Psychiatric Mental Health Nurse Practitioner vs. Psychiatrist: What’s the Difference?

Gayle Morris, BSN, MSN
Updated April 11, 2024
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Psychiatric nurse practitioners are similar to psychiatrists, but there are differences in education and scope of practice. Get details on both careers.
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Senior Black female psychiatrist asks a female patient questions about her mental health during a therapy session.Credit: SDI Productions / E+ / Getty Images

Psychiatrists and psychiatric mental health nurse practitioners (PMHNPs), also known as psych NPs, assess, diagnose, and treat patients with behavioral and mental health conditions.

Psychiatrists are medical doctors who have completed medical school and residency. Yet, psychiatric NPs are advanced practice registered nurses (APRNs) who have completed MSN degrees and have nursing backgrounds. The scope of practice for each role varies by state, with some states limiting psychiatric NPs’ duties.

Learn more about the similarities and differences between these two careers, including educational requirements, salary potential, and job duties for each role.

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Psychiatric Mental Health Nurse Practitioner vs. Psychiatrist: Key Similarities and Differences

PMHNPs and psychiatrists assess, diagnose, and treat patients with mental health conditions. Treatment may include analysis, psychotherapy, counseling, prescribing medication, and hospitalization. Both types of professionals use in-depth knowledge of human behavior and mental health conditions to help patients manage symptoms associated with mental health and substance use disorders.

Psychiatrists and PMHNPs work in hospitals, substance use treatment programs, private or group practices, schools, and correctional facilities. The American Psychiatric Association reports that more than half of psychiatrists work in private practice. In contrast, psychiatric NPs are more likely to work in hospitals or mental health clinics, although many go into private practice.

What is a Psychiatric Mental Health Nurse Practitioner?

A PMHNP is an advanced practice role that assesses mental health status comprehensively and develops individualized treatment plans. They collaborate with psychiatrists or work independently and practice a holistic approach to mental health care that considers psychological, biological, and social factors.

What is a Psychiatrist?

A psychiatrist is a medical doctor (MD) or doctor of osteopathic medicine (DO) who specializes in the diagnosis and treatment of mental illnesses and emotional disorders. They develop personalized treatment plans using therapy, medication, and other therapeutic modalities. Psychiatrists take a medical approach to mental health care and focus on the biological aspects, using medications to manage symptoms.

The scope of practice, education, licensure requirements, and salary potential differ when comparing psych NPs vs. psychiatrists. A PMHNP has a nursing background, a master of science in nursing (MSN) degree, and NP licensure. A psychiatrist has a medical background, an MD or a DO degree, and a medical license.

Psych NPs can only practice independently in states that allow them full practice authority. Some states with full practice authority for NPs still require them to get physician involvement when prescribing medications. However, psychiatrists can practice and prescribe medications independently in any state.

PMHNPs vs. Psychiatrists
Points to ConsiderPsychiatric Nurse PractitionerPsychiatrist
Degree RequiredMSNMD or DO
Experience Required At least two years of nursing experience and 1,000 hours of PMHNP practicumFour years of residency
Required Licensure and Certification Psychiatric-mental health nurse practitioner board certification (PMHNP-BC)

NP state license

MD or DO state license

Board certification from the American Board of Psychiatry and Neurology

Duties and ResponsibilitiesThe scope of practice varies by state but typically includes:
  • Psychiatric assessments, including functional impairments and assessing potential risk
  • Developing and implementing treatment plans
  • Providing psychotherapy
  • Medication management
  • Monitoring patients progress
  • Educating patients and Families
  • Advocating for mental health awareness to destigmatize mental illness
The scope of practice varies by state but typically includes:
  • Diagnostic assessment
  • Psychotherapy (talk therapy)
  • Medication management
  • Patient education
  • Research and scholarly activities
  • Electroconvulsive therapy (ECT) psychiatrists can perform as medical doctors
  • Legal ability to commit patients to involuntary hospitalization, also called civil commitment, when a person poses a danger to themselves or others
Average Annual Salary$119,500 (Payscale, March 2024) $247,350 (BLS, May 2022)

Duties and Responsibilities

Responsibilities for psychiatrists vs. psych NPs are similar for mental health care patients, but these healthcare professionals come from different educational backgrounds and have separate scopes of practice. While psychiatrists are medical doctors with specialized training in psychiatry, PMHNPs are advanced practice registered nurses specializing in mental health care.

Though they share some responsibilities, psychiatrists have a broader scope of practice in every state due to their medical training. In contrast, some states limit PMHNPs’ scope of practice. Psychiatrists and PMHNPs both provide essential, comprehensive care to individuals with mental health conditions. They both can:

  • Conduct psychiatric assessments
  • Develop treatment plans
  • Provide psychotherapy (talk therapy)
  • Prescribe and manage medications
  • Educate patients and families
  • Advocate for mental health awareness
  • Collaborate with a multidisciplinary team
  • Monitor patient progress

However, a psychiatrist’s medical degree allows them to prescribe and perform ECT, initiate involuntary hospitalization, diagnose illnesses, and treat medical conditions with psychiatric implications. Psychiatrists also have full prescriptive authority in all states, but some states require physician involvement for PMHNPs to prescribe medication.

Education Comparisons: Psychiatric Mental Health Nurse Practitioner vs. Psychiatrist

Becoming a PMHNP takes 2-4 fewer years than a psychiatrist. In total, becoming a psychiatrist takes 12 years. Psych NPs typically take 8-10 years to earn licensure, depending on how many years they spend earning their master’s degrees and gaining nursing experience.

Psych NPs can qualify for licensure sooner by completing 1,000 hours of practicum during their MSNs, rather than a four-year residency after graduation. Psych NP MSN programs typically take one fewer year than medical school. If you’d like to start working sooner rather than later, consider these educational differences.

Psychiatric Mental Health Nurse Practitioner

Becoming a psychiatric mental health nurse practitioner begins with a nursing degree. A PMHNP is an advanced practice role that requires an MSN or doctor in nursing practice. Most master’s programs require a bachelor of science in nursing (BSN) degree, but some bridge programs accept candidates with associate degrees in nursing.

A BSN program typically lasts four years, while MSNs usually take at least two years to complete. Graduate programs provide candidates with advanced coursework and clinical training on mental health assessment, diagnosis, treatment, and management.

Courses cover psychopharmacology, psychotherapy, therapeutic modalities, and psychiatric disorders across the lifespan. During the program, a PMHNP gains hands-on clinical experience through supervised clinical rotations in mental health settings like psychiatric hospitals, outpatient clinics, and private practices. These experiences allow them to apply theoretical knowledge and work with a diverse patient population.

  • Undergraduate Degree: A four-year bachelor’s degree in nursing
  • Entrance Exam: National Council Licensure Exam for RNs (NCLEX-RN)
  • Graduate Degree: MSN
  • Practicum: At least 1,000 hours
  • Licensing Exam: Psychiatric-mental health nurse practitioner (across the lifespan) certification
  • Board Certification: Psychiatric-mental health nurse practitioner board certification


Becoming a psychiatrist begins with earning a bachelor’s degree in a pre-medicine field like biology or physiology. Then, they must earn an MD or DO degree.

Medical school takes four years, including coursework, lab work, and clinical rotations. After medical school, a candidate must complete a four-year residency program in psychiatry. These programs provide aspiring psychiatrists with specialized training in diagnosing, treating, and preventing mental health conditions.

As residents, they gain hands-on clinical experience in community mental health centers, outpatient clinics, and psychiatric hospitals under the supervision of experienced psychiatrists. After completing medical school and residency training, a psychiatrist can choose an additional specialization or subspecialization and complete an optional fellowship program.

This work could include areas like child and adolescent psychiatry or forensics psychiatry. Fellowship programs generally last one to two years and involve clinical rotations, research, and mentorship.

  • Undergraduate Degree: A four-year bachelor’s degree with pre-med courses
  • Entrance Exam: Medical college admission test
  • Graduate Degree: MD or DO
  • Residency: Four-year psychiatry residency
  • Licensing Exam: United States medical licensing examination (USMLE) or comprehensive osteopathic medical licensure examination (COMLEX)
  • Board Certification: Board certification from the American Board of Psychiatry and Neurology

License and Certification Differences

Psychiatric mental health nurse practitioners and psychiatrists must be licensed to practice. A psychiatric NP must hold an active RN license to qualify for graduate-level or doctoral programs. Then, they must receive an NP license before working as a PMHNP.

Psychiatrists must pass the USMLE to receive a state MD license or the COMLEX to receive a state DO license before practicing independently. PMHNPs must become board certified in all but two states. Most employers require psychiatrists to become board-certified or eligible for board certification to get a job.

Psychiatrists can seek certification from the American Board of Psychiatry and Neurology once they meet the education, training, and experience requirements. The American Nurses Credentialing Center offers certification for psychiatric NPs.

Salary and Job Outlook Comparison: Psychiatric Mental Health Nurse Practitioner vs. Psychiatrist

In recent years, there has been a growing recognition of the importance of mental health in peoples’ personal and professional lives. This awareness has contributed to increased salary potential and strong job outlooks for psych NPs and psychiatrists.

Salary Comparison

Psychiatrists earn an average higher salary than PMHNPs because of their medical training and broader scope of practice. Specializations and added certifications affect earning potential in both careers. These specializations include child mental health or forensics. Geographical location and cost of living, years of experience, and work setting also influence salary.

Psychiatric Mental Health Nurse Practitioner vs. Psychiatrist: Median Salaries Compared
Career Average Hourly Wage Average Annual Salary
Psychiatric Mental Health Nurse Practitioner$67.82$119,500
Psychiatrists $118.92$247,350
Source: Bureau of Labor Statistics (BLS), Payscale (March 2024)

Job Outlook Comparison

Both professions have a strong job outlook. The BLS projects employment for nurse practitioners to increase by 45% from 2022-2032, compared to the estimated growth of 7% for psychiatrists.

Psychiatric Mental Health Nurse Practitioner vs. Psychiatrist: Projected Job Growth Compared
Career Projected Job Growth Projected Employment Change
Nurse Practitioners45%118,600
Source: BLS (1), (2)

How to Decide Which Career Is Right for You

Consider several factors when deciding whether to become a psychiatrist vs. a psych NP. While there are key similarities between the positions, it’s important to consider the differences and which factors are more important to you. Psych NPs can practice independently in certain states that allow for full authority, while psychiatrists can practice independently across the country.

The average annual salary for a psychiatrist is higher than for a psychiatric NP. However, nurse practitioners can finish their education more quickly and, on average, have less student loan debt.

Psychiatrists and psychiatric mental health nurse practitioners must be licensed to practice, take board certification exams, or be board-eligible to get a job. The BLS projects a 45% job growth for nurse practitioners and a 7% job growth for psychiatrists.

  • Education Timeline: A PMHNP must complete at least six years of education and 1,000 hours of clinical rotation. A psychiatrist completes 12 years of education with thousands of hours of clinical experience as a doctor, along with a mental health residency.
  • Debt: The median amount of graduate nursing student debt ranges from $40,000-$54,999, according to an AACN report. The average debt after graduation for a psychiatrist is $190,000, according to the AMA. The debt depends on whether the student attends a public or private institution and the amount borrowed.
  • Salary: According to Payscale data from March 2024, the average salary for a PMHNP is $119,500, while the BLS reports an average psychiatrist salary of $247,350. Both professional salaries are influenced by geographical location, cost of living, specialization, certification, and work setting.

Frequently Asked Questions: Psychiatric Mental Health Nurse Practitioner or Psychiatrist?

Page last reviewed on February 16, 2024

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