What is a Psychiatric-Mental Health Nurse Practitioner (PMHNP)?
Role and Responsibilities
A Psychiatric-Mental Health Nurse Practitioner (PMHNP) is an advanced practice registered nurse (APRN) specializing in mental health services for individuals and families across diverse settings. Their responsibilities include:
- Diagnosing psychiatric disorders and conducting therapy.
- Prescribing medications for mental health and substance use conditions.
- Providing emergency psychiatric care and managing treatment plans.
- Offering consultations and education for families and staff.
- Focusing on mental health maintenance and wellness through medicinal and therapeutic interventions.
PMHNPs may choose sub-specialties focused on populations (e.g., children, elderly) or issues (e.g., addiction). They are distinct from other APRNs and may or may not require physician oversight depending on the state.
About the Certification
PMHNPs are certified by the American Nurses Credentialing Center (ANCC), earning credentials such as:
- PMHNP-BC (Psychiatric-Mental Health Nurse Practitioner-Board Certified).
- Certification covers advanced knowledge in psychiatric diagnosis, therapy, and psychopharmacology.
Scope of Practice and Work Environments
PMHNPs work in a variety of healthcare settings, including:
- Primary care (family medicine, pediatrics, OB/GYN).
- Prisons, hospitals, outpatient clinics, and home healthcare.
- Specialized settings for vulnerable populations, such as the homeless, victims of abuse, and incarcerated individuals.
They assist diverse populations, such as children, adults, and the elderly, managing mental health disorders or stress due to chronic conditions.
PMHNP Salaries
As of 2022, PMHNPs in the United States earn competitive salaries, with averages varying based on data sources and influencing factors such as experience, location, and work setting.
Salary Overview
- According to CompHealth’s 2024 NP Salary Report, PMHNPs reported an average salary of $134,000 in 2022.
- Indeed reported in September 2024 that the national average salary for PMHNPs was $105,403, though some positions offered significantly higher pay, with listings up to $232,909 in certain locations.
- The U.S. BLS reported a median annual salary of $120,680 for nurse practitioners overall as of May 2021.
Employment Outlook
The demand for PMHNPs is expected to grow significantly due to increasing awareness and treatment of mental health issues. The BLS projects a 45% growth rate for nurse practitioner employment from 2020 to 2030, much faster than the average for all occupations. This trend is likely to encompass PMHNPs, given the rising need for mental health services.
Sources referenced for the most current salary and employment outlook for PMHNPs:
- U.S. Bureau of Labor Statistics (BLS)
- Website: BLS Nurse Practitioners Overview
- Insight: Provides median annual salary and growth projections for nurse practitioners overall.
In summary, PMHNPs play a critical role in mental health care, offering high earning potential and diverse career opportunities, though salaries and scope of practice vary by region.
Influences on a PMHNP’s Salary and Scope of Practice
Factors Influencing PMHNP Salaries:
- Demand for Services: The high demand for PMHNPs stems from their specialized training in mental health and psychotherapy, a role not typically filled by primary care providers or other advanced practice nurses.
- Liability and Expertise: PMHNPs mitigate risks associated with misdiagnoses or improper treatments by untrained providers, making their role invaluable.
- Psychotherapy Billing: PMHNPs can bill for psychotherapy, unlike some other disciplines (e.g., physician assistants, CRNAs), further increasing their value.
- Geographic Location: Salaries vary widely by location. For example, states like Alaska and California may offer $200K+ due to cost of living and demand, whereas Midwest salaries typically start at $110K.
- Workload and Setting: Compensation correlates with job expectations such as caseload size and job complexity. Additional benefits like billing support or continuing education coverage often accompany hospital roles.
PMHNPs as Primary Care Providers:
- Scope of Practice: PMHNPs primarily focus on mental health but may handle basic medication refills (e.g., allergy meds, inhalers) within their scope or for the sake of continuity of care.
- Dual Certification: PMHNPs with Family Nurse Practitioner (FNP) certification can manage both physical and mental health conditions.
- Advanced Degrees: Degrees like DNP or Ph.D. grant PMHNPs the title of “Dr.” but do not replace or suggest the role of an MD.
A PMHNP’s ability to negotiate competitive salaries and expand their practice scope depends on their credentials, location, and the specific demands of their role.
A DNP/Ph.D. promotes nursing excellence with a greater commitment to the profession and patient care.
How else can a PMHNP Work?
Other than a hospital, a PMHNP has many other great opportunities or considerations to help with mental services, advocacy, and awareness:
- Psychiatrist/Private Practice: PMHNP’s are such valuable assets to psychiatrists and usually doing the same functions and more available/flexible than other health professionals. Physician Assistants, other NP’s…etc. are not trained in psychotherapy or minimally involve with psychotropics, which means PMHNP’s are more favorable.
- Outpatient Clinics: PMHNPs can work in substance abuse treatment centers, veteran clinics, run support sessions or psychoeducational groups, specializing in pediatrics, and other areas that are more mobile.
- Home Care/Telepsy: A PMHNP can travel, schedule home visits for people who lack transportation or have difficulty ambulating. Therefore, telepsychiatry is becoming more popular and important.
- Self: PMHNPs can market themselves to do in-services or offer mental health services in multiple settings like a high school or churches. PMHNPs can also become great medication representative.
- Other: prison systems/state institutions, hospice, integrated/community care, government positions, research & facilities/colleges, postpartum care. Also, consider starting an online community, writing articles, or have fun and start a blog!
What about a Ph.D. versus a DNP for PMHNP?
Plainly speaking, a DNP does not take as long as a Ph.D. to complete for example you may test screening tools, to see how they apply in practice, i.e. are they helpful or need to be modified? what are the measures and implications? or basically how to improve the practice.
With a Ph.D., you are creating the tools, with a DNP you are putting them (the created tools) into practice. Furthermore, I’ve been told from multiple sources that a Ph.D. is more “respected” and “carries more weight” since people in general still simply don’t know or understand what a “DNP” is or the significance…
The Ph.D. route is more standard and better well-known across the board. However, a Ph.D. takes longer because you are developing a theory or the research (that may be used for the practice/profession) and more time-consuming since it includes collecting data i.e. hundreds of surveys, conducting statistical data, analyze/review/interpreting results…every step of the process could take months if not more to complete and hopefully, you’ll get financed or it’ll be greater delays. However, one of my teachers’ was able to get her Ph.D. completely funded via NIH grant and didn’t have to pay for her research.
Overall, a DNP and Ph.D. show the greatest amount of dedication for the nursing practice and is definitely a valuable asset to have especially with mental health but just like everything else, you have to factor in time and money.
While there is no single right choice when it comes to deciding between a DNP and Ph.D. in nursing, remember that DNP students should be committed to the highest levels of nursing practice while Ph.D. students should have a clear focus on furthering research in nursing and health policy. More information about DNP and Ph.D. -Nurse Practitioner Schools
What about the Scope of Practice?
The scope of practice for PMHNPs is a controversial topic, as it can sometimes be overly broad or disingenuous, potentially complicating treatment. In most states, PMHNPs must collaborate with a medical doctor, especially for prescribing scheduled medications, and rarely can operate independently, though this is changing in some areas. Advocates emphasize the need for PMHNPs to gain greater independence to help meet the rising demand in mental healthcare, while maintaining a focus on providing safe, competent, and accessible psychiatric care.
If you are interested in anything psychiatric or mental health plus nursing, APNA is your # 1 source!
What is the American Psychiatric Nurses Association (APNA)?
The American Psychiatric Nurses Association is the largest national professional society representing psychiatric nurses. APNA is committed to the specialty practice of psychiatric-mental health nursing, health, and wellness promotion through identification of mental health issues, prevention of mental health problems and the care and treatment of persons with psychiatric disorders. Learn more about what APNA has to offer by exploring their website –APNA
Last Updated 2025
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