Psychiatric Nurse Practitioner (NP) Career Overview

Psychiatric nurse practitioners (NPs) work primarily in hospitals, psychiatric facilities, outpatient clinics, substance abuse programs, and private psychiatric or mental health practices where they diagnose conditions and prescribe treatment. Behavioral telehealth is a growing area as well, offering patients accessible virtual mental healthcare no matter where they live. Some psychiatric mental health nurse practitioners (PMHNPs) specialize in certain patient populations as well, such as pediatrics or military/veterans.

Salaries for psychiatric NPs are considerably above the U.S. average. Like other practitioners, PMHNPs have high levels of professional autonomy.

Psychiatric NPs care for patients with psychiatric/mental health conditions. Many supervise registered nurses (RNs) or nursing assistants. Depending on the state where they practice, PMHNPs may need to work under the supervision of or in collaboration with a physician; however, the supervision requirements are generally light. These are among PMHNPs’ key responsibilities:

Psychiatric NPs work in a variety of settings usually, but not always, dedicated to mental health. Some of the more common healthcare settings include hospital psychiatry/mental health departments, mental health centers, private psychiatric practices, and clinics. They may also work in correctional systems, social services settings (such as schools), and domestic violence shelters.

Psychiatric NP jobs in hospitals include delivering care to patients directly, supervising nursing assistants or RNs, and collaborating with physicians on care planning and delivery.

Depending on the state, psychiatric NPs may manage their own practices or work with physicians. Their responsibilities include seeing and diagnosing patients, overseeing their care, and prescribing medications.

In schools, particularly colleges and universities, PMHNPs provide counseling and other psychiatric services to students, referring them to psychiatrists as needed. In some states, PMHNPs can work autonomously. In shelters, psychiatric NPs work with people who have experienced domestic violence and help them recover from psychological trauma.

Psychiatric NP salaries are considerably above the national average salary. These professionals have high levels of professional autonomy. However, working with patients with psychiatric conditions can be emotionally demanding.

For a broader overview, see How To Become a Psychiatric Nurse Practitioner.

Psychiatric NP salaries are considerably higher than the U.S. average median annual salary of $39,810. As of 2019, the median annual base salary was $120,000 and the total median annual compensation was $131,500. Psychiatric NP salaries for family practice were slightly lower at a median of $125,000 total annual compensation, and psychiatric NPs specializing in adult care earned a median $135,000 in total annual compensation — making this the highest paid specialty among NPs.

The number of NP jobs in the U.S. is growing dramatically with approximately 24,000 new jobs projected each year between 2019 and 2029. Though this figure includes all NP jobs, not just PMHNPs, it is indicative of strong growth ahead.

Psychiatric NPs treat both chronic and acute mental health conditions as well as neurodevelopmental disorders. Some of the most common conditions they treat include anxiety disorders (such as phobias), mood disorders (such as depression), personality disorders (such as narcissism), psychotic disorders (such as schizophrenia), substance use disorders, trauma/stressor related disorders, and eating disorders.

The Commission on Collegiate Nursing Education and the Accreditation Commission for Education in Nursing helps to ensure the quality and integrity of baccalaureate, graduate, and residency programs in nursing. The accreditation process reviews the curriculum, faculty qualifications, policies, and other academic and administrative facets of a program to determine whether it provides the education and training graduates need to perform psychiatric NP jobs safely and effectively.

The psychiatric NP curriculum includes courses in nursing, psychological and psychiatric assessment, advanced physiology and pathophysiology, advanced health assessment, cognitive science, counseling, and psychopharmacology. It also includes fieldwork in settings such as mental health centers and clinics, hospitals, private practices, residential programs, and emergency psychiatric services.

Questions on the PMHNP certification exam cover the content included in accredited programs’ curricula, including practice skills for working with patients and their families, diagnosis and treatment of mental health conditions, the scientific and biological underpinnings of mental health, psychotherapy/counseling, and legal/ethical principles and considerations.