Psychiatric-Mental Health Nursing: Scope & Standards of Practice

This publication explains the psychiatric-mental health nursing profession and the roles of PMH-RNs and PMH-APRNs. In nursing, scope of practice describes the services an RN or APRN is educated, competent, and legally permitted to perform under their professional license.

The scope portion of this publication:

• Defines psychiatric-mental health nursing and describes its evolution in nursing
• Explains the levels of practice based on educational preparation
• Explores current clinical practice activities and sites
• Highlights current trends and issues relevant to PMH nursing practice.

The standards of psychiatric-mental health nursing practice and professional performance describe the responsibilities for which its practitioners are accountable. They describe a competent level of nursing practice demonstrated by the nursing process, a model of critical thinking that encompasses nurses’ significant actions and forms the foundation of the their decision-making. The 17 standards list the minimum competencies that all PMH nurses must demonstrate, as well as additional competencies for which PMH-APRNs and graduate-level prepared PMH-RNs are accountable.

“Psychiatric-mental health (PMH) nursing promotes integrated and comprehensive health and wellness through prevention and education, as well as assessment, diagnosis, care, and treatment of the full range of psychiatric-mental health disorders, including substance use disorders, across the lifespan. Psychiatric nurses practice transpersonal caring to promote the health and healing of humanity. The practice of PMH nursing is a science and an art, based on evidence and the purposeful use of self and the therapeutic relationship. PMH nurses provide care at the individual, family/relationship, community, and societal levels to promote well-being and quality of life, as well as to sustain positive health outcomes” (p.1).

This publication gives PMH-RNs and PMH-APRNs clear boundaries for their roles and the minimum competencies they need. It also helps policymakers, educators, students, employers, and others understand the psychiatric-mental health nursing profession.

The scope and standards support role clarification, educational preparation, professional development, workforce planning, and discussions about psychiatric-mental health nursing. They also help inform state-level nurse practice acts and the rules and regulations that govern nursing practice.

The scope and standards provide an important foundation, but each nurse is responsible for practicing within the limits of their state requirements, employer policies, education, certification, and competency.

• State nurse practice acts
• Licensing board requirements
• Regulations
• Employer policies
• Education, certification, and competency

Check out this article for more information on staying within your scope of practice.

The Scope and Standards Revision Joint Task Force, composed of members from the American Psychiatric Nurses Association and the International Society for Psychiatric-Mental Health Nursing, revised and updated all sections of the document, including the definition of psychiatric-mental health (PMH) nursing, reorganization and expansion of the scope of practice section, and creation of a new Standard on Cultural Humility. The following lists some of the main changes/additions made in this 3rd edition:

• Expanded focus on population health, the social determinants of health/mental health, and inclusion of these factors in PMH nursing assessment
• Expanded review of disparities/inequities in PMH care
• Recognition of substance use disorders as psychiatric disorders and the need for all PMH nurses to be competent in providing the full range of care
• Identification of new/expanded roles for PMH RNs/APRNs (e.g. integrated care, telehealth care)
• Completely updated references and glossary terms
• Creation of a PMH Nursing timeline graphic from 1882-2020

A draft of the updated scope and standards was made available for public comment through January 18, 2021.