Do you want to advance your nursing career in mental health care? Psychiatric-mental health nurse practitioners (PMHNPs) prevent, identify and treat mental illnesses in people of all ages, helping them achieve positive change and personal growth.
If you have asked yourself, “what is it like to be a psychiatric nurse practitioner?”, read on to explore the job duties, challenges and rewards of the PMHNP profession, plus the steps to become one.
Their patient population varies depending on where they work. The most common work settings for PMHNPs are behavioral health/addiction clinics, psychiatric-mental health facilities and private practices.
PMHNPs address a variety of mental health conditions, with examples ranging from ADHD and eating disorders to obsessive-compulsive disorder (OCD).
Each state board of nursing defines PMHNPs' scope of practice. Twenty-eight states permit full practice authority, where PMHNPs can practice independently to the full extent of their training. Other states limit the scope of practice, which means PMHNPs work under physician supervision.
Generally, the job responsibilities of PMHNPs include:
- Conducting and interpreting health assessments
- Developing diagnoses
- Creating individualized treatment plans
- Prescribing medications
PMHNPs regularly collaborate with other health care providers, including physicians and other mental health professionals.
PMHNPs diagnose acute and chronic psychiatric disorders through patient assessment. Assessment involves collecting and analyzing information about patients' physical, psychological, intellectual and social well-being.
PMHNPs gather data through various methods—interviews, observation and standardized tests, to name a few.
Each day, PMHNPs may perform and interpret various assessments, including:
- Physical Assessment: PMHNPs conduct physical exams, as well as order and analyze lab and diagnostic tests to evaluate patients’ physical well-being.
- Psychological Assessment: Psychological assessment looks at symptoms of psychiatric illness and family psychiatric history. PMHNPs may interview patients and their family members, perform mental status exams and conduct psychological tests with screening tools.
- Cognitive Assessment: PMHNPs perform cognitive assessments to evaluate patients' mental function. One example is the Mini-Mental State Examination (MMSE), which assesses memory, attention, calculation and language function.
- Social Assessment: A psychosocial assessment looks at mental health and social well-being. PMHNPs review patients' lifestyles, cultures, family relationships and spirituality.
PMHNPs can make a diagnosis after completing the assessment process.
PMHNPs can diagnose psychiatric and mental health disorders and assess the risk of developing one. They form diagnoses using assessment data, diagnostic reasoning and the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
Sometimes, the diagnosis is clear. But some patients' symptoms overlap with multiple disorders. In these cases, PMHNPs use differential diagnosis to develop a list of likely options. The process of confirming or ruling out each one may involve additional assessment.
PMHNPs address the nearly 300 disorders in the DSM-5. Some of the most common diagnosable mental health conditions among U.S. adults are:
- Anxiety Disorders
- Substance Abuse Disorders
- Bipolar Disorder
- Post-Traumatic Stress Disorder
- Suicidal Thoughts
PMHNPs can diagnose certain disorders in as little as one patient visit. Other conditions take more time.
Following diagnosis, PMHNPs develop treatment plans with the patient and other health care providers. The type and duration of treatment depend on the nature and severity of the diagnosis.
PMHNPs educate patients and their family members about the treatment options. Then, they choose the appropriate plan based on critical factors, such as risks, benefits and patient preferences.
PMHNPs may have the following duties as part of treatment:
- Conducting individual or group psychotherapy
- Teaching self-care strategies
- Providing health promotion and maintenance
- Prescribing medications (depending on the scope of practice where they work)
The length of treatment varies by intervention. PMHNPs evaluate patients' responses and modify treatment plans as needed.
Like any profession, becoming a PMHNP comes with challenges and rewards. PMHNPs can enjoy the numerous benefits of this career path when they are aware of the potential difficulties and how to overcome them.
PMHNPs must manage the potential emotional overwhelm of dealing with patients in crisis. They must also handle client resistance and the mental health needs of an increasingly diverse society.
It can be challenging to avoid the emotional toll of patients’ circumstances, from violence to discovering a serious illness. Constant exposure to patients’ problems can lead to stress and overwhelm, so PMHNPs need to monitor and treat their own mental health.
PMHNPs may encounter uncooperative patients. Patient resistance can be frustrating when the PMHNPs’ intention is to provide support for their mental health needs. Fortunately, there are evidence-based techniques that PMHNPs can use to overcome opposition.
Effective care integrates patients’ preferences, culture, values and beliefs. But the U.S. is becoming more culturally complex. PMHNPs must commit to lifelong learning about themselves and others so that they can empathize with and deliver on the mental health needs of every patient.
PMHNPs provide invaluable service to those with mental health needs, while benefiting from a strong employment outlook and a higher salary than RNs.
Making a Difference
PMHNPs can make a tremendous difference in people's lives because the need for mental health care is so great. Nearly 1 in 5 U.S. adults have a diagnosable mental disorder, and the coronavirus pandemic has exacerbated mental health problems. Because PMHNPs can care for patients across the lifespan, they can improve access to psychiatric and mental health care.
The U.S. is facing a shortage of mental health care providers and a growing demand for their services. Almost half of the population lives in an area lacking mental health care providers. At the same time, providers have reported an increase in the number of patients with mental health disorders.
The increased demand for mental health care will likely continue for years. PMHNPs can address the gap while benefiting from a favorable employment outlook, with job opportunities estimated to grow 62% by 2030—over 20 times faster than the national average. PMHNPs have ample job opportunities, especially in underserved rural areas.
High Earning Potential
The rewards of a PMHNP career illustrate why now is an ideal time to become a PMHNP. Here are the four steps for RNs with a Bachelor of Science in Nursing (BSN):
- Complete an accredited psychiatric nursing program: RNs with a BSN can become PMHNPs by earning an accredited master’s or doctoral degree in psychiatric nursing. A doctoral degree is the most advanced and takes longer. If becoming a PMHNP in less than three years is important to you, consider a master’s degree.
- Obtain PMHNP national board certification: Graduates of psychiatric nursing programs apply for the national board certification exam. A passing score earns candidates the Psychiatric-Mental Health Nurse Practitioner-Board Certified credential (PMHNP-BC™).
- Obtain state licensure: Board-certified PMHNPs apply for licensure in the state where they wish to practice. The eligibility requirements vary by state.
- Complete continuing education: Every few years, licensed PMHNPs must complete continuing education to renew their state license and national board certification.
Start Your Journey to Becoming a PMHNP at Rockhurst University
Through holistic psychiatric and mental health care, PMHNPs empower well-being and positive change for individuals, families and communities. In turn, PMHNPs benefit from a rewarding career with endless learning opportunities.
Do you want to address the need for mental health professionals through an advanced nursing career? Consider becoming a PMHNP through Rockhurst University’s online MSN-PMHNP program, delivered by the highly respected Saint Luke’s™ College of Nursing and Health Sciences.
The flexible, immersive program features:
- 100% online coursework
- Two immersions—one virtual and one on Rockhurst’s campus in the heart of Kansas City, Missouri
- Hands-on clinical rotations in your local community, supported by complimentary placement services
Authorized by 23 states, including Missouri and Kansas, the accredited online MSN-PMHNP program prepares RNs with a BSN to pursue leadership as mental health advocates. Students develop as advanced practice nurses who care for the whole person.