Advanced Practice Nursing

Psychiatric Nurse Practitioner Vs. Psychiatrist

Psychiatric Nurse Practitioner Vs. Psychiatrist
Psychiatric nurse practitioners and psychiatrists perform similar tasks when it comes to assessing, diagnosing, and treating those with mental health conditions. Image from Pexels
Katy McWhirter profile
Katy McWhirter September 21, 2022

Psychiatric mental health nurse practitioners and psychiatrists share many responsibilities but the roles also differ in significant ways. This article explains how.

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Only one out of every three college students who reported mental health challenges participated in counseling or therapy services during the pandemic. That’s a startling number for a population facing increased stress and strong emotions. While some of these learners simply chose not to seek support, many faced a daunting barrier: colleges and universities lack sufficient psychiatry practitioners to address increasing needs.

If you’re interested in helping college students with mental health issues but are not sure whether to take the path of psychiatric nurse practitioner or psychiatrist, you are not alone. Many prospective students want to learn more about these two specialist roles before making a decision. In this article we compare the roles of psychiatric mental health nurse practitioner and psychiatrist and explore the questions:

  • How do you become a psychiatrist?
  • How do you become a psychiatric mental health nurse practitioner?

Psychiatric nurse practitioner vs. psychiatrist

Psychiatric nurse practitioners and psychiatrists perform similar tasks when it comes to assessing, diagnosing, and treating those with mental health conditions, but the roles as well as the educational and licensing requirements vary in important ways.

What psychiatric mental health nurse practitioners do

Psychiatric mental health nurse practitioners (PMHNPs) are advanced practice registered nurses (APRNs) who work with patients across the lifespan to provide psychiatric health services. Whether meeting with first-time clients to assess their mental health care needs, checking in with existing patients to update treatment plans, or consulting on whether inpatient psychotherapy services are necessary, these professionals use their extensive knowledge of psychiatry and mental health to provide appropriate services.

Like psychiatrists, PMHNPs can prescribe medications in full-practice autonomy states and make recommendations and referrals concerning any additional therapies such as counseling. PMHMPs in full-practice states can work autonomously outside the supervision of medical doctors and open private practices; those in reduced or restricted practice states may need physician supervision to prescribe medications and cannot work autonomously.

Where PMHNPs work

PMHMPs work in myriad healthcare settings, including both clinical and nonclinical. Some may prefer the fast pace of inpatient rehabilitation centers for substance abuse or eating disorders, while others enjoy the more stable outpatient settings of community mental health centers. In full-practice states, private practice is also an option.

Those drawn to nonclinical settings can find work in public and private schools, correctional facilities, and nursing schools.

What do PHMNPs earn?

Indeed reports that psychiatric NPs currently earn average base salaries of $140,302 per year. While those working for other organizations or facilities may receive bonuses from time to time, PMHNPs working in private practice can also benefit from profit sharing and percentages of income from others working in their practice. Where PMHNPs live can also make a difference, with some states paying these professionals significantly more.

PMHNP required training, certification, and licensing

To work as a PMHNP, individuals must first earn an associate degree in nursing (ADN) or bachelor’s degree in nursing (BSN), pass the NCLEX-RN examination, and apply for licensure in their state. From there, they can pursue a Master of Science in Nursing (MSN) and/or Doctor of Nursing Practice (DNP), both of which require both academic work and clinical training.

Graduates must sit for and pass the Psychiatric-Mental Health Nurse Practitioner (Across the Lifespan) Certification exam and renew their credentials every five years.

What psychiatrists do

Psychiatrists spend their days working with new and existing patients to perform assessments, develop treatment plans, and review the effectiveness of those plans. In addition to prescribing medications, psychiatrists may also provide psychotherapy. Psychiatrists can specialize their scope of practice across a wide spectrum of areas, including addiction, geriatric, neuro, or even multispecialty.

Unlike PMHNPs, their work tends to be more specific, with many psychiatrists focusing on a particular population or type of mental illness. Others work across the lifespan in generalist roles.

Where psychiatrists work

Like PMHNPs, psychiatrists can work in varied clinical and nonclincal settings. While many decide to work in private practice, maintaining a portfolio of clients and setting their own schedules, others work in community agencies, psychiatric inpatient and outpatient facilities, rehabilitation programs, or long-term health centers such as nursing homes.

Psychiatrists less inclined toward clinical work can find employment with government agencies, prisons and courts, the military, or in research and/or teaching roles at colleges and universities.

What do psychiatrists earn?

Payscale reports average base salaries for psychiatrists hover between $102,000 to $296,000, as of September 2022. Psychiatrists can also receive bonuses ranging from $2,000 to $44,000 each year as well as profit sharing in the range of $9,000 to $33,000 annually. All together, these professionals can earn average annual salaries between $105,000 and $333,000. Those who own or co-own private practices typically draw the highest income.

Psychiatrist: required training, certification, and licensing

Psychiatrists must complete a bachelor’s degree in psychology, pre-med, or a related degree before taking the MCAT and entering medical school. At this stage, learners can choose from a Doctor of Medicine (DM) or Doctor of Osteopathic Medicine (DO) program. With both, students spend between four and five years completing coursework and clinical rotations. After graduating, students move into a residency program, spending three to eight years building specialized knowledge.

After passing the U.S. Medical Licensing Examination or the Comprehensive Osteopathic Medical Licensing Examination, students receive their license. They can then seek board certification by passing the examination provided by the American Board of Psychiatry and Neurology.

Psychiatric nurse practitioner vs. psychiatrist: pros and cons

For many, the amount of time required to prepare for each of these careers ranks high among their pros and cons. While psychiatric nurse practitioners can complete educational requirements in approximately six years, future psychiatrists spend about 12 years completing all educational and residency program requirements.

Income also plays a large role in the decision making process. As demonstrated earlier, psychiatrists can potentially earn substantially more than PMHNPs – although they won’t start earning for six years after the PMHMP completes requirements and may have more extensive student loan debt to repay after graduating.



University and Program Name Learn More

How do you become a psychiatric mental health nurse practitioner?

After earning an ADN or BSN, passing the NCLEX-RN exam, and receiving licensure as a registered nurse, the next step for those planning to become PMHNPs is to undertake an MSN or DNP. These programs can last between two and five years.

Yale University’s School of Nursing recently introduced its new MSN with Psychiatric-Mental Health Nurse Pracitioner specialty for students seeking a two-year program that provides the credentials and training required to work as a PMHNP. Consisting of both academic and clinical components, learners cover topics such as mental health assessment across the lifespan, clinical outcome management in psychiatric-mental health nursing, group psychotherapy, and psychopathology across the lifespan. When not in class, students complete 774 clinical hours. Yale plans to offer an online version of this program starting in the summer of 2023.

After completing an MSN or DNP, students must sit for and pass the American Nurses Credentialing Center’s Psychiatric-Mental Health Nurse Practitioner (Across the Lifespan) Certification exam. The 150-question exam lasts 3.5 hours. Students must renew this certification every five years to continue practicing as a PMHNP.

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About the Editor

Tom Meltzer spent over 20 years writing and teaching for The Princeton Review, where he was lead author of the company's popular guide to colleges, before joining Noodle.

To learn more about our editorial standards, you can click here.


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