In this article:
- Today's mental health needs
- What does a psychiatric mental health nurse practitioner do?
- Difference between psychiatric nurse practitioner and family nurse practitioner
- Why become a psychiatric mental health nurse practitioner?
- Job projections for advanced nursing practice
- Particular needs for psychiatric mental health nursing
- How to become a psychiatric mental health nurse practitioner?
- Education and certification requirements
In the United States today, almost 20% of adults and approximately half of adolescents struggle with some level of mental illness. Close to eight percent of adults have a substance abuse disorder. These epidemics have led to sharp increases in demand for the specialized role of the psychiatric mental health nurse practitioner.
For nurses considering this expanding area of healthcare, this post explores the question: what does a psychiatric nurse practitioner do?
- Depression and anxiety
- Eating disorder
- Personality disorder
- Disruptive behavior
- Trauma-related disorder
A psychiatric mental health nurse practitioner is licensed and nationally board certified to provide psychiatric care for patients with mental illness. The current nationwide mental health crisis has created a wide range of psychiatric needs in contemporary healthcare.
Mental health disorders are diagnosed following the standards of the Diagnostic and Statistical Manual of Mental Disorders (DSM). This extensive reference book, widely considered authoritative, was developed by the American Psychiatric Association in collaboration with leading scientists and practitioners. The most current version, the DSM-5, includes a broad range of diagnosable mental health issues such as:
- Depression and anxiety
- Eating disorder
- Personality disorder
- Disruptive behavior
- Trauma-related disorder
The U.S. Department of Health and Human Services has specifically studied the pervasiveness of mental health disorders among teens. The HHS statistics identify the most frequently occurring conditions in adolescence. Affect this percentage of teens:
The broad category of Any Mental Illness (AMI) includes mental health conditions from mild to severe in scope. The subset Serious Mental Illness (SMI) identifies AMI patients whose condition intensely affects life in one or more significant ways.
Approximately one in five American adults – more than 46 million—are categorized with AMI, and approximately one-fourth of these are identified as SMI. Almost one-half of teens experience AMI, with 22% of these categorized as Serious Mental Illness.
The experience of mental illness is also linked to substance abuse in almost 20% of cases. Likewise, almost half of adults presenting a substance use disorder also struggle with mental illness. Adolescents are particularly at risk for the development of co-occurring mental health and substance abuse issues.
A psychiatric mental health nurse practitioner is trained to care for patients with mental health issues across the lifespan. Nurse practitioners are qualified in assessment, diagnosis, planning and evaluation, often providing some of the same services as medical doctors.
Nurse practitioner scope of practice varies from state-to-state, with regulations varying from full practice to reduced or restricted practice. In 22 states and Washington, D.C., nurse practitioners now have full practice authority. In states with reduced or restricted practice, nurse practitioners often work in collaboration with, or under the authority of, a physician.
When caring for a patient, the psychiatric mental health nurse practitioner role may include a series of steps in patient care, such as:
- Carry out examinations and mental health assessments
- Diagnose psychiatric illness
- Educate the patient and family
- Prescribe a treatment plan, including medications
- Lead psychotherapy sessions
- Coordinate services for other healthcare components
A Distinction in Roles
The question “what does a psychiatric nurse practitioner do?” also raises the need for clarification about nurse practitioner roles. It is helpful to consider the practical differences in psychiatric nurse practitioner vs family nurse practitioner.
A psychiatric nursing role focuses on a patient’s mental health, while the family nurse practitioner coordinates many aspects of healthcare. The psychiatric mental health nurse practitioner often works in collaboration with a family nurse practitioner to promote holistic care.
Nurse Practitioners Working Together
Due to high rates of co-occurring conditions with psychiatric disorders, coordinated care is especially important for patients experiencing mental illness. Individuals with psychiatric and physical comorbidity face complex effects, including:
- High degree of medical complications
- Decrease in activity levels
- Lower life expectancy
- Diminished quality of life
- Higher medical expenses
The cause-and-effect nature of mental health/medical comorbidity can go either way. For example, drugs prescribed for psychiatric conditions can cause adverse physical effects such as weight gain. On the other hand, an adverse medical condition can lead to mental health implications like depression.
This is why healthcare advocates like the Robert Wood Johnson Foundation promote models of collaboration in the treatment of mental illness.
A psychiatric mental health nurse practitioner is prepared with advanced knowledge in the focused area of mental health. This includes the scientific basis of identified disorders and specific treatments, including psychotropic medication and psychotherapy.
A family nurse practitioner is well-positioned as a central point of primary care and may need to coordinate services of another specialist. Educated in comprehensive primary care of both acute and chronic conditions, the FNP looks out for the patient’s overall health and collaborates with other specialties as needed.
The FNP is also a primary gatekeeper for assessing a patient’s need for mental health services and identifying family risk.
The profession of nurse practitioner is one of today’s fastest-growing fields, with high growth projections in the next several years. Practice settings related to mental health are some of the highest locations of growth. According to the Bureau of Labor Statistics, here are some points of interest for the psychiatric mental health nurse practitioner:
|Projected increase in jobs 2018-2028|
|Offices of mental health practitioners (except physicians)||
|Outpatient mental health and substance abuse centers||24.8%|
|Psychiatric and substance abuse hospitals||14.3%|
|Residential mental health and substance abuse facilities||30.7%|
Nurse practitioner is one of today’s most sought-after careers. The Bureau of Labor Statistics calculates the median annual salary for a nurse practitioner at $109,820. U.S. News & World Report rankings list nurse practitioner at #5 in Best STEM Jobs, #4 in Best Healthcare Jobs, and #5 in 100 Best Jobs overall.
Further specializing, such as becoming certified as a psychiatric mental health nurse practitioner, gives an advanced practice nurse distinct career opportunities.
As the country is facing a crisis in mental health, there is also an alarming shortage of psychiatric providers. This means many people are not getting needed help, leading to a multitude of implications for individuals, families and communities. The rise of the role of psychiatric mental health nurse practitioner may help to fill the gap.
Of the approximately 290,000 nurse practitioners in the United States, less than two percent are certified in psychiatric/mental health–family. The needs far exceed the resources, which is a compelling answer to the question, “why become a psychiatric nurse practitioner?”
Recent studies show a decrease in the number of practicing psychiatrists in recent years, while needs have also steadily increased. A summary of research includes these findings:
- 77% of counties in the U.S. report detrimental shortages of mental health providers.
- 55% of counties have no psychiatrists actively practicing.
- 43 states are vulnerable to the significant effects caused by a lack of providers.
- There is an expected shortage of 12–25% of needed psychiatrists by the year 2025.
- The needs for child and adolescent psychiatric services are particularly severe.
Because of the limited number of mental health providers, many individuals remain undiagnosed or have long wait times for treatment. According to the National Alliance on Mental Illness, there is often a gap of many years before an individual begins treatment. This lag means that the condition may progressively worsen, decreasing the likelihood of positive outcomes.
Opportunity to Channel Your Passion and Change Lives
A psychiatric mental health nurse practitioner can make a lasting difference in the lives of patients. Effective prevention and treatment of mental illness have been shown to affect long-term outcomes positively, and nurses play a crucial role.
The U.S. Office of Disease Prevention and Health Promotion has identified strong correlations between mental health intervention and favorable results. These are some examples:
- Preventative care can influence the trajectory of issues that typically progress and develop over a number of years.
- Intervention can reduce the prevalence of depression in identified high-risk groups.
- When mental health care begins at an early age, there is a higher possibility to affect positive outcomes.
- In some cases, even severe mental disorders may be preventable.
- Mental illness prevention includes a combination of factors, including healthcare, family dynamics, and educational initiatives.
The expanding presence of the psychiatric mental health nurse practitioner will be critical to meeting the demand for mental health care. Beyond patient care, a nurse practitioner can also be a leader in healthcare, advocating for cultural and system changes.
A workforce development report by the American Psychiatric Nurses Association identifies several opportunities for influence. Some of the proposed action areas include:
- Engagement in public policy development
- Advocacy for the role of nursing in psychiatric care
- Strategic influence of mental health nurses in education
- Input in healthcare initiatives within leading organizations
Advancing to the role of psychiatric mental health nurse practitioner positions a nurse for a greater scope of influence. The opportunity to broadly affect mental health care further answers the question, “why become a psychiatric nurse practitioner?”
Education for a psychiatric mental health nurse practitioner (PMHNP) includes a master’s in nursing with specialized study in mental health. Completing a PMHNP program prepares students for the national certification exam administered by the American Nurses Credentialing Center (ANCC).
For board certification by the ANCC, candidates are evaluated in comprehensive areas of expertise. The exam components include practice, diagnostic and treatment skills, as well as scientific and legal analysis. These are some examples of the range of competencies covered in the testing:
- Neurological development, anatomy, and physiology
- Clinical screening and risk assessment
- Treatments and pharmaceuticals
- Theories of psychotherapy
- Patient rights and standards of care
The Psychiatric/Mental Health Nurse Practitioner (PMHNP) Track at Wilkes University
The Wilkes University Master of Science in Nursing – Psychiatric/Mental Health Nurse Practitioner program is preparing nurses to change lives in the field of mental health. A psychiatric mental health nurse practitioner degree elevates your nursing career as you channel your passion. Clinical placement services, national board certification exam preparation, and support resources are integrated into the Wilkes program.
If you are already a nurse practitioner, the Wilkes post-graduate certificate program is an accelerated pathway to certification in psychiatric mental health.
The Psychiatric/Mental Health Nurse Practitioner (PMHNP) concentration will lead you to develop:
- Competence in prescribing and monitoring medications used in the treatment of psychiatric/mental health disorders across the lifespan
- Skills in completing comprehensive mental health assessments
- Experience in conducting individual, family and group psychotherapy
- Knowledge of clinical modalities and theories
- Appropriate approaches for specified psychiatric/mental health conditions
- Aptitude for identifying individuals/populations at risk for mental illness
- Insights for prevention in mental health, with consideration to culturally diverse, rural, and underserved populations
Becoming a psychiatric mental health nurse practitioner (PMHNP) is within reach for nurses who are ready to move forward in healthcare.
How Do I Learn More about Becoming a Psychiatric Nurse Practitioner?
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