America is suffering a shortage of mental health profiessionals across the spectrum, from pediatric psychiatry to geriatric mental health care. With 60 percent of psychiatrists approaching retirement—that's the proportion age 55 and older—this problem doesn't seem likely to abate soon.
As a result, many who need treatment find it difficult or impossible to procure. The impact on children is particularly heartbreaking; delays in psychiatric treatment can have devastating effects on the young (the sooner a child is in mental health care, the better the outcome). An interactive map produced by the American Academy of Child and Adolescent Psychiatry illustrates the significant shortage of mental health professional in most counties across the US and highlights how many lack even a single practicing child and adolescent psychiatrist.
The shortage of psychiatrists creates a negative cycle of overworked doctors burning out and retiring. Pressures from the ongoing pandemic exacerbate the problem, prompting the American Academy of Child and Adolescent Psychiatry, the Children's Hospital Association, and the American Academy of Pediatrics to declare a national emergency regarding child and adolescent mental health in America.
To address the situation, the Centers for Disease Control and Prevention (CDC) has outlined areas of focus to understand the gaps in the mental health workforce and improve strategies to connect families to mental healthcare services. One of the best ways to support these initiatives is to link families in need of care with psychiatric mental health nurse practitioners (PMHNPs). These advanced practice nurse practitioners provide comprehensive diagnostic and prescriptive care to patients of all ages. They can also help reach patients in underserved and rural parts of the country where mental health services are scarce.
If you’re interested in becoming a PMHNP and are wondering what is the PMHNP ANCC, we have your answer. This article also addresses:
All practicing PMHNPs must hold current licensure and certification in their state, which requires the successful completion of the PMHNP ANCC certification exam.
The American Nurses Credentialing Center (ANCC)'s Psychiatric Mental Health Nurse Practitioner (PMHNP) board certification examination is also known as the Psychiatric Mental Health Nurse Practitioner (Across the Lifespan) Certification (PMHNP-BC). The exam assesses the knowledge and skills of advanced practice nurses pursuing the credential and aligns with the licensure, accreditation, education, and certification of the Consensus Model for APRN Regulation. The PMHNP-BC credential is valid for five years and must be renewed to maintain licensure.
According to the ANCC, the Psychiatric Mental Health Nurse Practitioner board certification examination is competency-based and "provides a valid and reliable assessment of the entry-level clinical knowledge and skills of the PMHNP."
The PMHNP exam assesses knowledge and skills across five domains:
Test takers may be interested in using exam prep resources that cover materials taught in PMHNP masters program courses and during clinical hours and instructional training. Students can find review courses and apps online that provide practice questions and address test FAQs.
There are several exam prep books and practice manuals available for purchase. There’s even a bundle of PMHNP-BC Test Prep Essentials that includes a Psychiatric-Mental Health Nurse Practitioner Review Manual 4th Edition with 2020 Addendum (the most current test content outline), a Psychiatric-Mental Health Nurse Practitioner Certification Interactive Online Review Course (Review & Resource Manual eBook included), the Psychiatric-Mental Health Nurse Practitioner Certification PracticeIQ (including 16.5 contact hours upon completion), and a Certification Exam Test-Taking Strategies Online Course with correct answer rationales.
The PMHNP ANCC exam is offered at authorized testing centers in digital format year-round. The 175 questions (150 scored and 25 randomly distributed pre-test questions) must be completed in 3.5 hours. There is no penalty for wrong answers, but you must answer every question. Scoring is different across the five domains tested: scientific foundation (30 questions) is 20 percent of your score, advanced practice skills (38 questions) and diagnosis and treatment (37 questions) count for 25 percent each, and psychotherapy and related theories (22 questions) and ethical and legal principles (23 questions) each constitute 15 percent of the total score.
The PMHNP ANCC exam is taken after the completion of all master's or doctorate-level coursework (MSN or DNP), clinical training in at least two psychotherapeutic treatment modalities, and 500 faculty-supervised clinical practice hours.
The PMHNP ANCC pass rate is 86 percent. The exam can be taken (or retaken) a maximum of three times a year, with at least 60 days between test sittings—and only after the candidate takes 15 contact hours of continuing education to address material in any weak domain. Exam results are available before you leave the test site.
A psychiatric mental health nurse practitioner is an advanced practice registered nurse (APRN) with graduate-level training in psychiatric health care. After completing an accredited psychiatric mental health nurse practitioner Master of Science in Nursing (PMHNP MSM) degree program, PMHNPs are qualified to sit for the PMHNP-BC ANCC exam necessary for credentialing and licensure to practice in their state.
PMHNPs perform detailed psychosocial and physical assessments, diagnose mental health disorders, and prescribe and oversee medication management for patients in long and short-term care. They also may provide individual and group therapy, educational services to patients and their families regarding their treatment plan, and support to public health initiatives in presentations to larger community groups.
Psychiatric mental health nurse practitioners work in clinical settings like hospitals and mental health or addiction treatment clinics, or in non-clinical settings like schools and correctional facilities. Many work remotely via telemedicine or travel to reach underserved and rural communities. Some PMHNPs work in private practice and may work autonomously or in collaboration with other psychiatric health care professionals.
Generally, psychiatric mental health nurse practitioners are well-paid. The national average PMHNP salary is around $147,000, but pay in each state varies considerably. PMHNPs earn the most in Washington State ($159,000) and the least in Louisiana ($106,000).
Most PMHNPs start as RNs who hold an associate's or bachelor's degree in nursing and have gained years of experience working in the field. To become PMHNPs, they pursue a master's-level nursing program, specifically a PMHNP Master of Science in Nursing (MSN). Completion of this master's degree qualifies graduates to sit for the PMHNP-BC ANCC and then state licensure.
There are many board-certified PMHNP MSN programs, like the one offered on campus at the Yale School of Nursing (their online PMHNP program starts enrolling students in the summer of 2023). Coursework and training opportunities are school-specific, but all accredited programs' academic classes cover developmental and personality theory, individual, group, and family psychotherapy, mental health assessment, and psychopharmacology.
Academic coursework and clinical experiences typically take one to two years, followed by clinical placement opportunities in acute and long-term care, emergency psychiatric services, community care settings, and in private practice. Faculty oversee coursework and advising and select or act as preceptors for clinical work.
At Hunter College, PMHNP class offerings include healthcare systems and policies, therapeutic counseling modalities, epidemiology of behavioral health, theoretical foundations of nursing science, and health promotion/disease prevention in diverse populations. Yale's curriculum offers similar coursework and classes in statistics and research for evidence-based practice, group psychotherapy, pathophysiology, pharmacology, and transitions to professional practice.
All PMHNP MSN programs utilize seminars, practicums, and preceptorship experiences to allow students to apply theory into practice in real-world situations, with curated placements across the lifespan.
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