Psychiatric mental health nurse practitioners (PMHNPs) focus on clinical work with patients suffering from mental illnesses or psychiatric disorders. PMHNPs may work in mental health facilities, hospitals, community health centers, public policy organizations, or outpatient mental health clinics with many choosing to focus on underserved communities.
According to the National Organization of Nurse Practitioner Faculties (NONPF), the responsibilities of these interdisciplinary nursing professionals include taking a holistic approach to disease diagnosis and treatment, paying special thought to a patient’s mental health status; thoroughly assessing patients’ mental and physical health using evidence-based approaches from medicine, psychiatry, sociology, and other relevant fields; developing multi-pronged treatment plans using medication, psychotherapy, and/or other applicable interventions; and educating patients and their families about health conditions.
Please note that the scope of practice for PMHNPs may vary by state. For instance, the California Mental Health Planning Council reports that mental health NPs require the supervision of a mental health professional—typically a psychiatrist—in the delivery of certain treatments. Other states, predominantly concentrated in the midwest, grant more generous and autonomous privileges of practice to all NPs such as performing and interpreting diagnostic tests, designing treatment plans, and prescribing remedies without the oversight of other medical personnel. The American Association of Nurse Practitioners (AANP 2015) provides a color-coded map of the scope of practice across states. For details, please consult specific state boards of nursing, a list of which is provided by the National Council of State Boards of Nursing (NCSBN).
So how does one join this stimulating, integrative subfield of nursing? First, the vast majority of these professionals have at least a master’s degree and some form of national certification. In fact, AANP (2015) reports that fully 95.1 percent of all NPs hold graduate degrees, and 96.8 percent maintain active certifications. Although pursuing a two-year master of science (MSN) degree is one common route to become a PMHNP, an increasing number of NPs are earning the terminal degree of the discipline: the doctor of nursing practice (DNP). The American Association of Colleges of Nursing (AACN 2015) notes that nursing is one of the last fields of healthcare to embrace a practice-centered doctorate, and advocates for the DNP as “the changing demands of this nation’s complex healthcare environment require the highest level of scientific knowledge and practice expertise to assure quality patient outcomes.”
Read on to discover the varied paths to become a PMHNP, including information on specific schools (on-campus and online), professional certification, and program accreditation.
There are multiple routes to becoming a PMHNP, but many of these healthcare professionals begin by pursuing a four-year bachelor of science in nursing (BSN) degree from a program accredited by the Commission on Collegiate Nursing Education (CCNE) or the Accreditation Commission for Education in Nursing, Inc. (ACEN). These undergraduate programs—such as the one at U.S. News & World Report’s (2015) top-ranked nursing school at the University of Pennsylvania (UPenn)—provide courses such as integrated pathophysiology & pharmacology; scientific inquiry for evidence-based practice; pathways to practice; nursing of women & infants; and leadership in complex systems. At this phase, it’s advisable for aspiring PMHNPs to take elective courses and seminars in mental health, psychiatry, or psychology.
One advantage to pursuing a BSN as opposed to an associate or non-nursing bachelor’s degree is that BSN programs fulfill many of the prerequisite courses for graduate PMHNP programs such as microbiology, chemistry, epidemiology, and general education (i.e., breadth requirements). That said, there are various graduate programs for candidates with associate degrees or non-nursing bachelor’s degrees. Often referred to as bridge, accelerated, direct entry, or alternate entry programs, these schools generally require extra coursework and/or clinical hours to complete the prerequisites, sometimes rewarding the BSN en route to the MSN or DNP degree. For example, UPenn’s direct entry BSN/MSN program awards both degrees and is open to both RNs with associate degrees and non-nursing bachelor’s degree recipients. The American Association of Colleges of Nursing (AACN) has a list of “accelerated” BSN and MSN programs for candidates with a non-nursing baccalaureate.
As part of a BSN or associate (i.e., ADN) program, aspiring PMHNPs are prepared to take the National Council Licensure Examination for Registered Nurses (NCLEX-RN) to become registered nurses (RNs) and typically get one- to two-years of experience prior to applying to graduate PMHNP programs.
There are two main program specializations for PMHNP: adult psychiatric mental health and family psychiatric mental health. The latter specialists deal with patients throughout their lifespans and are generally referred to as simply “psychiatric mental health nurse practitioners.” The American Nurses Credentialing Center (ANCC) provides separate certifications for these subfields of PMHNP. Please reference the “PMHNP Certification” section below for more information.
Whether pursuing an MSN or DNP in the PMHNP subspecialty, the admissions committees typically ask applicants for the following:
For a more detailed discussion of the steps to becoming a PMHNP, visit the how to become an NP page which covers the various subfields and professional certifications at length.
There is a rich abundance of PMHNP programs across the U.S., both on-campus and online, MSN and DNP. Here are four standout options for prospective PMHNPs to consider:
New York University (NYU) hosts a 48-credit, two-year MSN program in mental health nursing which involves 750 clinical hours and rigorous didactic instruction through classes including clinical pharmacotherapeutics across the lifespan; nursing issues & trends within the healthcare delivery; and seven distinct mental health modules. Boasting internationally acclaimed faculty and an opportunity to specialize in substance-related disorders, NYU’s program is committed to spurring social change.
The University of Virginia (UVA) has a nationally renowned program which tied for #8 among U.S. News & World Report’s (2015) top PMHNP schools. This 20-month MSN involves more than 500 precepted clinical hours and 48 credits of comprehensive coursework covering health policy (local to global); epidemiology & world health; and theoretical foundations of nursing. Please note that UVA also has a DNP program in this specialty.
The University of Washington (UW) offers a top-ranked program which tied for #8 among U.S. News & World Report’s (2015) best PMHNP schools. UW’s three-year DNP program combines supervised clinical practicums and courses such as social determinants of health & health equity; older adult mental health assessment & evaluation; psychopharmacology & biological interventions; and psychiatric mental health nurse reflective practice. Please note that although some coursework is available in a distance-based format, students are still required to travel to campus at least twice for every course.
The University of Tennessee Health Science Center provides a unique dual-specialty option (psychiatric mental health and family NP). This DNP program has classes such as health care economics and leadership and health policy; biostatistics & epidemiology for clinical practice; advanced health assessment and pathophysiology and advanced family clinical practice; psychiatric mental health disorders and child and adolescent mental health care; and evaluation of practice. This rigorous three-year full-time curricula if entering the program as a BSN to DNP combines 79-credit hours of coursework and 1,500 clinical hours, preparing students to sit for both the FNP and PMHNP certification exams. Other plans of study are available for obtaining a DNP degree with a single initial or post MSN second certification as a PMHNP. Part-time study options are also available.
Finally, please visit the online NP programs page for additional web-based PMHNP programs.
Following graduation from an accredited PMHNP graduate program, students may be eligible to seek to national certification and licensure through local state boards of nursing.
There are two main national certifications for PMHNPs offered through the American Nurses Credentialing Center (ANCC): adult PMHNP and psychiatric mental health NP (across the lifespan). Prerequisites for these five-year certifications include being a graduate of an approved MSN or DNP program; being an RN; providing proof of at least 500 faculty-supervised clinical hours; and passing an exam.
To maintain these certifications, PMHNPs must show proof of having provided 1,000 hours of direct patient care and 75 hours of continuing education (CE). Opportunities for CE can be found through the American Psychiatric Nurses Association (APNA).
Finally, all NPs must seek licensure through their local state board of nursing. Procedures differ by state, and a list of contact information for state boards of nursing can be found through the American Association of Nurse Practitioners (AANP 2015).
Prior to enrolling in any undergraduate or graduate PMHNP program, students are cautioned to verify their school’s accreditation status. The accreditation process serves to ensure curricular consistency, quality of educational delivery, and comprehensiveness of courses to benefit both prospective PMHNPs and their future patients.
There are two programmatic accreditation organizations for nursing programs recognized by the U.S. Department of Education: the Accreditation Commission for Education in Nursing, Inc. (ACEN) and the Commission on Collegiate Nursing Education. These groups take into consideration criteria such as school facilities (e.g., laboratories, libraries); eminence of faculty; student outcomes; institutional finances; and other factors to evaluate the quality of programs.
Additionally, there are institutional accreditation organizations which assess and recognize universities as a whole, including the Commission on Colleges for the Southern Association of Colleges and Schools (SACS), the Higher Learning Commission of the North Central Association of Colleges and Schools (HLC-NCA), the Middle States Commission on Higher Education (MSCHE), the Western Association of Schools and Colleges (WASC), the Northwest Commission on Colleges and Universities (NWCCU), and the New England Association of Schools and Colleges (NEASC).