Increasingly common is the understanding that mental health is just as important as physical health. As the stigma surrounding mental illness continues to break down, more and more people may find themselves seeking psychiatric and mental health care—and that care may be provided by a Psychiatric-Mental Health Nurse Practitioner (PMHNP).

Steps to Become a Psychiatric-Mental Health Nurse Practitioner

There are some common steps to take in order to become a PMHNP. Review the step-by-step guide below to get a general sense for what the process entails:

1. Become a registered nurse. 

To become a PMHNP, you must first obtain a license as a registered nurse (RN) in a U.S. state or territory. To do this, you’ll need to complete an associate degree in nursing program, a diploma in nursing, or a four-year Bachelor of Science in Nursing. After you complete your program, you’ll be eligible to take the RN licensing examination.

2. Pass the NCLEX-RN examination. 

To be certified as an RN, you’ll need to complete and pass the official RN licensing examination—the NCLEX-RN. After that, you can apply for state licensure as an RN.

3. Apply to accredited PMHNP programs. 

Whether you’re applying to a master’s or doctoral PMHNP program, it must be accredited by either the Commission on Collegiate Nursing Education (CCNE) or the Accreditation Commission for Education in Nursing (ACEN), to ensure it meets educational standards.

4. Complete 500 relevant, faculty-supervised clinical hours. 

To meet the requirements of the Psychiatric-Mental Health Nurse Practitioner (PMHNP-BC) certification, you’ll need to complete 500 faculty-supervised hours specifically related to the PMHNP role and client population.

5. Apply to take the psychiatric-mental health nurse practitioner exam. 

To earn your PMHNP certification, you’ll need to take—and pass—the psychiatric-mental health nurse practitioner exam administered by the American Nursing Credentialing Center (ANCC).

6. Apply for state-specific PMHNP certification. 

You’ll also need to apply for PMHNP certification in the state you wish to practice. Note that there are different state-specific requirements and disparities in practice laws, regulations, and qualifications across the U.S. In other words, practice laws in the state where you currently live may not be the same as those in the state where you attended school.

Once you’ve passed the exam and earned your PMHNP certification, you’ll need to renew it every five years, through the ANCC board as well as through your specific state board. Keep in mind that in some cases, this may require the fulfillment of continuing education hours. 

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A PMHNP works with individuals, families, groups, and communities. PMHNPs follow a multi-stage workflow for each client: assessing mental health needs, developing a nursing diagnosis and plan of care, implementing the nursing process, and evaluating it for effectiveness.

PMHNPs combine a variety of nursing, psychosocial, and neurobiological expertise and methodologies to diagnose, treat, and improve the outcomes of patients facing psychiatric or mental health challenges. 

Day-to-day, PMHNPs fulfill broad responsibilities that contribute to therapeutic relationship-building with their clients. Depending on a PMHNP’s specialization and targeted client base, their specific daily approaches and methodologies may vary. But generally, a PMHNP’s scope of practice involves patient assessment, diagnosis, planning, treatment, and evaluation—and may be ongoing for months or even years for each single client. 

PMHNPs don’t only provide individualized care, they also work with their patients’ families, engage their fellow health care peers in dialogue and research, and actively educate communities to decrease stigma surrounding mental health and the seeking of mental health services. 

PMHNPs can work across a wide array of settings. Some of the common work environments include hospitals, primary care settings, clinics, schools, telemedicine settings, public health facilities, and private practices. 

Depending on the setting, PMHNPs can work with a variety of different patient profiles. These may include individuals struggling with opioid, alcohol, or other substance use disorders, children exposed to adverse or traumatic events, soldiers or other military personnel, older adults struggling with Alzheimer’s or dementia, adolescents and adults confronting anxiety or depression, and anyone experiencing suicidal thoughts. 

A career as a PMHNP can be both fulfilling and rewarding for anyone interested in improving the mental health and psychiatric well-being of patients and communities. Today, many PMHNPs and aspiring mental health care professionals are passionate about reducing the lingering stigma around mental illness, closing the access gap for mental health services, and integrating mental health care further into the primary care setting. 

Working as a PMHNP may help these professionals actively engage with their passions and contribute to making these long-term goals a reality. If improving mental health outcomes and access to services are causes you care about, becoming a PMHNP might be a fulfilling path for you.

According to the National Alliance on Mental Illness, 1 in 25 adults experience serious mental illness [PDF, 504 KB]. But all too often, access is limited for the communities most in need of mental health services. Psychiatric nurses are uniquely poised to fill in these gaps, helping to increase equitable access to mental health care and providing much-needed services. The employment outlook for the field matches the growing demand. According to the National Center for Health Workforce Analysis, the national supply of psychiatric nurse practitioners is projected to grow by 6,690 between 2016 and 2030 [PDF, 734 KB]—that’s an estimated growth rate of 18 percent.

Is there a need for Psychiatric-Mental Health Nurse Practitioners?

Yes, there is and there’s lots of evidence to show for it. According to the Kaiser Family Foundation, more than 112 million Americans live in mental health care HPSAs (HPSA stands for health professional shortage area). 

As with all nursing specialties, there is a shortage of nurses at every level and in most roles. Why? Our aging, expanding population continues to endure new and uncertain circumstances—and this reality comes with an increased need for psychiatric care. In fact, the need for qualified mental health professionals in the United States has never been greater.  

• In 2019, 44.8% of adults in the United States with mental illness received treatment [PDF, 2.8MB]. 
• As of 2018, 55% of U.S. counties do not have a practicing psychiatrist [PDF, 5.9 MB].
• Furthermore, a 2017 survey notes that more than 50 percent of adults affected by the most common mental health conditions—depression and substance use—did not receive any form of treatment in the year prior to the survey. 
• Meanwhile, racial, cultural, and ethnic minorities face a disproportionate lack of access and higher levels of unmet mental health needs. A shortage of mental health professionals and services, particularly in rural and low-income areas, contributes largely to these gaps. 

Countrywide estimates of mental health professional shortages in 2020 revealed that only 26.9% of mental health services need is met. The professionals include psychiatrists, clinical psychologists, mental health counselors, substance abuse social workers and more. Skilled PMHNPs can be relied on to fill some of these care gaps.

How much does a Psychiatric-Mental Health Nurse Practitioner make?

The salaries for nurse practitioners vary depending on factors like specialization, setting and role. According to the American Association of Nurse Practitioners (AANP), PMHNPs had a median income of $137,000 a year in 2019.

According to the U.S. Bureau of Labor Statistics (BLS), the median annual wage for nurse practitioners in 2020 was $111,680. California, New Jersey and Washington were among the top-paying U.S. states for nurse practitioners in 2020. Below is a table detailing their mean hourly and annual wages.

State	Mean Hourly Wage	Mean Annual Wage
California	$70.18	$145,970
New Jersey	$62.93	$130,890
Washington	$60.81	$126,480

There is one certification offered by the ANCC for PMHNP to pursue. The ANCC offered PMHNP certification aligns with the Consensus Model for APRN Regulation. After meeting eligibility requirements and passing the competency exam, nurses are awarded the credential. 

American Nurses Credentialing Center (ANCC) – Psychiatric-Mental Health Nurse Practitioner (Across the Lifespan) Certification (PMHNP-BC)

Eligibility Requirements:

Fees:

Renewal:

Certifications must be renewed every five years. Renewal applications are due at least three months before your certification expiration date.

Information for the PMHNP-BC certification from the ANCC was last retrieved in October 2021. For the most up-to-date information, visit the ANCC website.

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Below are some organizations with resources that may be helpful for aspiring and current PMHNPs: 

Here are answers to some frequently asked questions about the PMHP path, profession, and practice. 

Last updated October 2021.

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