The Role of Psychiatric-Mental Health Nurses Post-Pandemic
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Nearly 170 million Americans lived in a Mental Health Professional Shortage Area[1] as of December 2023, according to the National Center for Health Workforce Analysis[2] (NCHWA). That can mean difficulty accessing basic mental healthcare for a full range of conditions, from mild to life-threatening.
In many areas, psychiatric-mental health nurse practitioners (PMHNP)[3] — advanced-practice nurses trained to care for people with mental health conditions — are helping to fill this gap. PMHNPs deliver evidence-based, patient-centered care, including in underesourced communities where mental healthcare is in short supply.
Like other nurse practitioners (NP), PMHNPs can independently perform important clinical tasks. In most states, this includes prescribing medication, a cornerstone of many mental healthcare treatment strategies.
With 11 campuses in eight states, Wisconsin-based Herzing University has a presence in or near many health professional shortage areas, including for mental health services. Herzing also has an online division and offers an online PMHNP program for students around the country. It is accredited by the Commission on Collegiate Nursing Education (CCNE).
Monique Scott, DNP, PMHNP-PC, is the program chair for Herzing University’s online PMHNP program, which is headquartered in Milwaukee, Wisconsin. She recently spoke with NurseJournal about the state of the nation’s mental health, the role and job outlook for PMHNPs, and Herzing’s online PMHNP program.
“[PMHNPs] are trained to ask questions that the typical person who may not have this specialty are not going to ask,” Scott tells NurseJournal. “We know what to look for. We know what to dig into…Our patients, they’re the experts in their bodies. We’re the experts in the specialty. So we come together, and we create the plan.”
Nation’s Mental Health Still Feeling Pandemic Shockwaves
According to the National Institute of Mental Health[4], COVID-19 — particularly post-COVID conditions like long COVID[5] that can persist for weeks, months, or even years after the initial infection — has been linked to upticks in several mental health problems, including anxiety, depression, substance use disorders, sleep disorders, cognitive impairment, and even psychosis.
As the impact of COVID-19 intensified, mental health service requests overwhelmed the healthcare system.
“I’ve never seen an influx in the way that I’ve seen an influx in years during that timeframe,” Scott says. “And it wasn’t just the influx, but it was also the types of patients we were seeing. We were seeing first responders, we were seeing nurse practitioners. We were seeing physician assistants. We were seeing med school students.”
The 2023 Stress in America survey[6] from the American Psychological Association revealed that although the pandemic has officially ended, Americans continue to experience collective mental trauma[7].
But the nation’s mental health is facing other challenges beyond the pandemic’s ripple effects. In Scott’s experience, factors like the nation’s polarized political climate can lead more people to seek mental health services. At times, even the mental healthcare system itself can be a source of stress.
“Whenever our government seems shaky and there’s a lot of uncertainty, it really affects [mental health] on a systemic level, and then I start to see it with my patients,” Scott says. “Access to mental health is very difficult. Is insurance going to cover it or not? Can I get telehealth or not?”
Learn More About Herzing University’s PMHNP Program
Assessing The Shortage Of Mental Health Professionals And Mental Health Services
There is a shortage of mental health professionals and mental health services across the U.S. According to 2023 data, 69% of rural and 31% of urban counties did not have a PMHNP[8].
Delays in treatment and access to care are common problems in shortage areas. According to the NCHWA data, the nation’s average wait time for behavioral health services was 48 days in 2022.
PMHNPs are particularly helpful because of the versatile services they are trained to provide, including to diverse and underresourced populations.
“As nurses, we are all about taking care of communities,” Scott says. “We provide education…We are the extenders in the community. When there are not enough psychiatrists, that’s where we come in…We’re not just focusing on medical management. A lot of us can provide therapy.”.
Still, the workforce shortage is a major hurdle that doesn’t seem ready to go away any time soon. According to Scott, however, some overarching initiatives could help train more PMNHPs and help address the gap:
- Increasing awareness of PMHNP programs
- Offering scholarships and grants
- Loan forgiveness
- Expanding mental health training models
Another solution is continuing to expand telehealth nursing services, especially in mental health shortage areas. Herzing’s PMHNP trains students to use telehealth as a tool for expanding access to care.
“So when they’re out, they already know how to initiate [telehealth], and we’re focusing on some things in the future so that they’re even more advanced,” Scott says.
What A Psychiatric Mental Health Nurse Practitioner Does
PMHNPs are trained in assessing, diagnosing, and treating mental health conditions. During school they take courses in the sciences, the practice of nursing, the science of medicine, psychiatry, and psychology.
“We do a full-spectrum evaluation of every patient,” Scott says. “Not only are we looking at your labs, we’re looking at your history. We’re looking at your psychiatric family history and your medical history…Then we move on to a treatment plan.”
For first-time patients, PMHNPs complete a full assessment, which includes:
- Past medical and surgical history
- Existing medication assessment
- Psychiatric family history
- Review of systems
- Review of past blood work
- Review of psychiatric and psychological needs
Scott points out that the difference between a patient’s primary care provider and a PMHNP is that a PMHNP fully addresses the patient’s psychological needs.
Ultimately, a treatment plan, which may or may not include medication, is created between the patient and the PMHNP. Scott believes in shared decision-making, which has been shown to improve health outcomes[9].
PMHNPs Job and Salary Outlook
From a professional standpoint, the future appears bright for PMHNPs. For the entire field of advanced practice registered nurses (APRNs) — a broad field that includes NPs — the federal Bureau of Labor Statistics (BLS) projects a job growth rate of 40% from 2023-2033[10] — the fastest job growth rate[11] in the country.
According to ZipRecruiter[12], PMHNPs earn an annual average salary of $139,486 as of December 2024. However, Scott warns against becoming a PMHNP solely for financial security.
“The one thing I say is ‘don’t jump into this because of the money,’ because you have to really enjoy what you do,” Scott told NurseJournal. “You’re going to be dealing with stress; you’re going to deal with frustrated patients, frustrated parents, just like in any other aspect of nursing. But now, this is the emotional and behavioral aspect you’re dealing with. So you have to be sure you love what you’re doing and are doing it for the right reasons.”
How Herzing’s PMHNP Program Prepares Students
Herzing University’s PMHNP program is unique in several ways. APRNs can also apply for the university’s doctor of nursing practice (DNP)[13] program.
To help accommodate working professionals, the program is available in in-person, hybrid, and online formats.
“We believe that everyone can learn, and we meet you where you are and help you get through those hurdles so you can get there,” Scott says. “So you could be a full-time stay-at-home mom or a part-time mom working, or you could be an RN. If you need more flexibility, we have it.”
Herzing guarantees clinical placements for graduate nursing students. Psychiatric clinical experiences involve seeing patients via telehealth and in person. Students also see patients within their communities.
Herzing’s PMHNP program trains nursing students on the nuts and bolts of mental healthcare, including how to bill and code for mental health services. Effective collaboration with patients and other healthcare professionals is a key soft skill that, Scott says, is emphasized throughout the coursework.
The ideal Herzing PMHNP candidate, Scott says, wants to learn and is disciplined but is also someone who is prepared to serve in communities where the need is greatest.
“We aren’t here to do this alone,” Scott says. “We have faculty who are from around the country, with a vast amount of experience and expertise in different things. So when you get out there, you’re ready.
“It’s all about really working as a community.”
Dr. Monique Scott (she/her) is a board-certified psychiatric nurse practitioner with over 18 years of combined nursing and advanced practice experience, specializing in child and adolescent psychiatry, chronic mental health disorders, and geriatric psychiatry. She is the program chair for Herzing University’s PMHNP program, bringing a passion for mentorship, community mental health education, and cultural dynamics in treatment. An alum of New York University and Wilkes University, Dr. Scott is committed to advancing the field of psychiatric nursing through education and leadership.
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