The following interview has been edited for clarity.
VWM: Dr. Marsh, thank you so much for chatting with us.
Can you talk a little bit more about the focus of your work?
Marsh: Right now I work in anoutpatientmental health program.
Its a community-based clinic, which means that we see people regardless of insurance status.
The main focus of that is addressing trauma.
And then there’s also a version of CBT for older teens and young adults calledcognitive processing therapy.
Im all-around interested in trying to address all those kinds of things to the extent I can.
Marsh: Oh, that’s a great question.
Its so, so layered.
I think of it like it was a majorcollective traumafor the entire world, honestly.
So theres a lot of having to deal with that.
Marsh: I would say that for kids, they start to cycle into it.
Usually, a parents intuition can pick up things like,this person doesn’t quite seem like themselves.
It starts with something soft, maybe you could’t quite put your finger on it.
And then issues in schoolbehavioral concerns.
Those could all be different signs or presentations fordepression.
You’ve got to know what’s really underlying to pinpoint it.
What are some ways that parents can better show up for their kids despite these stigmas?
Marsh: I feel like oftentimes we’ll take it as a personal failing.
People don’t usually say it but that’s the feeling I get.
It’s very easy to get frustrated.
What are those accommodations that are available for students with depression?
And are there challenges in achieving equal access to these accommodations?
Marsh: Yeah, there are definitely challenges because a lot of times systems will be resistant.
It starts with them often actually not recognizing that something may be going on.
All of those things are potentially accessible.
It’s just a matter of what that individuals need is and then actually being able to get it.
Ive seen schoolswhen they do their evaluationmay input less services than what actually meets the childs needs.
Can you talk more about the disparities in therapy for marginalized youth?
And then number two, there’s more or likely to be access to providers wherever they’re living.
Theres still a shortage, but you have a higher likelihood of getting access to a provider.
The majority of providers are White.
It doesn’t exactly match up with the demographics of the communities.
So, that can add a layer to complicate things.
The way that evidence-based treatments were developed is mostly in big research configs.
A lot of times they’re working with populations that have insurance or are generally not marginalized.
VWM: Whats the solution for equal access to affordable, high-quality medications?
That information is not easy to find, so that complicates it further.
Have you seen these conversations shift, if at all?
Marsh: Honestly, I think so, thankfully.
And it’s been an increasingly normalized part of pop culture.
I think that helps, along with efforts to raise awareness.
I’ve seen it not just in pop culture but also professional organizations.
VWM: Speaking of stigma, what common misconceptions about therapy come up in your line of work?
People might think if they talk about things that happen, Child Protective Services could get involved.
VWM: The privacy layer is interesting.
Marsh: Yeah, that’s pretty big.
We think its secure, thats what were told, but theres a possibility that something could go awry.
VWM: Cultural competence/safety is something thats especially important for people of color.
Can you explain the importance of havingculturally competent treatment?
Marsh: Yes, absolutely.
I would say thats actually a cornerstone of mental healthcare.
There have been studies looking at the rate of effectiveness of therapyyoull see differences in that.
And why is that, what’s going on here?
That’s where therapy starts: feeling like you’re seen and heard and understood by someone else.
Marsh: Unfortunately, that is very true that medical gaslighting happens all the time.
We’re subject to our own biases.
Cultural competence isn’t good enough.
Maybe you’re not the best person to see this patient.
Everyone has something like that.
VWM: Aside from cultural competence, what are some tips for finding the right therapist for your child?
Good places to start would be the primary doctor’s office and insurance company.
What other options or resources would you suggest?
Marsh: So the programs Im in, in the city, work basically like a mental health clinic.
Then maybe they’re connected with another provider who can assist with ongoing treatment.
VWM: How can parents model healthy behaviors for their kids?
So I’m not gonna say anything.'
But the child knows somethings going on.
Be open and vulnerable.
Just let them know they’re going through something as well.
We’re human, and part of being a human is going through things and having certain struggles.
Because that would really have a meaningful impact on the child.
And trust your instincts.
