How to Become a Psychiatric-Mental Health Nurse Practitioner (PMHNP)

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).

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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. See the APNA’s list of PMHNP programs by state to learn more about the many available programs.

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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What is a Psychiatric-Mental Health Nurse Practitioner?

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.

What does a Psychiatric-Mental Health Nurse Practitioner do?

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. 

Where does a Psychiatric-Mental Health Nurse Practitioner work?

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. 

Should I become a Psychiatric-Mental Health Nurse Practitioner?

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, 754 KB]—that’s an estimated growth rate of 18 percent.

Sponsored Online Nursing Programs

Sponsored

Earn an MS in Nursing online from Georgetown University.

  • Earn your MS in Nursing in as few as 23 months
  • Choose from one of four APRN specialty areas: AG-ACNP, FNP, NM/WHNP, or WHNP
  • Gain hands-on clinical experience in evidence-based practice

Earn a Master of Science in Nursing online from Simmons University.

  • Accredited by the Commission on Collegiate Nursing Education (CCNE)
  • Preparation to pursue certification as a Family Nurse Practitioner
  • Part-time, full-time, and extended plans of study

Earn your MSN online from USC’s Top-Ranked School of Social Work.

  • Prepares RNs to pursue board certification as family nurse practitioners
  • Earn a CCNE-accredited MSN in as few as 21 months
  • Choose from part-time and full-time study options

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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.  

Countrywide estimates of mental health professional shortages in 2009 revealed that 96 percent of all counties had an unmet need for mental health prescribers. Fast forward to 2016, the U.S. Department of Health and Human Services released a report in which they projected shortages of more than 10,000 full-time mental health professionals by 2025 [PDF, 463 KB]. 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. Barton Associates, a recruiting and staffing agency for NPs, notes that nurses who specialize in psychiatry have historically earned higher-than-average salaries.  

According to the U.S. Bureau of Labor Statistics (BLS), the median annual wage for nurse practitioners in 2019 was $109,820. California, Washington and Hawaii were among the top-paying U.S. states for nurse practitioners in 2019. Below is a table detailing their mean hourly and annual wages.

State Mean Hourly Wage Mean Annual Wage
California $66.66 $138,660
Washington $61.02 $126,920
Hawaii $59.62 $124,000

Psychiatric-Mental Health Nurse Practitioner (PMHNP-BC) Certification 

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:

  • Active RN license in a state of territory of the United States or legally recognized equivalent
  • Master’s degree or higher from a psychiatric-mental health nurse practitioner program with at least 500 clinical hours accredited by the CCNE or the American Commission for Education in Nursing ACEN
  • Three graduate-level courses in advanced physiology/pathophysiology, advanced health assessment, and advanced pharmacology
  • Content in health promotion and/or maintenance and differential diagnosis and disease management.
  • Clinical training in at least two psychotherapeutic modalities
  • Passing competency-based examination

Fees:

  • $395 non-member
  • $295 American Nurses Association member
  • $340 American Association of Nurse Practitioners (AANP) member
  • $290 AANP student member
  • $220 American Psychiatric Nurses Association member
  • $340 International Society of Psychiatric-Mental Health Nurses member

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 July 2020. For the most up-to-date information, visit the ANCC website.

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State Nursing Licensure Information

PMHNP Resources

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

FAQs

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

Can psychiatric nurses prescribe medication?

Nurse practitioners are given various levels of prescriptive authority across the United States. For the most part, the degree to which a nurse practitioner is able to prescribe medication is dependent on the state in which they’re certified to practice, and the schedule of the drug that they’re seeking to prescribe. The American Medical Association has state-by-state information about nurse practitioner prescriptive authority. 

Do psychiatric nurse practitioners provide counseling?

Psychiatric nurse practitioners may—and often do—provide psychiatric evaluations and psychotherapy in addition to managing medical diagnoses and treatments. PMH nursing can overlap with methodologies used in the psychiatry and counseling fields, and PMHNPs may find that they provide professional advice and support in similar ways that a psychiatrist, counselor, or other mental health professional might as part of an effective, comprehensive scope of practice. 

Can I become a psychiatric nurse practitioner with a psychology degree?

The short answer is yes, although you’ll still need a nursing degree. A background in psychology could be a valuable asset for the practice and is typically part of the required coursework for BSN, MSN, or DNP students. But bear in mind such a background doesn’t translate directly to psychiatric nursing. Whether you have a bachelor’s, master’s, or other higher education degree in psychology, you’ll still need to study the basics of nursing to become a PMHNP. Other necessary steps for becoming a PMHNP include gaining RN licensure, gaining field experience, and obtaining PMHNP certification.

What is the difference between a PMHNP vs Psychiatrist?

While psychiatrists and PMHNPs are both key members of the mental health field, their responsibilities, roles, and qualifications differ vastly. The key differences between PMHNPs and psychiatrists center around differing degree requirements and prescriptive authorities. Becoming a practicing psychiatrist requires obtaining a full medical degree, gaining a state certification, and completing an internship and/or residency. PMHNPs generally earn a BSN, as well as an MSN or DNP, and are licensed, advanced practice registered nurses, but are not MDs. Clinical psychiatrists, as MDs, can prescribe medications to treat mental illnesses—and for a long time, they were the only professionals allowed to do so. 

What is the difference between a PMHNP vs FNP? 

A PMHNP also differs from an FNP—or a family nurse practitioner. FNPs are also RNs, but instead of specializing in psychiatric-mental health work, they work as a nurse practitioner in family medicine. This means they completed an MSN or DNP as an RN, but took additional coursework to specialize in family medicine. FNP programs may cover topics such as family planning, child development, and geriatric care. As such, FNPs tend to develop relationships with entire family units, providing comprehensive care and counseling across the entire lifespan, but are not specifically trained or qualified to provide psychiatric-mental health services, like PMHPs.

Information on this page was last retrieved in July 2020.

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