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What Is a Psychiatric Mental Health NP?

Psychiatric Mental Health Nurse Practitioner

Psychiatric mental health nurse practitioners (PMHNPs) are in high demand in the United States. Legislation guaranteeing insurance coverage for mental health conditions, a severe shortage of psychiatric mental health professionals, and a retiring psychiatrist pool are factors that create this scenario. This occupation is a quickly growing specialty in the country and Medicare expects this trend to continue in the near future.

The State of the Mental Health Field

In the United States, mental health practitioners are in short supply. [1] Universal healthcare provides a means for many patients to receive critical mental health services. Additionally, reforms require insurance providers to deliver coverage for mental health conditions equivalent to the protection afforded for other medicinal needs. The requirement, outlined in the Mental Health and Addiction Parity Act of 2008, is a supplement to an act of the same name mandated in 1996 that requires insurance companies to provide lifetime benefits for mental health equivalent to other medical care benefit ceilings. These guidelines – which regulate co-pays, deductibles and visitation frequency – are important, because almost one in five American citizens seek mental health treatment annually. Due to the Mental Health and Addiction Parity Acts of 1996 and 2008, there is an increase in patients pursuing treatment for mental illnesses. Additionally, increased media attention has lessened the stigma attached to mental illness. Because of this opinion shift, more individuals seek mental health assistance. However, there are now more patients than practicing caregivers. As a result, psychiatric specialists are in high demand. Healthcare organizations put forth considerable effort training and recruiting individuals in the field. Despite this, the discipline suffers from a talent shortage.

Factors Contributing to Shortage

The dwindling psychiatrist talent pool exacerbates this problem. To put this in perspective, the sum of all physicians rose nearly 50-percent between 1995 and 2015, yet the psychiatrist pool increased by only a little over 10-percent; physician supply outpaced the population by almost 10-percent, but psychiatrist supply lagged behind by almost 25-percent. Additionally, almost 70-percent of all psychiatrists are at or over the typical retirement age for the profession. A decreasing number of medical academics pursue psychiatry training, and within the psychiatry field, fewer students complete their residencies. The average medical student spends one and a half to two hundred thousand dollars to earn their degree. Healthcare related training is among the most expensive learning paths, and psychiatry is among the lowest paid physician practices. Currently, insurance companies report spending only around five and a half percent of funds for mental health treatment, which falls disastrously short of demand. This minimal expenditure has caused analysts to underestimate the need for mental health treatment for some time. Among the states realizing this deficiency, communities desperately need personnel trained in this field. Mental health talent has dispersed erratically throughout the United States, with rural communities experiencing the worst shortages. These combined circumstances create a newly recognized critical need for mental health professionals across the country.

Hope on the Horizon

To fill the psychiatric provider shortage, the medical community enlists mental health nurse practitioners (PMHNPs). [2] These professionals deliver mental health services to individuals, families and communities. They establish, organize, institute and appraise mental health services.

Roles and Responsibilities

Because PMHNP professionals undergo nurse training, they practice their discipline in a way specific to the nursing field. Psychiatric nurses practice several mental health specialties, such as:

  • Adolescent care
  • Chronic condition management and diagnosis
  • Combined physical and mental health services
  • Emergency services
  • Geropsych (Senior) care
  • Military care
  • Nicotine addiction services
  • Recovery services
  • Substance abuse care

Master’s degree practitioner roles sometime intersect with psychologist, social worker and psychiatrist roles. While all individuals practicing these disciplines conduct psychotherapy, only PMHNP and psychiatrists prescribe medication and only psychiatrists train to conduct psychological testing. The American Psychiatric Nurses Association regulates the PMHNP discipline. [3] According to the organization, state regulations determine whether to recognize these caregivers as NPs or Clinical Nurse Specialists (PMHCNSs). Overall, NPs frequently act as primary care providers, while CNSs typically practice administrative oversight or psychotherapy. Currently, NPs prescribe medication anywhere in the United States, while this trait varies by state for CNS practitioners. Each state enforces different regulations regarding what services mental health nurse practitioners deliver.

Demand Forecasted Well into the Future

The psychiatric mental health field outpaces job growth among all United States occupations, including any among medical professions. [4] Analysts predict 26-percent growth in the field by 2020, and government medical officials forecast a severe shortage of mental health professionals over the next few decades. According to the Bureau of Labor Statistics, the field will expand by 35-percent by 2024 and create almost 45,000 job openings. In the past, PMHNPs assisted physicians in extending community mental health service delivery. Today, due to the mental health professional shortage, nurses provide primary care in several states.

A Different Method of Delivery

As the medical field shifts its attention toward community health, service delivery is changing among care providers. [5] Because nurses spend more time with activities involving direct patient contact, they are leaders during this transition. Rural communities, where mental health services are scant, need PMHNPs sorely. To remedy this, some PMHNPs opt to deliver service in clients’ homes. In these underserved communities, mental health nurses help lower barriers to treatment, such as marginal transportation and limited wellness education. <h2> Varying Salaries for Mental Health Nurses Salaries in the PMHNP field vary based on discipline, facility type, education and certification. Psychiatric nurse practitioners earn an average $75,000 to $125,000 annually. Pay also varies by region; in Phoenix, for example, PMHNPs earn $95,000 to $135,000 each year. Salaries are slightly lower in Boston with PMHNPs earning around $87,000 to $113,000 annually. PMHNPs employed by the United States Veteran’s Administration typically earn around $77,000 annually, while practitioners at provider networks – such as Gerald Champion Regional Medical Center – earn around $110,000 yearly.

Answer the Call

Medicare forecasts an additional eight million citizen enrollment increase under universal healthcare in addition to the two million citizens already covered. While mental health advocates view this as a positive outcome, they worry that the medical community cannot meet the nation’s caregiving needs. Despite an increase in mental health nurse practitioners as primary care providers, the advocates still foresee an acute talent shortage among psychiatric professionals. To date, almost eighty percent of all United States counties report a shortage of prescribing mental health service providers. With a growing number of individuals seeking aid for mental health conditions, this situation is growing into a national problem. Mental health conditions severely affect patients, caregivers, insurers and families and are the number one source of disability claims. To fill this critical need, many more psychiatric mental health nurse practitioners must enter the field. Many factors merge to make the psychiatric mental health nursing practice the fastest growing field in the United States. It is a challenge for the medical community to staff the abrupt growth created in this profession. As a result, they turn to PMHNPs to fill this dire need. With America’s mental health demands steadily increasing, it is unlikely that employment opportunities in this field will subside over the next several decades.

Learn More

Psychiatric Mental Health nurse practitioners play a significant role in the modern health care system. Our online MSN with a focus on Psychiatric Mental Health program can help you develop your communication and therapeutic skills, expertise in behavioral sciences, and emotional intelligence so you can assess, diagnose, manage, and treat mental illness in a variety of populations.


  1. U.S. News & World Report
  2. American Psychiatric Nurses Association
  4. The Online Journal of Issues in Nursing
  5. Nurse Journal