About Psychiatric-Mental Health Nursing

Psychiatric–mental health (PMH) nurses provide care to individuals, families, and communities who have current or potential mental health needs. Essential components of PMH nursing practice include health and wellness promotion through:

• Identification of mental health issues
• Prevention of mental health problems
• Care of mental health problems
• Treatment of persons with the full range of psychiatric-mental health disorders, including substance use disorders

PMH-RNS

A psychiatric–mental health registered nurse (PMH-RN) cares for those with mental health issues, mental health problems, psychiatric disorders, and co-occurring psychiatric and substance use disorders. Working with individuals, families, groups, and communities, PMH nurses select and implement evidence-based interventions to promote positive outcomes and recovery. They are key members of interdisciplinary teams and develop partnerships with those with whom they work to assist them with their individual recovery goals. They help people gain, re-gain, or improve coping abilities, living skills, and managing symptoms; maximize their strengths; and prevent further disability.

PMH-RNs with advanced degrees often focus on design, implementation, evaluation, and operations of psychiatric-mental health care delivery. They develop workforce, manage culture, ensure access to care, maintain quality standards, foster safe practice environments, and improve outcomes for individuals and communities.

PMH-APRNS (Nurse Practitioners or Clinical Nurse Specialists)

PMH-APRNs assess, diagnose, and treat individuals, families or groups with complex psychiatric-mental health problems or the potential for such disorders. They provide a full range of psychiatric-mental health services to persons from pre-birth until death. Their key roles include prescribing or recommending psychiatric medication, providing various forms of psychotherapy, and providing clinical supervision. PMH-APRNs are prepared to work independent of other disciplines and may be self-employed or employed by an agency, practice autonomously or collaboratively, and may or may not bill clients for services provided. Due to the need for the services they offer, the scope of practice for PMH-APRNs is continually expanding.

Areas of focus within psychiatric-mental health nursing include acute care, child and adolescent mental health, gerontological-psychiatric care, forensics, substance use disorders, disaster care, military mental health, and more. All PMH advanced practice nurses are education to provide care and treatment to persons across the full lifespan, as indicated in the APRN Consensus Model. Some PMH-APRNs specialize in the consultation-liaison role, providing consultation and services to patients and families with multiple and complex mental and physical health concerns. Others specialize in collaborative, integrative health care roles with primary care providers.

You can enter the field of PMH nursing in a variety of ways. Science, liberal arts, and nursing undergraduate or master’s students are all fantastic candidates to work toward a career in PMH nursing. Similarly, licensed practical nurses working in other areas of health care are also excellent candidates for education, training, and licensure in psychiatric-mental health nursing.

To become a psychiatric-mental health registered nurse (RN), you must qualify for the national nursing exam (NCLEX-RN) by graduating from a nursing program. These include:

• Two year programs leading to an associate’s degree in nursing
• Three-year programs for a diploma in nursing (usually hospital-based)
• Four-year college or university programs leading to a bachelor’s degree in nursing (BSN).
• Accelerated BSN program (for those who already have a bachelor’s in another discipline)

Basic nursing programs provide a “rotation” in psychiatric-mental health nursing that will introduce you to the profession. You must then pass the NCLEX-RN to obtain your RN license. The APNA Transitions in Practice Certificate Program is an option to give you the foundational knowledge you will need to transition into practice in a mental health setting. After 2 years of practice as a full-time registered nurse. 2,000 hours minimum of clinical practice in psychiatric-mental health nursing within 3 years, and 30 hours of continuing education in psychiatric-mental health nursing within 3 years, you may also choose to obtain certification as a psychiatric-mental health nurse from the American Nurses Credentialing Center.

To become a psychiatric-mental health advanced practice nurse, must obtain the Psychiatric-Mental Health Nurse Practitioner Certification (PMHNP-BC) from the American Nurses Credentialing Center. To sit for this certification exam you will need:

• An RN license
• A masters or doctoral degree from an accredited Psychiatric-Mental Health Nurse Practitioner program. (The American Association of Colleges of Nursing and National League for Nursing accredit programs.) Your program must include:
  • At least 500 supervised clinical hours
  • Three separate courses in: advanced physiology/pathophysiology, advanced health assessment, advanced pharmacology
  • Content in: health promotion/maintenance, differential diagnosis and disease management
  • Clinical training in at least two psychotherapeutic treatment modalities.

APNA membership provides substantial discounts on both the PMH-RN and PMH-NP certification exams!

These requirements are determined by the nursing regulatory board and each state’s board of nursing. The National Council of State Boards of Nursing is the organization that works with state boards of nursing throughout the U.S. in testing and licensing nurses to practice. Find contact information to learn about requirements in any state or Canadian province here.

The best way is to apply for an entry-level psychiatric-mental health nursing position in a hospital or agency. Some schools provide courses for a review of psychiatric-mental health nursing. Some individuals choose to obtain an advanced degree such as a master’s or doctoral degree in psychiatric-mental health nursing.

PMH nursing provides strong compensation due to the rising demand for their services. The pay scale depends on many factors, such as level of education, years of experience, size of the agency or hospital, and geographic location. You can find up-to-date salary information for psychiatric mental health registered nurses here: http://www.payscale.com/research/US/Job=Psychiatric_Nurse_%28RN%29/Salary and for psychiatric mental health advanced practice nurses here: https://www.payscale.com/research/US/Job=Psychiatric_Advanced_Registered_Nurse_Practitioner_(ARNP)/Salary.

Psychiatric-mental health nurses have degrees in nursing. This means that the nursing process informs how they practice. At times, the role of a PMH-APRN may overlap with that of a psychologist, social worker, and psychiatrist. For example, all of these positions usually do psychotherapy. PMH-APRNs and psychiatrists can prescribe, whereas psychologists and social workers cannot. Psychologists are trained to do psychological testing and members of the other three disciplines are not trained in this way. All of these different psychiatric providers can practice independently, but are also subject to state laws governing practice and scope of practice.