Psychiatric mental health nurse practitioners (PMHNPs) are advanced practice registered nurse specialists who assess and diagnose mental health issues, and who offer treatment by means of pharmacotherapeutic and psychotherapeutic interventions.
PMHNPs work in clinical settings that include private, state or Veterans Administration in-patient or outpatient psychiatric facilities, private psychiatric practices, and community mental health centers. PMHMPs also provide services in settings such as correctional facilities, domestic violence shelters, residential substance abuse facilities, and schools.
PMHNPs may work with a wide range of people, including:
- Children who have or are at risk for emotional and behavioral disorders
- Adults dealing with stressful and emotional situations, including people dealing with chronic medical conditions and older adults at risk for emotional and cognitive decline
- People with a serious, chronic mental illness or who have mental health problems that lead to criminal behavior
- People with substance-related problems
- People who are in prison, homeless, victims of violence and abuse, and similar circumstances
Increasingly, PMHNPs are also involved in mental health care in primary care settings. Although primary care generalists often treat common mental disorders through psychotropic drug interventions, they don’t typically have specific training in psychiatric conditions, and often have limited time to spend with patients. Psychiatric mental health nurse practitioners serving in a primary care capacity are more often in a position to devote the time needed to provide specialized intensive mental health services.
PMHNP Education Programs
A registered nurse interested in becoming a PMHNP must complete a master’s degree, post-master’s program, or Doctor of Nursing degree program with a concentration in psychiatric mental health. Post-master’s programs are typically pursued by nurses who already have a master’s degree in nursing (MSN) and later decide to specialize in psychiatric mental health.
Highly specialized programs are available that focus specifically on either adult or family (including children’s) mental health. Programs typically offer both theoretical and clinical practice courses that teach a broad range of skills, such as:
- Psychosocial and physical assessment and differential diagnosis of mental health conditions
- Managing the care of a patient, including managing symptoms and behavioral change using education, therapy, and medication
- Promoting mental health
- Understanding cultural differences in providing mental health care
- Using data to evaluate patient outcomes
- Working with families, other healthcare practitioners, and communities
PMHNP Certification and Licensure
National certification is a necessary part of being licensed or recognized by state Boards of Nursing as an advanced practice registered nurse (APRN) serving the psychiatric mental health patient population. Each state has its own licensing laws and requirements and also defines the scope of practice for nurse practitioners.
Certification offered through the American Nurses Credentialing Center results in the designation credential PMHNP-BC. Two exam options are available:
- Adult Psychiatric & Mental Health Nurse Practitioner — requires master’s, post-graduate, or doctorate degree from an adult psychiatric and mental health nurse practitioner program
- Family Psychiatric & Mental Health Nurse Practitioner — requires master’s, post-graduate, or doctorate degree from a family psychiatric and mental health nurse practitioner program
The educational program must have accreditation from the Commission on Collegiate Nursing Education (CCNE) or the National League for Nursing Accrediting Commission (NLNAC). The program must also have included all of the following:
- A minimum of 500 faculty-supervised clinical hours
- Three separate courses in advanced physical/health assessment, advanced pathophysiology, and advanced pharmacology
- Content in promoting health and preventing disease and in differential diagnosis and disease management
- Clinical training in at least two modalities of psychotherapeutic treatment
To be eligible to take a certification exam, nurses must have a current, active RN license in the United States or the equivalent in another country.
These computer-based exams are administered through Prometric Testing Centers, and applicants have 90 days after acceptance of their application to take an exam. Renewal of certification takes place every five years and requires professional development.
Psychiatric mental health nurse practitioners that complete educational programs specific to family psychiatric health and hold certification as Family Psychiatric and Mental Health Nurse Practitioners can also become certified as a Pediatric Primary Care Mental Health Specialist (PMHS) through the Pediatric Nurse Certification Board (PNCB).
This certification is for nurse practitioners who want to specialize in working with children who have mental health and psychiatric issues. PNCB recommends, but does not require, that candidates for this certification exam have professional experience that includes the following:
- At least 1,000 hours of nurse practitioner experience within the past two to three years in clinical practice related to primary care or behavioral and mental health issues
- Nurse practitioner continuing education in pediatric behavioral mental health
- Continuing education in pediatric psychopharmacology for nurse practitioners
- Continuing education in a variety of advanced practice nursing mental health content
The computer-based exam is administered through Prometric Testing Centers. Recertification takes place every three years and requires meeting all the following requirements:
- 30 contact hours of pediatric psychopharmacology within the past three years
- 30 contact hours of continuing education and/or professional practice learning activities within the past three years
- Having an active primary certification that is in good standing
Two national elective membership professional organizations exist to represent all psychiatric mental health nurses, including clinical nurse specialists serving the psychiatric-mental health patent population, and PMHNPs: the American Psychiatric Nurses Association and the International Society of Psychiatric-Mental Health Nurses.
State-level associations and chapters of national associations such as the Association of Advanced Practice Psychiatric Nurses in Washington State or the California Association of Psychiatric Mental Health Nurses in Advanced Practice.
The National Salary Report 2011 from Advance for NPs and PAs found that the average full-time salary for nurse practitioners working in a mental health setting was $92,396 yearly. The average pay for those working part-time was $82.86 an hour.