Honoring Black History Month: Q&A With Dr. Marisa Spann

February 26, 2021

We spoke to Marisa Spann, PhD, MPH, the Herbert Irving Associate Professor of Medical Psychology in Psychiatry and Pediatrics, about her work in early childhood psychiatry, her new role as Assistant Director of the Office of Equity, Diversity and Inclusion, and having honest, direct conversations about race. "I think a huge piece is awareness and the department’s support. Obviously people want to see change and support change and I think just creating a culture that allows for that safe space and openness. I don’t know the answer yet, but I do think we’ll continue to dialog about how to impart change."

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Communications: Tell us about your current work.

Marisa Spann, PhD, MPH: I study early childhood psychiatric risk markers, so I mind the spectrum of early childhood psychiatry. I work with families starting in the prenatal period and follow them and interact with them through preschool age. I’m on the neuroscience end of things. I’m using MRI and cognitive-behavioral assessments to look at different brain systems that are implicated in psychiatric disorders and have been identified as central precursor symptoms that congregate and are associated with psychiatric disorders, for example, emotion regulation and attention. 

Communications: How do people find you? 

MS: We find them through partnership with the Department of Obstetrics and Gynecology. They have research nurses that are in their clinics and they have a research infrastructure to support recruitment into studies. My other line of research asks similar questions, but with national and international birth cohorts. Right now, I’m working with one of my mentors, Alan Brown, doing parallel research with a Finnish birth cohort. Because early childhood is a time period when psychiatric symptoms emerge, the national cohorts allow identification of those with psychiatric symptoms or diagnoses that can be related to their past prenatal and early developmental history records. 

Communications: When you have identified markers that tell you there will be future difficulties, do you follow to see if that indeed is what happens? Are there services you connect the family to? 

MS: I follow families through preschool age, and partner with research collaborators who study school age children so we can continue to follow the same families through the age window most common for childhood psychiatric disorders.  The goal is to develop early risk markers. We are still working towards that goal. If the family has a particular concern about a child’s development, then we provide suggestions for community resources or, with their permission, speak to their child’s pediatrician. One of the things I like about this work is our team become an integrated part of the family because we work with them through so many of their child’s milestones. They may come for a visit and  have questions and concerns. This provides another opportunity to share resources with them as well provide a space, an opportunity for support.

Communications: Its Black History Month. Has Black History Month meant something to you in terms of your work and is there a connection to earlier pioneers?  

MS: I’m the Assistant Director of the Office Equity, Diversity and Inclusion, so I definitely think this is important. I think the 2 things that stand out to me are feelings of hope and reflection during this month. One thing that I always think about are the sacrifices my ancestors made, the opportunities that they didn’t have so that I could have those opportunities --- to be at a top research center and do the work that I do, and then the idea of having this awesome challenge, blessing, but weight as well, that I also need to do that for the next generation.

Communications: To pay it forward?

MS: Yes, and I’m now on the tenure track and that has meaning kind of beyond myself in terms of what’s important, and how I can pave the way for the next generation to be successful in achieving this significant benchmark.

Communications: Why did you even choose psychology and research? 

MS: Well, it’s funny. Originally I wanted to be a lawyer. I definitely argued a lot with my parents and I was very opinionated, so I think my parents were very surprised when I said I wanted to get a PhD and be a psychologist. But I took an advanced placement Psychology course in high school and I thought the brain was fascinating, I was really riveted by the complexity of mental illness and how it cuts across different disciplines and fields and communities and just how much wasn’t known and I definitely wanted to be part of the solution. And with neuropsychology or neuroscience, the tools that we use are validated and pretty technologically advanced, so I thought that those tools were kind of an answer or a way to help understand mental illness and prevent it.

Communications: I was just reading about the number of Black researchers, and how abysmally low it is. What are your thoughts about that and how to we begin to consciously address it? What do we need to be doing?

MS: The 2 things that come to mind for me are really having open, honest discussions about race, about the challenges that people may face and really putting it out on the table. And I think the other thing we have to think about is entry points and criteria for promotion and moving forward because it’s not so much loosening those or reducing those criteria, but appreciating how if structural systemic racism exists are these benchmarks even realistic, attainable, at the same time for those coming from different circumstance.

Communications: When we look at our pipeline of people applying for psychology internships, or psychiatry residencies, are there things we could do differently to reach out to a more diverse pool of candidates - is that something you and Jean-Marie hope to look at and make recommendations around?

MS: Establishing or adjusting the entry point criteria is going to be helpful. For example, there have been a few first generation college students, minority women that I’ve mentored, and they’re about to graduate from Columbia or other top institutions and they’re telling me, I’ve never worked in someone’s labI never did a summer internship, and the reason is economics – they had to work – and it was really important to graduate. The benchmark for them is to graduate and what that takes is different than thinking about OK, what’s the next step and then they’re thinking about OK, and then I want to go to medical school, but they can’t focus on that because they have to just make it through that first.

Communications: The young people we’re talking about aren’t able to take advantage of opportunities that would be doable if money were no issue? I could do an internship in a lab, but instead I’ve got to go find a job because I’ve got to cover some of my books and tuition for next term?

MS: Yeah, and then what happens is then they’re not qualified to get a research assistantship -- who’s going to hire you with no experience, right? So then your options are a volunteer position – OK, I struggled to pay for college, now I’m supposed to volunteer for a year? So, it makes it really hard.

Communications: I’ve been thinking about this lately -– my oldest grandson is a junior in high school and thinking about colleges, and we were having a conversation about what he’s interested in and the kind of internships he could pursue. He has the luxury of not having to work and he also has a network that can help him with internships. I know we shouldn’t be helicopter grandparents and parents, but of course, you do what you can for family but you’re talking about a group of students who are less likely to have both those things, the luxury of money and of a family that make introductions. 

MS: Exactly, the way that you said that is right on.

Communications: Don’t all kids deserve that opportunity?

MS: Yeah, that is beautiful.

Communications: We have to think about how to operationalize that at Columbia. How do we create pathways for students with the resources we have at Columbia? We need to walk the talk. 

MS: Yeah, and it’s taking a leap of faith.

Communications: We take leaps of faith all the time – why shouldn’t we do it in this arena? I’m a believer that leaders need to reflect that diversity; that what the leader wants is what happens in most organizations. What can be our goals?

MS: Yeah, that’s really critical too and may require a leap of faith as well because the person may not have experience in being a leader because of opportunity, but might be a leader in their community and you don’t even know it.

Communications: Talk about your new Office and work Jean-Marie? 

MS: There’s different phases. The office started as a committee, so the committee has some goals they’re working on. One of which they’ve already implemented is creating a space for psychiatry residents and trainees. They have diversity initiatives for those that are applying and so some of those activities they’ve started to implement. We are also working on a survey to get a sense from all of Psychiatry, whether that’s faculty, trainees or staff, what they think the challenges might be related to equity and inclusion. So I think the initial step is getting a sense from the larger group, what are the points that we need to work on, so once that survey happens, I think that’s going to point us in the direction of what the main objectives should be.

Communications: You started earlier in the conversation talking about having honest, direct conversations in a safe way. Do you have some suggestions for that?  

MS: One forum utilized in the past is a Town Hall. We are planning another in early March. Smaller focus groups and trainings about how to address potential concerns, such as microaggression will be essential. But, prior to this we have to ensure a space where a vulnerable person who feels like a victim is able to speak freely without concern of being turned into the aggressor. There has to be an opportunity for discord that removes the fear of being treated poorly. 

Communications: How do you make it safe?

MS: I think a huge piece is awareness and the department’s support. Obviously people want to see change and support change and I think just creating a culture that allows for that safe space and openness. I don’t know the answer yet, but I do think we’ll continue to dialog about how to impart change.

Communications: I wonder if there are other Departments of Psychiatry at other academic medical centers that we can learn from -- imitation is the best kind of flattery. Is there a group amongst academic medical centers that are coming together to share? 

MS: Actually Jean-Marie is part of a larger group of psychiatrists that are diverse representatives in their departments. I’m less familiar with that work, I’m just coming into this world, but I think more openness and awareness we have now will probably allow for more opportunities to have programs and interventions that cut across universities. One of the things that you said made me think about a cross collaboration with some of the New York universities. I know Jean-Maria also does speak to the diversity officers that are in positions across the university at large – they have kind of a working group. But I think right now everyone, at least at our university, are acclimating and figuring things out.

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