Among the many paths a nursing career might take, the path of psychiatric-mental health nurse practitioner (PMHNP) is one of the most rewarding. While nurses of all specialties are in high demand, the need for healthcare providers trained in psychiatric-mental health is even greater.
PMHNPs provide an ideal mix of knowledge, experience and versatility to help their communities receive the behavioral healthcare they need.
Serving as a PMHNP is rewarding—you'll make an impact daily, be well compensated for your work and enjoy great flexibility in your career.
In this blog, we shed light on what a PMHNP does, how these nurse practitioners fit into the behavioral healthcare ecosystem, and steps you can take to become one.
What Is the Role of a PMHNP?
A psychiatric-mental health nurse practitioner is a nurse practitioner (NP) licensed to serve healthcare needs within the framework of behavioral healthcare. Along with the ability to perform physical evaluations, this specialty qualifies them to:
- Evaluate, diagnose and treat psychiatric and mental health conditions
- Work with individuals, families and groups
- Perform psychotherapy
- Prescribe medication
- Coordinate care with other healthcare professionals
- Intervene for those experiencing a health/behavioral health crisis
Because a PMHNP is qualified to treat patients across the lifespan, they can help people from all walks of life—from children to adults to the elderly.
A PMHNP's patient population is diverse; they may work in a school helping students experiencing stress-induced mental health conditions or treating individuals who have experienced trauma to cope with the effects of post-traumatic stress disorder.
A PMHNP may also help seniors and their families manage illnesses such as Alzheimer's or dementia or treat people struggling with substance use disorder(s).
The scope of practice for a PMHNP is also determined by the state's regulations in which they work. The American Association of Nurse Practitioners (AANP) tracks scope of practice and which states allow full, reduced and restricted NP practice authority.
The State of Behavioral Healthcare
In 2013, President George W. Bush signed the Mental Health Parity and Addiction Equity Act into law—a milestone for behavioral healthcare that requires insurers to cover mental and physical illnesses equally.
The measure was intended to make behavioral healthcare more accessible to those battling mental illness and substance use disorders. But another obstacle stood between patients and the care they needed: an acute shortage of providers.
From 2003 to 2013, the number of psychiatrists treating public sector and insured patients dropped by 10%. Additionally, just as the number of providers was shrinking, the scope of the opioid epidemic was growing.
Today, one in five Americans are living with a mental health condition. The Department of Health and Human Services (HHS) reports that less than half of adults (44%) and less than a quarter of children (20%) receive the behavioral healthcare they need. And these numbers may rise as 77% of US counties remain underserved by psychiatrists.
Indeed, the Health Resources & Services Administration (HRSA) expects that this shortage will only continue. In its report "Behavioral Health Workforce Projections: 2017–2030," the administration claims, "between 2017 and 2030, the total supply of all psychiatrists is projected to decline as retirements exceed new entrants."
As the need for behavioral healthcare grows, so will the demand for mental health care professionals, including qualified PMHNPs.
The Impact of COVID-19 on Behavioral Healthcare
The World Health Organization (WHO) found in October 2020 that the COVID-19 pandemic has disrupted or stopped critical mental health services in more than 90% of countries across the globe. The pandemic has also pushed demand for behavioral healthcare higher, as grief, isolation in quarantine, anxiety and fear have taken an emotional toll.
These conditions have culminated in a national mental health crisis. The behavioral healthcare field faces some critical challenges in overcoming this crisis, including:
- An aging workforce
- Demand for care that outpaces provider availability
- Care that is disproportionately disbursed, with rural areas experiencing even greater shortages of care
- A migration of providers into cash-only private practices
- Insufficient cross-training for collaboration with primary care
These challenges present an opportunity for an influx of new providers who are willing to work with integrative care teams and serve patients in need of services.
What Value Does a PMHNP Bring to Patients and the Community?
A PMHNP is uniquely qualified to help tackle the shortage of behavioral healthcare providers and bridge gaps in the behavioral healthcare landscape. Especially valuable are their foundational training, their versatile clinical skills and the individually-based care they deliver.
Behavioral Healthcare and Primary Care
Because they've completed an advanced degree in nursing with a concentration in psychiatric-mental health, a PMHNP gains crucial knowledge in primary and integrative care.
One main benefit is that they are able to deliver targeted psychiatric care while screening for other comorbid conditions (e.g., hypertension or diabetes). For instance, in community care settings, this is particularly important for treating patients with a variety of medical needs.
Serving Vulnerable Populations
The AANP highlights that the role the PMHNP serves is to promote healthcare to its fullest definition since "health cannot exist without mental health."
The AANP also notes most PMHNPs work in psychiatric-mental health facilities—not cash-only private practices, which may have barriers to care accessibility—and over 80% of full-time nurse practitioners serve patients on Medicare and Medicaid.
Formal education in the treatment of mental health may also serve to promote advocacy and fight against stigmas surrounding psychiatric conditions, which, at times, may reside in some healthcare settings.
In a 2019 report, the American Psychiatric Nurses Association (APNA) cited research that found, "non-psychiatric nurses often view patients with mental illness as problematic, disruptive, more complex, and unpredictable." These preconceptions do not serve patients and may negatively impact the quality of care.
There is a need for mental health providers to deliver care and advocates to spread knowledge and compassion in the industry. A dedicated PMHNP stands to make a difference on many levels, promoting health and wellbeing on an individual and large scale.
Closing the Gap
The impact of each PMHNP is significant—in fact, the HRSA reports that "rapid growth in the supply of psychiatric nurse practitioners and psychiatric physician assistants may help blunt the shortfall of psychiatrists."
The smaller the disparity between the supply and demand for qualified behavioral healthcare providers, the better off communities are.
When communities can access behavioral healthcare services that they need, they experience a variety of positive impacts, including:
- Increased earnings due to greater productivity at work
- Increased student retention in schools
- Reduced rates of suicide
- Reduced mortality due to drug overdose
- Improved care for patients with mental health disorders across care settings
PMHNP Career Outlook
In general, nurse practitioners enjoy a healthy job outlook. The Bureau of Labor Statistics reports that NP employment is expected to grow by more than 50% over the decade from 2019–2029, making it the second-fastest-growing job in the US.
There are just over 12,600 PMHNPs in the US, according to a survey by AANP. And the APNA reports that "[psychiatric-mental health] nurses are the fastest growing non-physician specialty in healthcare."
At the same time, psychiatric-mental health nursing programs are more scarce than other specialties, making it challenging for some nurses who want to transition into the field or advance as a PMHNP.
PMHNP Pay and Work Environment
Among all nurse practitioners, a PMHNP earns the highest median salary at $125,000 per year. And the median total annual income of the role, which includes bonuses and incentives, is $131,500.
A PMHNP can work in a variety of clinical settings, including:
- Mental health
- Private practice
- Inpatient centers
- Public health organizations
- Schools and universities
- Correctional institutions
This diversity of settings means that a PMHNP can choose the type of work environment that best fits their needs. Those seeking traditional business hours may benefit from working at community centers or similar settings; whereas, those who prefer working a few days a week with longer shifts may choose hospitals.
How to Become a PMHNP
Becoming a PMHNP can be a fulfilling and rewarding way to advance your career. If you are interested in behavioral healthcare and want to become a PMHNP, you'll need the right preparation and education.
To start the path to becoming a PMHNP, a candidate must have both:
- An active registered nurse (RN) license
- A master of science in nursing degree (MSN) or doctor of nursing practice degree (DNP)
For RNs who hold an associate's degree, you'll need to earn a bachelor's in nursing (BSN) before pursuing an advanced degree (or in tandem with a reputable RN-MSN bridge program).
After you earn your MSN with a PMHNP concentration, the next step will be to gain licensure through a credentialing body and the state(s) in which you hope to work.
Choosing a PMHNP Degree Program
Online PMHNP programs can be a flexible way to earn a degree while working.
Spring Arbor University offers two online paths to achieve a thriving PMHNP career through its Master of Science (MSN)-Nurse Practitioner programs:
- Online BSN to MSN-NP degree program
- Online RN to MSN-NP bridge program
Both programs offer NP specialization in psychiatric-mental health and support for online students, from the day classes start until graduation.
PMHNP students will learn:
- A foundation in theory and clinical practice guidelines for assessing, diagnosing and intervening in psychiatric disorders across the lifespan
- Skills in psychotherapeutic treatment modalities and communication
- Epidemiology, health and mental health promotion and prevention, risk factors, cultural factors, and assessment issues of major psychiatric disorders
Ranked No. 5 for best online MSN program by Best Value Schools, Spring Arbor is noted as one of the top NP programs in Michigan.
Uniquely designed for working nurses, the online MSN-NP program allows PMHNP students to:
- Take just one course at a time and earn your degree while you continue working
- Enjoy a week off in between classes with a flexible 7-1-7 model (7-week courses, 1-week break)
- Join a caring community of students from different backgrounds who share common career goals as you learn from engaged faculty
- Grow professionally, personally, and spiritually through a curriculum rooted in an ethical, Christian perspective
- Be supported by a dedicated Student Success Coach who serves as your personal liaison
You can find balance without compromising work, school, and your home life while earning your degree—and be prepared to change lives as a PMHNP.
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