The Affordable Care Act of 2010 took substantial steps toward addressing the mental health care gap in America. By mandating mental health care coverage in most employer and individual health insurance plans, the law extended insurance protection to millions of Americans.
What the bill could not and did not do, however, was build a mental health care workforce sufficient to meet the new demand. As a result, the nation faces an impending shortage of psychiatrists somewhere between 14,000 and 31,000, according to the Association of American Medical Colleges (AAMC).
One possible solution to the alarming shortfall is to train more psychiatric mental health nurse practitioners (PMHNP). These professionals perform many of the same tasks as psychiatrists; they can diagnose patients, offer therapy, and prescribe medication to treat mental health issues. PMHNPs are highly educated professionals who complete hundreds of clinical practice hours as part of a master's or doctoral program.
What sort of clinical experience will you get in a psychiatric mental health nurse practitioner program? This article answers that question and explores:
PMHNPs perform a litany of mental health patient care duties. They can test, diagnose, offer therapy, and prescribe and manage medication. PMHNPs can even open a private practice in many states.
These professionals work with varied populations, including the elderly, adolescents, families, and those with substance abuse issues. They work in inpatient and outpatient settings, such as clinics, schools, hospitals, and prisons. A small number operate in rural areas and serve patients who cannot ordinarily access mental healthcare.
Psychiatric mental health nurse practitioners need a broad range of hard and soft skills to excel in their profession. First and foremost, the role requires a deep knowledge and understanding of the myriad manifestations of mental health challenges and disorders patients face. PMHNPs also need technical skills to operate technology like SAS statistical software and database management systems. They must be organized and analytical to document, schedule, and interpret tests.
PMHNPs also need emotional intelligence to support not just patients but coworkers. Nurses face high burnout rates from the emotional wear and tear of their daily experience. Similarly, they benefit from excellent communication skills, especially when leading technicians and other nurses, working with patients, or reporting to managers.
Advanced practice registered nurses (APRNs) fall into several categories: nurse practitioners, nurse specialists, and nurse midwives. Specializations for nurse practitioners include psychiatric mental health nurse practitioner, family nurse practitioner, cardiology, pediatrics, women's health, neonatal care, adult gerontology, acute care, surgery, and hospice and palliative medicine.
Becoming a PMHNP can take many years. Graduate programs—either a Master of Science in Nursing (MSN) or Doctor of Nursing Practice (DNP)—typically require at least two years of full-time study; part-time programs take longer. Many graduate programs require applicants to acquire two or more years of work experience as a registered nurse (RN) before they can enroll.
After completing a graduate program, you'll pursue NP certification through the American Nurses Credentialing Center (ANCC). That means passing the Psychiatric-Mental Health Nurse Practitioner (Across the Lifespan) Certification (PMHNP-BC) exam. The test consists of 150 graded questions covering everything NPs need to succeed; accredited graduate programs prepare graduates for this challenge. The exam covers five knowledge areas: scientific foundation, advanced practice skills, diagnosis and treatment, psychotherapy and related theories, and ethical and legal principles.
A Master of Science in Nursing is the standard degree for nurse practitioners, although the more-demanding Doctor of Nursing Practice also qualifies you for the role. The most straightforward pathway to PMHNP licensure is to attend a BSN-to-MSN or DNP program, but other options exist. aRN-to-MSN programs often cater to those with an Associate Degree in Nursing (ADN). The time commitment ultimately comes down to the program and how much previous education you have.
Graduate program core courses can include health assessment, patient-centered care, and pathophysiology. Yale University PMHNP students complete courses with titles like Individual Psychotherapy, Family Psychotherapy Seminar, Advanced Pathophysiology, Transitions to Professional Practice, Clinical Psychopharmacology Across the Lifespan, and Promoting Health in the Community.
The American Association of Colleges of Nursing (ACCN) requires all NPs gain at least 500 or hours of clinical experience. Programs may offer more than the minimum. Rotations can happen in many settings and expose students to different kinds of psychiatric nursing within the main specialization.
At Yale, students complete four psychiatric-mental health clinical practice across the lifespan courses—one per term. Students can work in diverse places like private practices, integrated psychiatry and primary care facilities, and community mental health centers. Each clinical setting provides a unique experience.
Professionals may complete rotations after graduation. For instance, PMHNPs can gain veteran-focused clinical experience through a postgraduate program based at a Veterans Affairs facility.
While schools like Vanderbilt University can help MSN students find preceptors (experienced clinician mentors), students often make arrangements for themselves. That doesn't mean they go through the entire process alone. Yale dedicates program time for students to discuss, analyze, and learn from their clinical rotations alongside faculty and peers.
Many nursing schools offer online programs. Yale will launch its online MSN in the summer of 2023. These programs typically feature the same core and specialization coursework as their in-person counterparts. Students still complete in-person clinical hours. Online nursing programs traditionally cater to working students, though brick and mortar programs can too.
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