Psychiatric Nurse Practitioner vs. Psychiatrist

 A nurse practitioner conducts a patient evaluation in a medical office.
A nurse practitioner conducts a patient evaluation in a medical office.

Mental health challenges affect millions of people in the United States, with nearly one in five adults experiencing mental health issues every year. Without proper care and support, mental illness can be debilitating, making access to quality mental healthcare an essential element of our healthcare system. 

Providing professional care to patients with mental health issues requires an advanced education and specialized certifications, such as a doctorate degree or post-master’s certificate in psychiatric mental health nursing. Those interested in this career path may benefit from learning more about the differences between a psychiatric nurse practitioner vs. a psychiatrist and what it takes to become a qualified practitioner. Through time and dedication, mental health practitioners have the opportunity to make a positive, long-lasting impact on the lives of others. 

What Is a Psychiatric Nurse Practitioner?

Psychiatric mental health nurse practitioners (PMHNPs) are licensed and board-certified advanced practice registered nurses (APRNs) who specialize in providing mental healthcare. During their education as nurse practitioners (NPs), advanced practice nurses have the opportunity to choose between a variety of NP specialties, ranging from pediatric care to acute care or, in the case of PMHNPs, mental healthcare. 

Becoming a PMHNP requires many years of focused education as well as earning the necessary certifications. Beginning with either an associate's degree or bachelor’s degree, individuals can pursue licensure as registered nurses (RNs) by passing the National Council Licensure Examination for Registered Nurses (NCLEX-RN). 

For RNs, the journey to becoming an NP then requires the completion of either a master’s degree in nursing (MSN) and post-master’s certificate or a Doctor of Nursing Practice (DNP) This is followed by attaining certification and licensure in the state a graduate chooses to practice and in their specialization. By pursuing each program consecutively and completing clinical work experience, the path to becoming a psychiatric nurse practitioner may take around 8-10 years. 

What Does a Psychiatric Nurse Practitioner Do?

Psychiatric nurse practitioners are qualified to provide all of the same care as registered nurses, with the added skills and services reserved for advanced practice certified NPs. The list of duties an NP can assume includes: 

  • Prescribing and administering medication including pharmacotherapy, depending on the state practice environment
  • Monitoring patients 
  • Providing emergency care
  • Providing support services for patients and their families
  • Ordering tests and diagnostics
  • Ensuring and providing patient care programming
  • Offering counseling services

This broad scope of skills and responsibilities makes NPs incredibly valuable members of healthcare organizations. Tasked with the diagnosis, treatment and care of patients struggling with mental illness, these nurses undertake tasks that often look similar to the functions of psychiatry, encountering many of the same illnesses and conditions. In many cases, what distinguishes the psychiatric nurse practitioner vs. psychiatrist is the practice environment in which NPs perform, including the state and type of healthcare facility. 

Depending on where psychiatric nurse practitioners work, they may encounter different illnesses, the severity of cases, patient age groups or chronic versus acute care. Some of the facilities PMHNPs may find themselves in include: 

  • Mental health clinics
  • Hospitals 
  • Private practice
  • General and psychiatric hospitals
  • Community agencies
  • Courts and prisons
  • Long-term care facilities
  • Rehabilitation programs

Earning an advanced degree and specialization can help practicing nursing leaders better shape their future, allowing them to pursue opportunities in the type of facility that works for them. In addition to variations in severity and types of cases, patient demographics and work responsibilities, different facilities and work settings will offer different schedules, on-call availability and salary or bonus structures. This enables prospective nurses to make choices in line with their personal and professional goals. 

What Is a Psychiatrist?

Psychiatrists are medical doctors who specialize in the field of mental healthcare. Tasked with providing preventive care as well as diagnosing, treating and managing the care of patients who suffer from mental illness, psychiatrists are instrumental to the health and overall productivity of individuals across society. 

Requiring the completion of a bachelor’s degree, medical school and a clinical psychiatric residency program, the journey to becoming a psychiatrist is a significant commitment that typically takes 12 years. Psychiatrists are certified as medical doctors (MDs) or Doctors of Osteopathic Medicine (DOs). By passing the United States Medical Licensing Examination (USMLE®) and the certifications required by their state, they can provide much-needed, life-saving care to their patients. 

What Does a Psychiatrist Do?

The care that psychiatrists provide is a combination of empathetic communication and treatments based on advanced knowledge of medical science. Because they diagnose, treat and deliver care plans often including the prescription of psychotropic medications, the care they provide is critical, complex and closely regulated. With nearly one in 20 Americans suffering from severe mental illness, the decisions that psychiatrists make can have a long-lasting impact on the lives of their patients.

On a day-to-day basis, psychiatrists may provide services including:

  • Patient assessment and diagnosis
  • Ordering and interpreting tests
  • Providing counseling and care programming
  • Prescribing medications 
  • Administering medications or supervising other medical professionals in the provision of care
  • Monitoring patient progress
  • Providing emergency medical treatment 
  • Imparting mental healthcare education

While more than half of psychiatrists are in private practice, many work in a variety of healthcare settings and often find themselves providing highly specialized care. Some of these settings include:

  • Psychiatric and general hospitals
  • Nursing homes and clinics
  • Military settings
  • Community health centers and outpatient clinics
  • Government agencies, courts and prisons

Depending on their work environment, the types of cases and patients psychiatrists treat can vary greatly. Psychiatrists who choose to work in private practice can better manage variables such as scheduling and the scope of their practice. For prospective students, deciding between the psychiatric nurse practitioner vs. psychiatrist career paths may be influenced by the type of facility they would like to work in, the patient demographic they would like to treat and the long-term career goals they would like to achieve. 

Psychiatric Nurse Practitioner vs. Psychiatrist: Similarities and Differences 

For most medical professionals, a healthcare career is as much a calling as it is a job. Due to the complex nature of mental healthcare, treating and supporting patients with mental illness can be both challenging and incredibly rewarding, as it requires one to draw almost daily on extensive training, experience and knowledge.

Understanding how these challenges and rewards play out for the psychiatric nurse practitioner vs. psychiatrist roles may help prospective students choose which path is right for them. 

What Makes a Psychiatric Nurse Practitioner and Psychiatrist Similar?

Many of the day-to-day responsibilities of a psychiatric nurse practitioner and a psychiatrist are the same. Both are highly qualified practitioners who specialize in mental healthcare, and both will handle many of the same illnesses, patient requirements and daily tasks. 

Applying in-depth knowledge of human behavior and mental health conditions, both PMHNPs and psychiatrists diagnose, treat and prescribe medications or treatment plans to patients suffering from mental illness. These tasks require both groups of professionals to be strong communicators, treating their patients with empathy and understanding. Additionally, both roles have the opportunity to fight the stigma that is often attached to mental illness, by providing valuable services, education and resources to their communities. 

What Makes a Psychiatric Nurse Practitioner and Psychiatrist Different?

One of the main differences between psychiatric nurse practitioners and psychiatrists is the educational path for each role. PMHNPs typically need an undergraduate education to become RNs. They also need a graduate education — this could mean a master’s, a doctoral degree or a post-master's certificate. They also usually have several years of work experience. This may take around 6-8 years, depending on the educational path. 

Psychiatrists, on the other hand, need to complete an undergraduate degree, take the Medical College Admission Test (MCAT) and earn a doctor of medicine (M.D.) or a doctor of osteopathic medicine (D.O.). They must then complete their residency training and fellowship before applying for their medical license and relevant certification. This education and training can take about 12 years to complete.

Another difference between these two roles is their approach to care. While PMHNPs can prescribe medication in states with full practice authority, they tend to take a less pharmacological approach than a psychiatrist. Instead, they focus on holistic care and counseling approaches, building strong relationships with their patients. 

The rules that govern professional practice vary from state to state, and this impacts the difference between psychiatric nurse practitioners vs. psychiatrists. State practice authority laws regulate which care services NPs are legally allowed to provide, dictating whether PMHNPs are qualified to work under Restricted Practice regulations, Reduced Practice regulations or Full Practice Authority. 

In full practice authority states, qualified PMHNPs can provide comprehensive evaluation services to patients, including the ordering and analysis of tests, diagnosis of medical conditions and the prescription of medications and controlled substances. In states that do not allow full practice authority, PMHNPs may be required to be supervised by a psychiatrist or other medical doctor to provide these care services. 

Make a Positive Difference With a Nursing Career in Psychiatric Care 

Mental health practitioners provide essential and life-saving care every day, and there is a growing need for skilled mental health practitioners across the country. Able to administer a broad spectrum of care and services to their patients, PMHNPs play an essential role in our hospitals, improving access to mental healthcare in many regions and changing the way we think about mental illness.

If you are passionate about both mental healthcare and the nursing practice, pursuing a higher education — such as the Post-Master’s Nursing Certificate for Psychiatric Mental Health Nurse Practitioners from Spring Arbor University — can be a key step in reaching your personal and professional goals. Accredited by the Commission on Collegiate Nursing Education (CCNE), the program from Spring Arbor University is faith-based with a flexible schedule designed for working nurses. 

Discover how you can make a difference as a psychiatric mental health nurse practitioner. 

Recommended Readings

Top Nursing Team Building Strategies

PMHNP: Bridge Gaps in Behavioral Healthcare

Self-care for Nurses: How to Prioritize Yourself When Caring for Others


American Association of Nurse Practitioners, “Are You Considering a Career as a Psychiatric Mental Health Nurse Practitioner?”

American Association of Nurse Practitioners, State Practice Environment

American Psychiatric Association, Choosing a Career in Psychiatry

American Psychiatric Association, What is Psychiatry?

American Psychiatric Nurses Association, “About Psychiatric-Mental Health Nursing”

Incredible Health, “Psychiatric Nurse Practitioner vs. Psychiatrist: What’s the Difference?"

Indeed, “5 Steps to Become a Psychiatrist”

Indeed, “How to Become a Psychiatrist (With Salary, Skills and FAQs)”

Indeed, “Psychiatric Nurse Practitioner vs. Psychiatrist”

National Alliance on Mental Illness, Mental Health By the Numbers

National Institute of Mental Health, Mental Health Information

U.S. Bureau of Labor Statistics, Nurse Anesthetists, Nurse Midwives, and Nurse Practitioners

U.S. Bureau of Labor Statistics, Psychiatrist