About a PMHNP

pmhnp and mental disorders

Information about a Psychiatric-Mental Health Nurse Practitioner

What is a PMHNP?

A Psychiatric-mental health nurse practitioner (PMHNP) is an advanced practice registered nurse (APRN) who’s trained to provide a wide range of mental health services to patients and families in a variety of settings.

Within this nursing specialty, PMHNPs are able to select sub-specialties dealing with populations such as children, adolescents, or the elderly or with problems like addictions.

PMHNPs diagnose conduct therapy and prescribe medications for patients who have psychiatric disorders, medical organic brain disorders or substance abuse problems. They are licensed to provide emergency psychiatric services, psychosocial and physical assessment of their patients, treatment plans, and manage patient care.

They may also serve as consultants or as educators for families and staff. A PMHNP receives specialized training and education on therapy, psychiatric diagnosis, including the differential diagnosis of medical disorders with psychiatric symptoms, and on medication treatment for psychiatric disorders. They are NOT interchangeable with other APRNs.

PMHNPs also focus on psychiatric/mental health maintenance and wellness. They use both medicinal and therapeutic interventions in treatment plans to help patients. Depending on the state in which they practice, oversight by physicians may or may not be required.

How can a Nurse become Certified in Mental Health?

What is the Scope of Practice for PMHNPs and What Areas Can They Work?

  • APNA: Advanced Practice Psychiatric Nurses work in all areas of health care. They practice in primary care – that is family medicine, internal medicine, pediatrics, and obstetrics and gynecology, prisons, home health care, hospitals – as well in outpatient and other subspecialties treating symptoms of or mental health disorders.
  • According to Graduate Nurse, 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

NP Versus a PMHNP Salary

  • According to Nurse Practitioner Schools, Psychiatric-mental health nurse practitioners (PMHNPs)—also referred to as psychiatric NPs—are expected to enjoy a thriving employment climate and high salaries into the future. The American Association of Nurse Practitioners (AANP Oct. 2016), found that the average full-time base salary for all NPs was an impressive $102,526, more than double the average annual wages of all professions in the nation ($48,320, BLS 2015). It’s worth noting that the scope of practice for PMHNPs varies by region. There’s some evidence that working in a full practice state (as opposed to one with ‘restricted’ or ‘reduced’ practice) is correlated with higher wages, a consideration beyond the purview of this discussion. Irrespective of the state practice environment, PMHNPs tend to enjoy some of the highest salaries compared to other specializations.
  • The most reliable source of employment and salary figures in the US is the Department of Labor’s Bureau of Labor Statistics. While the BLS (May 2015) did not report numbers specifically for NPs in the PMH subfield, it did have figures for NPs as a whole, according to the report, the top-paying states for NPs nationwide were:
  1. California: $120,930 (average annual salary)
  2. Alaska: $117,080
  3. Hawaii: $114,220
  4. Massachusetts: $112,860
  5. Oregon: $111,210

Also, four of the five top-paying metropolitan regions were concentrated in California:

  1. Columbus, IN: $160,050
  2. Vallejo-Fairfield, CA: $156,340
  3. San Jose-Sunnyvale-Santa Clara, CA: $143,050
  4. San Francisco-San Mateo-Redwood City, CA: $142,430
  5. Oakland-Hayward-Berkeley, CA: $136,840

While the NP salary prospects look especially bright for the Golden State, it’s important to note that it’s also one of the most expensive states in the country. As proof of point, the Missouri Economic Research and Information Center (MERIC 2016) found that the five American states (or regions) with the highest cost of living were Hawaii, District of Columbia, California, Massachusetts, and Alaska. By extension, two of the most lucrative states for NPs also incur a relatively high cost of living.

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


PMHealthNP is not affiliated with APNA, ANCC, or any organization

PMHNP FAQ

(a personal version)

What May Influence a PMHNP’s Salary?

Multiple factors are important for an accurate PMHNP’s salary like the location and a person’s experience, but the greatest factor is how PMHNP’s are in DEMAND. Primary care or anyone other than a psychiatrist, generally does not manage mental illnesses and therefore, does not prescribe the medications needed, including those that treat mental disorders.

If the primary provider does decide to order psychotropics, there’s a huge risk due to inexperience, a lack of psychotherapy, or if the patient/others were harmed. Also, if there was a lack of screening/assessing people being affected by mental illness, getting misdiagnosed or not treated at all… A health provider can be held liable, which is why a PMHNP is so valuable.

A PMHNP is trained for psychotherapy but a physician assistant and other disciplines (i.e. CRNAs, family nurse practitioners) are not nor could they bill for it. Most of the time, the psychiatrist does not engage with psychotherapy -yet will receive a salary twice as much…. Therefore, a PMHNP certificate alone can demand 6 figures and be more essential than most disciplines.

I’ve seen offers in Alaska and California for 200K+ probably due to the location and cost of living. Around the Midwest, I’ve seen the starting price range +110K (don’t accept <70$ per hour), which is reasonable depending on the setting, caseload, etc. the more that’s expected, the more you should be compensated or negotiate for a higher salary. On the lower end i.e. in hospitals, they at least may cover billing, continuing education, license/extra fees…

Can a PMHNP also be a Primary Care Provider?

It is best for providers to be the most helpful to their patients while also considering their own scope of practice. A PMHNP should not manage a patient’s diabetes or a heart condition, but they may write a med refill for an inhaler or something simple. This is the same with most providers, for instance, while getting my physical assessment, I asked the NP if she could write for my allergy medications. Most of the time if the med refills are basic (aka nonscheduled) or can be done over the phone it shouldn’t be a problem.

Some PMHNPs are also dual certified with a Family Nurse Practitioner Certificate and can effectively manage and treat both chronic conditions and mental health. NPs can also be more advance and obtain a doctorate such as a DNP (Doctor of Nursing Practice), which is a clinical practice degree or a Ph.D. (Doctor of Philosophy), which is a research-focused terminal degree. Both of these titles give an advance practice nurse or a PMHNP the title of “Dr.” and while it can be confusing for patients or other healthcare workers, it does not substitute/replace a medical doctor/MD.

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 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 anything.

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?

This is probably the most controversial topic with a PMHNP certification. Sometimes a PMHNP’s scope of practice can be very broad and disingenuous, which may compromise or complicated treatment and care. In most states, they must work with a medical doctor and although they can write for any medication, -rarely can they have their own practice, though its changing for many states.

Most of the times a collaborating physician is needed to write for scheduled medications. However, PMHNPs should continue to become independently supported to alleviate the demands of the mental healthcare system. Overall, the scope of practice will continue to focus on safe and competent care while seeking ways to make psychiatric care more accessible and a priority.

Last Updated 10/2020

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