Advanced Practice Nursing

Where Do Psychiatric Mental Health Nurse Practitioners Work?

Where Do Psychiatric Mental Health Nurse Practitioners Work?
Psychiatric mental health nurse practitioners provide care and treatment plans for individuals, families, groups, and communities with mental health needs. Image from Unsplash
Courtney Eiland profile
Courtney Eiland August 31, 2022

Psychiatric mental health nurse practitioners (PMHNPs) work in hospitals, clinics, ambulatory care facilities, and nonclinical sites like schools and correctional facilities.

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Nurse practitioners constitute a growing profession in the American healthcare system. Over 350,000 professionals carry this designation, which requires a Master of Science in Nursing (MSN) and specialized training.

Of these, fewer than five percent are psychiatric mental health nurse practitioners (PMHNPs), according to the American Association of Nurse Practitioners (AANP). That’s not enough: an Archives of Psychiatric Nursing report projects demand for 250,000 mental health workers in the US by 2025, with 96 percent of US counties facing a shortage of professionals empowered to prescribe necessary medications.

PHMNPs can help fill the gap by performing proper evaluation and treatment of individuals with behavioral health disorders and mental illnesses. They work in a variety of settings with groups across the lifespan, ranging from adolescence to adulthood. PHMNPs assist patients through clinical and nonclinical settings, providing inpatient and outpatient care, prescribing medications, promoting overall mental wellness, and treating patients with acute stress or long-term trauma.

Consider the work PHMNPs currently do with military veterans suffering post-traumatic stress disorder (PTSD) and other mental health conditions. The University of California at San Francisco, in conjunction with the VA, offers a PMHNP residency program that uses evidence-based research to care for the veteran population. This one-year residency includes classroom learning and resident training for new graduates en route to a career in psychiatric-mental health. The Birmingham Veterans Affairs Medical Center, in partnership with the University of Alabama at Birmingham School of Nursing, and the Durham Veterans Affairs Health Care System, in collaboration with the Duke University School of Nursing, offer similar residency programs.

Military mental health facilities are just one example of where you will find psychiatric nurse practitioners. Where do PMHNPs work and what support do they offer? This article will answer that and more.

Where do psychiatric mental health nurse practitioners work?

Psychiatric mental health nurse practitioners work in clinical settings such as psychiatric facilities, hospitals, outpatient clinics, community mental health centers, and private practices. You can also find psychiatric nurse practitioners in nonclinical settings like schools, correctional facilities, and nursing homes. The rise of remote work and telemedicine provides another vehicle by which PMHNPs can expand their reach to more rural areas, serving patients with limited access to a clinic or hospital.

What is a psychiatric mental health nurse practitioner?

PMHNPs provide care and treatment plans for individuals, families, groups, and communities with mental health needs. Psychiatric nursing encompasses a plethora of focus areas, such as:

Roles may vary depending on the level of experience. The American Psychiatric Nurses Association (APNA) designates two types of psychiatric-mental health nurses: registered nurses (RNs) and nurse practitioners or advanced practice registered nurses (APRNs). RNs implement evidence-based interventions to aid individuals, families, groups, and communities dealing with mental health issues or psychiatric disorders. In addition, RNs work to ensure access to care, assist with recovery goals, and promote mental health and wellness across the entire lifespan. In contrast, APRNs carry out more extensive responsibilities such as assessing, evaluating, and treating patients with complex psychiatric and mental health disorders. Also, advanced practice registered nurses can prescribe or recommend medications and provide clinical supervision and psychotherapy.

PMNHP work locations

Psychiatric nurse practitioners often work in clinical settings such as hospitals, clinics, and mental health facilities. However, nonclinical settings and telemedicine offer more accessible ways to provide treatment. During the COVID-19 pandemic, remote students experienced an increase in depression, anxiety, substance abuse, and suicidal behaviors. In response, schools that hired PMHNPs within crisis intervention teams to deliver online help with these challenges. Other nonclinical settings in which PMHNPs work include correctional facilities.

Some PMHNPs work in the community as a part of assertive community treatment (ACT) teams to “meet patients where they are” in their homes or communities rather than transporting them to facilities.

How much are PMHNPs paid (and in which states do they earn the most)?

The role of a psychiatric mental health nurse practitioner requires a nursing education, advanced degrees, years of full-time clinical experience, licenses, and board certifications to practice. Salaries reflect these stringent job requirements. The average base salary for a PMHNP is $140,272 per year, with higher wages varying depending on location.

According to Indeed, the highest paying cities for psychiatric nurse practitioners in the United States are:

  • New York, New York: $162,475
  • Seattle, Washington: $157,632
  • Los Angeles, California: $153,866
  • San Diego, California: $150,261
  • Philadelphia, Pennsylvania: $148,018
  • Baltimore, Maryland: $146,856
  • Phoenix, Arizona: $143,011
  • St. Louis, Missouri: $141,420
  • Vancouver, Washington: $138,728

Zippia aggregates statewide income data for psychiatric nurse practitioners. Top-paying states in 2022 included:

  • New Jersey: $149,094
  • Alaska: $143,368
  • Massachusetts: $131,473
  • Maine: $128,299
  • Connecticut: $128,010
  • New York: $124,048
  • Ohio: $120,966
  • Vermont: $119,870
  • New Hampshire: $118,704
  • Pennsylvania: $113,448

Steps to become a psychiatric mental health nurse practitioner

Aspiring psychiatric mental health nurse practitioners must complete several steps to carry the PMHNP-BC credential from the American Nurses Credentialing Center (ANCC). First and foremost, a nursing degree from an associate’s degree program, a hospital-based nursing diploma program, or a four-year bachelor’s degree program resulting in a Bachelor of Science in Nursing (BSN) lays the foundation. Once you complete one of the required nursing programs, you can take the National Council Licensure Examination (NCLEX-RN) to become a registered nurse (RN).

Transitioning from an RN to an advanced practice registered nurse (APRN) requires two years of full-time practice as an RN, amassing at least 2,000 clinical hours and 30 hours of continuing education in psychiatric mental health within three years. Lastly, you will need to complete a master’s degree or doctoral degree from an accredited program that includes the following:

  • Clinical training in a minimum of two psychotherapeutic treatment modalities
  • Completion of at least 500 supervised clinical hours through a field practicum
  • Educational content that covers health promotion, differential diagnosis, and disease management
  • Three advanced-level courses in physiology/pathophysiology, health assessment, and pharmacology

The above steps satisfy the eligibility requirements to take the board examination and earn your PMHNP certification.

What is a Psychiatric Mental Health Nurse Practitioner Master of Science in Nursing (PMHNP MSN)?

A PMHNP MSN program can help future practitioners develop the knowledge and skills to aid individuals with mental health conditions or behavioral disorders. Many programs explore mental health care using a holistic approach to properly assess and diagnose psychological conditions, develop treatment and care plans, and evaluate and monitor patients across the lifespan.

In addition to in-depth classroom instruction, PMHNP MSN programs include a clinical practicum to gain hands-on experience working with patients to apply learning concepts under supervision. This combination of classroom-based content and real-time application develops well-rounded mental health clinicians.

How long does it take to earn a PMHNP MSN?

Generally, PMHNP MSN programs can take as little as three semesters and up to two years to complete. However, the length varies depending on full-time versus part-time status and whether you need to satisfy any prerequisite courses. For example, the PMHNP MSN program at Yale University requires a summer course, Advanced Health Assessment for the RN, before starting the fall semester.

Some programs offer both full-time and part-time options, providing much-needed flexibility for working professionals. Vanderbilt University‘s School of Nursing offers a two-year part-time opportunity that stacks classroom instruction in the first three semesters, averaging no more than eight credit hours each semester. The curriculum adds clinical practicum requirements during the second year.

Very few programs offer distance learning. However, some programs are launching even more flexible part-time options for registered nurses to take online courses and fulfill their practicum requirements in their community. Yale University plans to launch a hybrid program in the summer of 2023, with significant portions of the curriculum delivered online.

What are the PMHNP MSN program admissions criteria/prerequisites?

PMHNP MSN admissions prerequisites vary by program. However, most MSN programs require the following:

  • Cumulative undergraduate grade point average of 3.0 or higher
  • English language proficiency exam (if non-native English speaker)
  • Letters of recommendation
  • Official transcripts
  • Online application and application fee
  • Statement of purpose

Additional requirements for PMHNP MSN programs may include a BSN from an accredited institution, an RN license with a minimum of two years of full-time clinical practice, a detailed resume showcasing experience, and letters of reference that speak to related fieldwork.

What will I learn in a PMHNP MSN program?

Psychiatric mental health nurse practitioner programs deliver advanced courses to prepare students for PMHNP certification, which, in return, can help address the nursing shortage in this specialization.

According to a 2020 American Association of Nurse Practitioners (AANP) survey, the top focus areas for PMHNPs are psychiatry and behavioral health. The most common work settings are behavioral health or addiction clinics, psychiatric mental health facilities, and private practices.

Relevant topics and courses found in many PMHNP MSN programs include:

  • Advanced health assessment
  • Advanced pathophysiology
  • Advanced pharmacotherapeutics
  • Epidemiology of behavioral health
  • Mental health assessment across the lifespan
  • Mental health policy and advocacy
  • Neuroscience for mental health practitioners
  • Promoting health in the community
  • Theories of individual and family psychotherapy
  • Transitions to professional practice

PMHNPs fall under the category advanced practice nurse practitioners, a career that the US Bureau of Labor and Statistics (BLS) indicates is growing faster than average (at a 45 percent rate from 2020 to 2030).

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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.

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