(Photo by Lauren Gilger- KJZZ)

Jacob Demenna is a first-year resident in psychiatry at Desert Vista Behavioral Health Center in Mesa.

(Photo by Lauren Gilger- KJZZ)

Psychiatry residents sit in a meeting at Desert Vista Behavioral Health Center in Mesa.

“Initially in medical school, I wanted to do anesthesiology and then pain do management,” said Jacob Demenna, a first-year resident in Maricopa Integrated Health System’s program at Desert Vista Behavioral Health Center in Mesa.

But, when he did rotations as a student in those areas, he thought something was missing.

“After doing those rotations, I kind of felt like I saw a huge facet of these people’s lives that was just ignored,” he said.

Then, he did his rotation in psychiatry. “I realized, this is that other facet of people’s lives that is being addressed.”

Now, he’s one of a handful of new residents in the Maricopa Integrated Health System program who will spend at least the next four years training to become psychiatrists.

Psychiatry is one of the specialties you can choose as a med student, but it’s not the most common.

At the University of Arizona’s School of Medicine, about 10 percent of students in the class of 2016 went into psychiatry. About 30 percent went into primary care fields, and more than half chose other, often more lucrative specialties, like surgery, emergency medicine or radiology, according to data provided by the school.

As a result, psychiatry is a specialty that is in demand.

Across Arizona, there are not enough doctors in rural towns and inner cities.

It’s a problem that’s getting worse in the state, even though there are a number of programs aimed at filling the gap.

The state health department offers several programs to help bring doctors in to fill these gaps, like tuition reimbursement for physicians who work in underserved areas, and a visa program to hire foreign doctors to work in areas in need.

Ana Roscetti, workforce section manager for the Arizona Department of Health Services (ADHS), said she has seen these numbers increase, not decrease, over the last several years.

Roscetti oversees the programs that are supposed to alleviate the Health Professional Shortage Areas (HPSA’s) in the state.

“A lot of them are in the rural areas,” she said. “A lot of our tribal reservation areas are in HPSA’s, but there are also Health Professional Shortage Areas in our urban counties.”

There are shortages of certain kinds of doctors, as well.

“The highest unmet healthcare need in the state is mental health,” Roscetti said. “We are in dire need of psychiatrists.”

Arizona needs 204 psychiatrists to meet the need in the state, Roscetti said, as well as more than 400 primary care physicians, and more than 400 dentists.

Plus, according to Roscetti, the demand for healthcare is going up because of the Affordable Care Act, the aging population in Arizona and the state’s population growth.

According to ADHS, about five years ago, there were about 1.2 million people who were uninsured in Arizona. Since the Affordable Care Act, many of those are insured through the marketplace.

Most of the patients in Desert Vista are not there by choice. Many have been diagnosed with a Serious Mental Illness and are now ordered to treatment.

“Our training is 100 percent dealing with the difficult patient,” said Demenna. “Patients that other physicians either, they can’t connect with; they’re not perceiving reality the same way as the physician is. But, I mean, for four years that’s what I’m being taught to hone and to get better at.”

To his fellow first-year resident Brigham Niccol, the work can be trying.

“You have to deal with people not liking you, being very mad at you, yelling at you, cussing at you,” he said. “But you have to remember that they are sick and that your goal is not to feel good, yourself, but to help them feel better. And you just focus on that, and you just keep going, no matter how they treat you.”

To Christie Kesserwani, psychiatry meant she wasn’t just looking at a lab data. “I felt like I actually really got to know people, as opposed to running between patients,” she said.

They’re all aware that across the country, psychiatrists are in demand. But, that’s not necessarily why they chose the specialty, according to resident Maya Heck.

“There is a big shortage of psychiatrists and other mental health professionals, but I think it’s a huge need in our country and, I think, I kind of wanted to contribute that way too,” she said.

For Demenna, the job security that comes with entering a field in need is a plus. But, he said, it’s the patients that are really in need.

“Especially working here at county hospital, realizing the need for psychiatry is just, it’s profound,” he said, “and I think the vast majority of the world is quite insulated from the severe mental health issues that are occurring in our city.”