Psychiatric NP vs Psychiatrist

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Psychiatric mental health nurse practitioners (PMHNP) and psychiatrists have similar job duties. They both assess, diagnose, and treat those with mental health conditions and work closely with patients to prevent, identify, and manage symptoms resulting from psychiatric or substance disorders. Both clinicians are experts in psychopharmacology, and they each possess an in-depth knowledge of psychiatric medications and how to prescribe them effectively.

However, the paths that these professionals to become licensed and certified varies. Psychiatrists are physicians who typically attend a four-year medical school program and graduate to become either a medical doctor (MD) or a doctor of osteopathy (DO). They then choose to specialize in psychiatry by attending a two- to four-year residency program that focuses on mental healthcare.

Psychiatric nurse practitioners, on the other hand, typically attend a four-year nursing program, become a registered nurse, then choose to become a psychiatric nurse practitioner by completing a two- to four-year nurse practitioner program that focuses on mental healthcare.

What’s more, the laws governing nurse practitioners responsibilities vary by state. For example, in Washington, psychiatric nurse practitioners provide all the same services as psychiatrists. However, in states like Alabama or Florida, laws prevent nurse practitioners from providing some forms of care.

Specifically, states like Alabama and Florida require a psychiatrist to co-sign an involuntary commitment form—i.e., a document completed by a nurse practitioner that sends a patient to a psychiatric hospital after a suicide attempt—for it to be processed. In states like Washington, a physician co-signature is not necessary. It should be noted that all nurse practitioner schools educate nurse practitioners to perform independently, although laws in some states require varying levels of oversight from physicians.

The table below includes additional information that compares and contrasts these professionals.

Side-by-Side Comparison: Psychiatric NP vs. Psychiatrist

Psychiatric Nurse Practitioner Psychiatrist

Psychiatric nurse practitioners typically earn a bachelor of science in nursing (BSN), which takes four years. After, they attend a psychiatric nurse practitioner program, completing either a master of science in nursing (MSN) or a doctor of nursing practice (DNP) degree.

Psychiatrists enter medical school after completing a four-year bachelor’s degree in a relevant field. Upon graduating as either a medical doctor (MD) or doctor of osteopathy (DO), they complete a two- to four-year residency program focused on psychiatry.

Job Duties

PMHNPs assess, diagnose, and treat mental health and substance abuse disorders. This typically includes medication prescription and management along with psychotherapeutic interventions.

Psychiatrists and psychiatric nurse practitioners essentially perform the same job duties; however, some states have enacted laws that require psychiatrists to review or co-sign documents completed by psychiatric nurse practitioners.


There are no formal subspecializations for psychiatric nurse practitioners. However, they can work in subspecialty clinics that focus on children and adolescents, geriatrics, addiction, pain management, consultation-liaison, and forensics, among others.

Psychiatrists can subspecialize in children and adolescents, geriatrics, substance abuse, consultation-liaison, emergency, military, and forensics, among others.


According to the United States Bureau of Labor Statistics (BLS 2017), the average annual salary for a nurse practitioner $107,480. The American Association of Nurse Practitioners (AANP 2015) compensation survey found that nurse practitioners specializing in psychiatry earn an average annual income of $132,115.

According to the BLS (2017), the average annual salary for a psychiatrist is $216,090.

Common Practice Settings

Outpatient clinics, medical hospitals, psychiatric hospitals, emergency rooms, homeless shelters, and prisons, among others.

Psychiatrists and psychiatric nurse practitioners work in all the same types of practice settings.

Professional Organizations
Dr. Melissa DeCapua, DNP, PMHNP-BC

Dr. Melissa DeCapua, DNP, PMHNP-BC


Melissa DeCapua is a board-certified psychiatric nurse practitioner who graduated from Vanderbilt University. She has a background in child and adolescent psychiatry as well as psychosomatic medicine. Uniquely, she also possesses a bachelor’s degree in studio arts, which she uses to enhance patient care, promote the nursing profession, and solve complex problems. Melissa currently works as the Healthcare Strategist at a Seattle-based health information technology company where she guides product development by combining her clinical background and creative thinking. She is a strong advocate for empowering nurses, and she fiercely believes that nurses should play a pivotal role in shaping modern health care. For more about Melissa, check out her blog and follow her on Twitter @melissadecapua.