Psychiatric Mental Health Nurse Practitioner (PMHNP) vs. Psychiatrist

PMHNPs are advanced practice registered nurses (APRNs). They primarily care for the mental health and well-being of individuals, but their work may extend to families, groups, and communities. After PMHNPs diagnose a condition, they plan and implement a system of care. They then evaluate the results to look for room for improvement. PMHNPs are equipped to assess an individual’s current mental health and determine the possibility of future mental health concerns. PMHNPs can become registered under the American Psychiatric Nurses Association (APNA), allowing them to offer primary care services to patients.

In addition to seeing patients, PMHNPs may perform research to grow the field’s body of knowledge or consult with legislators and administrators to improve the state of local mental health facilities. The regulations regarding what qualified PMHNPs can do vary by state, including whether they can prescribe medications to patients.

The PMHNP role is multifaceted. Aside from fulfilling their nursing duties, PMHNPs can act as researchers, educators, consultants, and advocates. A PMHNP’s responsibilities include the following:

• Observing patients’ behavior and developing a baseline for each individual
• Reviewing patients’ medical histories to accurately diagnose mental health disorders
• Collaborating with other staff to come up with efficient and effective treatment regimens
• Treating patients using various methodologies, including contemporary and traditional medicine and psychotherapy techniques
• Developing a specific treatment plan for each individual
• Offering feedback to patients and their families about the patients’ state of care and treatment progress

In all these contexts, PMHNPs need to be able to provide emotional support to patients and their families. Patient and family education is another core competency for this role. A clear understanding of their mental illness and the corresponding treatment encourages patients to comply and helps prevent them and their families from feeling helpless.

PMHNPs need to have various skills to provide the quality and level of care that patients require from them. For example, PMHNPs should demonstrate competence in the following:

• Communication: Building rapport with patients and ensuring that they and their families know how to deal with mental disorders is one of the essential roles of a PMHNP. Communication allows a practitioner to foster these connections.
• Research: Looking at patient records to determine an individual’s mental health profile is another core activity. Having research skills ensures a PMHNP doesn’t miss the minor details that may help to diagnose a disorder.
• Pharmacology: In states where PMHNPs can prescribe medicine, the practitioner needs to know which ones work for which conditions, as well as how to prescribe dosages.
• Observation: A PMHNP’s observations inform a diagnosis. Knowing what sort of behavior suggests a specific mental disorder is essential.

Psychiatry is the branch of medicine that focuses on the diagnosis, prevention, and treatment of emotional, mental, and behavioral disorders. Psychiatrists are medical doctors who specialize in the field of mental health. They’re trained to diagnose mental, emotional, or behavioral disorders or conditions based on patients’ psychological and physical traits, as well as their external and internal symptoms. They also discuss these aspects with their patients to develop a complete picture of their mental state before proceeding with treatment.

Psychiatrists are required to have at least a medical degree in biology or psychology and pass state exams before they can practice. Many states require psychiatrists to complete a residency before they’re allowed to open a private practice. A psychiatrist may choose to earn board certification by taking a voluntary oral and written examination administered by the American Board of Psychiatry and Neurology. The certification is valid for 10 years, so psychiatrists need to retake the exam every decade to maintain this credential.

Psychiatrists evaluate patients using various methodologies and develop treatment strategies based on their assessment. These strategies are tailored to the patient and can include different psychotherapeutic treatments and medication. They also work with other healthcare professionals to ensure these strategies align with the full spectrum of patient needs. In some cases, psychiatrists may need to provide crisis intervention.

Psychiatrists need specific skills to provide a comprehensive level of care that can best address patients’ needs, as well as build trust and rapport in the psychiatrist-patient dynamic. These competencies include the following:

• Analytical Skills: Psychiatrists need to be able to accurately assess and interpret information given by the patient to develop concrete plans to establish strong and consistent coping strategies.
• Communication Skills: Psychiatrists need to have effective written and oral skills to communicate strategies clearly and concisely without leaving room for ambiguity or misinterpretation. They also need to have sharp listening skills to fully detect potential issues in patient discussions.
• Pharmacological Knowledge: Psychiatrists need to understand various medications prescribed in various situations and how they may impact a patient’s overall health and well-being. They need to also be aware of how these medications interact with other prescriptions that a patient may be taking.
• Empathy and Compassion: Psychiatrists need to display qualities that demonstrate sensitivity to the patient’s situation. They need to convey these characteristics in a respectful, professional manner.

Psychiatric nurse practitioners and psychiatrists share several traits. These similarities tend to involve some of the foundational elements found in the patient-provider dynamic.

• Duties: PMHNPs and psychiatrists both assess patients through various evaluation strategies. They also diagnose mental health conditions and develop treatment strategies based on what they observe.
• Skills: Both types of professional need to have exceptional communication skills to help build positive patient dynamics and ensure proper interpretation of patient strategies. They also need to have strong analytical skills to effectively evaluate and properly diagnose patient conditions.

The differences between a psychiatric mental health nurse practitioner and a psychiatrist aren’t immediately evident. Both professions work in the mental health field and try to help patients deal with their emotional, mental, or behavioral disorders. The distinction is primarily based on the following:

• Degree Requirements: A psychiatrist requires a medical degree to practice and usually needs local state certification and to complete an internship. PMHNPs, on the other hand, typically earn a Bachelor of Science in Nursing (BSN) and must complete an MSN with an NP concentration, a Doctor of Nursing Practice (DNP) with an NP concentration, or a Post-Master’s NP certificate. Maryville University’s PMHNP programs are an ideal choice for students who intend to follow this career path.
• Ability to Prescribe: Until very recently, psychiatrists were the only mental health professionals allowed to prescribe medication to individuals with mental illnesses. In many states, that standard remains. However, over the past decade, more than 20 states have passed legislation that allows PMHNPs to prescribe medication.

As a shortage of psychiatrists persists in the U.S., the role of a psychiatric mental health nurse practitioner is expanding, allowing these professionals to assume increasing clinical responsibilities.

Like others who are pursuing nurse practitioner careers, future PMHNPs need to have the training to be successful in the role. Maryville University’s online PMHNP programs focus on helping students develop these core skills in the following courses, among others*:

• Professional Role Development
• Advanced Health Assessment
• Psychopharmacology and Mental Health Assessment
• Psychiatric-Mental Health Diagnosis and Management I, II, and III

The PMHNP coursework also helps students grasp the importance of their role as future mental health professionals and what they can do to help their patients cope with or recover from their disorders.

Thanks in part to high demand for these professionals across the U.S., psychiatric nurse practitioner salaries are competitive. July 2022 data from PayScale show a PMHNP can earn a median annual wage of approximately $114,000, with the top 10% making roughly $145,000. The U.S. Bureau of Labor Statistics (BLS) also notes that the profession is expanding rapidly. The BLS projects the employment of nurse practitioners to increase by 52% between 2020 and 2030, much faster than for other jobs. This job growth means more room for new graduates to find employment.

For those interested in a career in the mental health field, becoming a psychiatric nurse practitioner is a great option. The qualification process is different from that of a psychiatrist, but psychiatric nurse practitioners are no less critical to the field of psychiatry. If you’re interested in joining the field and helping people improve their mental health, check out Maryville University’s PMHNP degree paths, including the MSN, DNP, and certificate-level programs.

*Note: Clinical hour requirements for state licensure may vary by state. Students are encouraged to visit the Board of Nursing website for the state where they intend to practice to verify specific requirements. Students may also reach out to our team of enrollment advisors for guidance.

American Psychiatric Association, What Is Psychiatry?

American Psychiatric Nurses Association, About Psychiatric-Mental Health Nursing

American Psychiatric Nurses Association, “Expanding Mental Health Care Services in America”

Indeed, Psychiatrist Job Description: Top Duties and Qualifications

Payscale, Average Psychiatric Nurse Practitioner (NP) Salary

U.S. Bureau of Labor Statistics, Nurse Anesthetists, Nurse Midwives, and Nurse Practitioners