology class as a senior, “I was just hooked,” she said.
Her psychology teacher also led groups for children of divorced parents, and watching her teacher play multiple roles within her school community intrigued Crusto. She was a participant in that group for children of divorced parents and remembers feeling comforted because she was not the only one with this experience. Later, participation in the group helped her understand the powerful role that schools could play in children’s social and emotional well-being.
When she realized there was a field dedicated to helping people overcome adversity, she decided she wanted to become a psychologist.
“I think we’re all the product of a cumulation of risks and protective factors. I’ve had my share of both in my life, and I’ve always been interested in how we can prevent or mitigate the impact of some of those negative life experiences,” she said.
Over the years, Crusto supplemented her interest in psychology with studies in political science, sociology, history, and Africana studies to build a career in community and clinical psychology.
Now, after spending the last 22 years at Yale, Crusto was recently promoted to Professor of Psychiatry, making her the first African American woman in the history of the Department of Psychiatry at Yale School of Medicine to reach that rank.
“There were many people who came before me who worked just as hard or harder than me, and so I have complex feelings about my accomplishment,” she said. “I know I worked extraordinarily hard to develop and carry out my career plan, and I am immensely proud. I was fortunate to have had mentorship, sponsorship, and advocacy, but at the same time, I have to remember we’re in this system that does not provide that for everyone, especially women and racial and ethnic minorities. I do feel an immense responsibility, and I’m thinking of what I can do daily to help someone else get to this point.”
Crusto arrived at Yale in 1999 as part of the Doctoral Internship in Clinical & Community Psychology within the Psychology section of the Department of Psychiatry. She came with a desire to learn more about and enhance her skills and experience with addressing the societal problems and challenges facing children and families, specifically children and families of color and communities of color. She was also interested in addressing issues of socioeconomic status. She said it was a challenge to build a career in academic medicine while wanting to conduct community engaged work.
“Today, community engaged work is the thing to do, everyone is doing it, but it was an anomaly when I was coming up,” she said. “It was really hard early on to build a career here doing that, and it’s still hard because people don’t fully understand what it is or the challenges of doing the work. It doesn’t always fit with the culture of academic medicine.”
Influenced in part by the 1998 Adverse Childhood Experiences Study, which found a strong relationship between the exposure to childhood psychological trauma and multiple risk factors for several of the leading causes of death in adults, Crusto sought to understand prospectively the role early childhood trauma plays in children’s health and development, and to ultimately discover how to prevent and mitigate the impact of trauma.
Crusto addresses culture, context, and human diversity in clinical work and community-engaged research and program evaluation. She has held leadership roles in the American Evaluation Association, including chairing a task force that developed practice guidelines for addressing culture and context in the profession and in the provision of evaluation services to the public and to evaluation consumers.
As Deputy Chair for Diversity, Equity, and Inclusion (DEI) in the Department of Psychiatry, Crusto is responsible for diversity, inclusion, and equity initiatives, including co-chair of the department’s Diversity Committee and Anti-Racism Task Force, curriculum development, and management of identity-based harmful behavior.
She holds additional leadership positions within Yale related to diversity and inclusion, including co-chair of the Yale School of Medicine Minority Organization for Retention and Expansion (MORE), a faculty developed and run organization designed to accelerate the appointment and retention of underrepresented racial/ethnic minority faculty members and enhance their professional environment; executive committee member of the Yale School of Medicine Committee on the Status of Women in Medicine (SWIM), which addresses gender equality at the Yale School of Medicine; and deputy Title IX coordinator at Yale.
Crusto is known for her work in community-engaged research, program evaluation and research, and intervention work in children’s exposure to psychological trauma and its impact on their health and well-being.
Her experience in trauma research has impacted her way of approaching her work in diversity, equity, and inclusion, she said, by recognizing that being in these spaces can be traumatic for minoritized groups.
“Yale School of Medicine and the Department of Psychiatry were not developed for women, people of color, or other diverse groups. These spaces can be inconsistent with our ways of being and knowing. Diversity, equity, and inclusion work is about making those systems more responsive to and reflective of those differences. These are the things that impact people’s ability to realize their goals or progress in the system. I’m trying to level the playing field and to eradicate the barriers people face.”
“What I’m trying to do is practice from a trauma-informed perspective and to think about supporting a trauma-informed system and organization, emphasizing psychological and physical safety; trustworthiness and transparency; peer support; collaboration; empowerment, and responsiveness to cultural, historical, and gender issues within an organization. If we have an eye toward these principles, we can help people overcome negative experiences they may have had in the department, and more importantly, we can prevent these experiences from happening in the first place, ” she explained.
Over the last year, America has seen an increase in anti-Asian rhetoric and hate crimes since the onset of the COVID-19 pandemic, as well as several high-profile cases of police brutality against Black Americans. Crusto said while it is in some ways helpful that these incidences have brought racism back to the forefront of the national conversation, there is still work to be done.
“The times we are in have allowed our system to progress, but we still have a long way to go,” she said. “We need to think about the degree to which we can challenge and interrupt these deeply held and ingrained patterns that perpetuate inequities, such as of who gets funding, published, physical space, honorifics, or equitable salaries. This is where people must demonstrate their commitment. We’re scratching the surface of understanding the root causes of these inequities, and we need to continue down the path.”
To that end, Crusto has led several department-based initiatives, such as collaborating with the department faculty affairs office to add an optional statement into the appointments and promotions process where people can write about how they have advanced DEI and anti-racism work, as well as an optional statement to explain the impact of COVID on their professional and academic progress. The department has also responded to community-level tragedies with open town halls and has made a concerted effort to address images in public spaces within department spaces.
Crusto said the department has also made progress in addressing inequities in care at affiliated institutions, as well as addressing DEI issues and racism in the training of residents and psychology fellows.
Crusto said her goal at the departmental level is to evaluate and measure the impact of the work being done and how it has affected system change. On a broader level within the School of Medicine, she is always searching for what more can be done and what other roles she can take on to champion change.