Idaho State University, University of Utah Graduate First Cohort of Idaho Rural Track Psychiatry Residents

Idaho State University and the University of Utah, both schools with a distinct educational focus on health professions, have worked together to bring about positive change for access to mental health care in Southeast Idaho.

The collaboration between the schools saw psychiatry resident physicians working and training in both states, offering critically needed mental health care for populations such as United States veterans, members of the Shoshone Bannock Tribes, students at ISU, and incarcerated individuals at Idaho State Women’s Prison. 

The first graduating class from the Idaho Rural Track Psychiatry Residency Program received their certificates, awarded by U of U, on June 7 in Pocatello. Their impact in the region has been substantial.

The University of Utah’s Psychiatry Residency Rural Track’s mission is to train community centered psychiatrists who will play an integral role in the development of mental health programs and practices in rural or high need communities where they will be able to use their creativity and passion to develop and fill diverse roles as advocates, consultants and leaders in various mental healthcare settings. 

Despite its small number, the Class of 2024 has done just that. Their experience in SE Idaho compelled each of them to grow in new ways in order to serve distinctly unique patient populations. 

Following her residency, Daisha Orchard, MD is taking on an enhanced role as the director of the new ISU Community Psychiatry Center, which opens July 15 in Pocatello. Orchard spearheaded the project after seeing patients at ISU’s Health Center, primarily students who sometimes struggled with not just one, but two or more mental health disorders at one time, such as bipolar disorder, schizophrenia or ADHD.The new ISU Community Psychiatry Center is open to everyone.

“For young adults, this is the first time they might have been away from home, away from their normal environment, and for a lot of these students, this is the first time they’ve ever seen a psychiatric provider,” Orchard says. “That’s the age range that a lot of first episodes of psychiatric illness happen. Working with students and student athletes, I’ve seen firsthand the enormous pressure they’re under, both academically and in their individual sports.”

Orchard, like many health care providers completing residencies, is a testament to the need for  individualization of residency training and location placement, which frequently leads to the desire of providers to stay and practice there.

“I feel very strongly that the only way we’re going to get physicians in rural areas is if they come from rural areas, or they have the opportunity to train in rural areas,” says Orchard. “I am thrilled to stay here and work in southeast Idaho. This is where my family is, but this is also where the community that I’ve grown to love is.”

Another resident, Christian Schmutz, MD, is going to a geriatric fellowship at Stanford University and joining U of U as adjunct faculty to provide supervision to future psychiatry residents at Indian Tribal Health Services in Fort Hall. 

Schmutz says one of the difficult parts of the health care system is that people with severe mental health needs often end up in prison or jails, and it can be even more compounded here on a reservation. 

During his time in SE Idaho, Schmutz developed a program there to instill confidence and boost mental health care visits among members of the Shoshone-Bannock tribes. By immersing himself in native activities, forming relationships and teaching himself some Shoshone phrases, Schmutz was influential in changing the stigma surrounding mental health treatment, and health care in general, among tribal members.

“The Shoshone and Bannock people have had a difficult history with Western medicine and have felt exploited. There is a trust barrier to overcome,” Schmutz explains. “For me personally, I approach my patients with a cultural humility, letting them teach me what experiences are normal for themselves, their families and their culture, without assuming anything is pathological.”

Matt Torbenson, MD, was able to bring much needed care for patients in both Idaho and Utah, seeing a broad spectrum of individuals throughout his residency. Working at Health West ISU in Pocatello, along with the Salt Lake City Veterans Affairs Medical Center, he served patients living with HIV, patients struggling with substance use disorders, veterans living with PTSD, and patients seeking transgender care, among others. 

Torbenson understands that medication is just one form of treatment he and other psychiatrists are able to provide. In order to bring about the best outcomes for patients, though, it’s not the only option. For many patients, behavioral treatment such as exercise, acceptance and commitment therapy (ACT), mindfulness and self-compassion therapy are equally successful when combined with prescription medications. 

“When it comes to psychiatric treatment, it’s all about understanding how we communicate with patients and therapy is a huge part of that,” says Torbenson. “Psychology and psychiatry blend so much and sometimes patients just don’t know where to go or what to do. I have the ability, right there as I’m working on medications with a patient, to encourage these behaviors as well,” he adds.

The next step for Dr. Torbenson is an addiction focused psychiatry fellowship at the University of Utah. 

The collaborative program between U of U and ISU was created due to the critical need in both states. Idaho ranks 49th in the U.S. for physicians per capita. For mental health care providers specifically, the entire state is considered a shortage area, or health care desert, as existing providers can meet only 25 percent of the current need. To the south, Utah faces a similar problem, with 99 percent of the state considered a shortage area. Tragically, both states are among the top 15 annually for the highest suicide rates among both adults and youth.

Orchard, Schmutz and Torbenson, along with other residents in the program, spend the majority of their first two years in Salt Lake City, UT working alongside fellow residents in the Adult Psychiatry program focusing on mastering skills in general medicine as well as completing required inpatient and some subspecialty psychiatric rotations. 

During years three and four, residents transition to Pocatello, where they continue to refine their psychiatric skills. During residents' third year they primarily focus on outpatient training with the fourth year being dedicated to trainee-specific interests, passions and individualization. 

“Even in just two short years, these residents have greatly impacted accessibility to mental health care by completing rotations at many institutions across SE Idaho who serve a variety of patient populations,” says Rex Force, vice president for health sciences and senior vice provost for ISU. “The addition of mental health care providers has led to increased access to care for patients in rural areas suffering from mental health crises, students at our universities, inmates incarcerated , our deserving veterans, and many more,” Force explains.

Force says that funding for the program came from a number of sources, including the Idaho State Legislature, Portneuf Medical Center, Health West, ISU and the Department of Veterans Affairs. By collaborating, these two schools, who lead the region in health professions education, have begun to greatly impact the state of mental health care and bring positive change to this health care sector.