The Process to Become a Psychiatric Nurse Practitioner – What to Know
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Psychiatric issues are relatively common, with one in five people in the US living with some form of mental health illness. These illnesses can vary from mild or moderate to severe. Patients at every level need targeted care, whether from a mental health counselor who can help them talk through their concerns or from psychiatric medical care providers who can prescribe medications and provide ongoing monitoring.
Psychiatric-mental health nurse practitioners (PMHNPs) are advanced practice nurses with specialized training in psychiatry and mental health. Not only do they provide psychotherapy services, but they also can prescribe medications based on a client’s needs. Their duties include everything from assessing a client’s mental health, diagnosing mental health illnesses, and writing a treatment plan. Depending on their state’s scope of practice laws, they can practice independently or under the supervision of a physician.
Becoming a psychiatric mental health practitioner requires becoming a registered nurse and then completing a master’s of science in nursing (MSN) or doctor of nursing practice (DNP) in psychiatric and mental health. While the education and training necessary for this career may seem daunting, many MSN and DNP programs are offered online so that nurses can continue to work while completing their additional education.
The primary certification psychiatric nurse practitioners earn is the Psychiatric-Mental Health Nurse Practitioner (Across the Lifespan) Certification (PMHNP-BC) from the American Nurses Credentialing Center (ANCC). In some states, this certification is required for licensure. Regardless of whether it is needed for licensure or not, this certification is an excellent way to demonstrate a high level of competency to potential employers or to use for career advancement.
Keep reading to learn five things you should know about becoming a psychiatric nurse practitioner, as well as a step-by-step guide on how to get started in this career.
Five Things to Know About Becoming a Psychiatric Nurse Practitioner
The care psychiatric nurse practitioners provide is critical to a healthy medical ecosystem. Here are some things that prospective professionals should know about this career.
A Graduate Degree Is Necessary
To practice as a psychiatric nurse practitioner, one must first earn either a master’s of science in nursing (MSN) or a doctor of nursing practice (DNP) in psychiatric and mental health. These degrees vary in length from as little as 18 months to several years, depending on the level of degree obtained and any previous education completed.
Many psychiatric nurse practitioner programs are available through distance learning, allowing nurses the opportunity to advance their education without having to quit their jobs or relocate.
Psychiatric-Mental Health Nurse Practitioners Are in High Demand
The demand for nurse practitioners is currently the highest among American occupations. According to the Bureau of Labor Statistics (BLS 2022), there will be a 46 percent increase in jobs for nurse practitioners between 2021 and 2031. This is nine times higher than the national average for all jobs during the same period.
The demand for psychiatric nurse practitioners specifically remains high because of an increased acceptance of seeking help for mental health issues and an uptick in mental health concerns due to the pandemic and long Covid.
Telehealth Is a Critical Part of This Profession
The pandemic fundamentally changed how people access medical care. The Department of Health and Human Services estimated a 63-fold increase in telehealth services during the pandemic and a 32-fold increase in telehealth services for behavioral health.
While face-to-face therapy services are still important, behavioral health care can be delivered efficiently over telehealth. Psychiatric nurse practitioners who are well versed in using online modalities to care for patients will find that they can reach more patients than those who strictly have an office-based practice.
Workplaces Can Be Varied
While many psychiatric nurse practitioners do work in traditional mental health clinics, the workplaces for this procession can vary significantly. Psychiatric nurse practitioners are key players in hospitals, outpatient clinics, correctional centers, domestic violence shelters, and Veterans Administration psychiatric facilities. Anywhere clients may seek mental health services or psychiatric care is somewhere psychiatric nurse practitioners can work.
Communication Skills Are Critical to This Career
Medication management is a key component of psychiatric nurse practitioner work, but so is mental health therapy, which means communication skills are critical for this job. Most psychiatric nurse practitioners provide psychotherapy services alongside medications and education to provide clients with well-rounded mental health care.
It is not uncommon for visits with a psychiatric nurse practitioner to last at least an hour to ensure clients have processed their concerns and are prepared to tackle their issues with new skills.
Steps to Become a Psychiatric Nurse Practitioner
Here are the basic steps to becoming a psychiatric nurse practitioner:
Step 1: Graduate From High School Or Earn A GED (Four Years)
The first educational step aspiring psychiatric nurse practitioners must take is graduating from high school or earning a GED. Not only does this demonstrate a base level of education, but it is also required by most nursing programs. Students should focus on science and math classes to help prepare them for additional studies.
Step 2: Complete an Undergraduate Nursing Education Program (Two to Four Years)
To become a psychiatric nurse practitioner, complete a general education nursing program. Students can earn either an associate’s degree in nursing (ADN), an associate’s of science in nursing (ASN), an associate’s of applied science in nursing (AASN) or a bachelor’s degree in nursing (BSN). While either degree will allow graduates to become registered nurses, a BSN is preferred by many employers and may be required for additional education.
Step 2A: Complete an ADN/ASN: (Two Years)
An ADN (also known as ASN) program is designed for licensed practical nurses (LPN), licensed vocational nurses (LVN), paramedics, and military personnel with medical training. Associate’s degree programs in nursing prepare graduates to take the NXCLEX-RN exam to be licensed in all 50 states.
An example ADN program is offered by Excelsior University, which has an online 66-credit ADN program. Students applying to this program can transfer up to 27 credits and shorten their degree completion time.
- Duration: 24 months
- Clinical hours: Two clinical courses
- Required courses: Transition to professional nurse role; advanced clinical practicum
- Transfer credits: Up to 27 credits
Step 2B: Complete an RN-to-BSN (One to Two Years)
An RN-to-BSN program offers a shorter pathway to earning a bachelor’s degree. RNs with an associate’s degree can complete full-time programs online in as little as one year.
For example, Southern New Hampshire University offers a fully online 120-credit accelerated RN-to-BSN program. Applicants with current, unencumbered RN licenses can earn up to 45 transfer credits and can transfer an additional 45 credits depending on previous coursework.
- Duration: 12 to 24 months
- Clinical hours: Yes
- Required courses: Community and population health; research & evidence-based practice
- Transfer credits: Up to 90 (45 credits for having an RN license)
Step 2C: Complete a BSN After a Non-Nursing Bachelor’s Degree (One to Three Years)
Those with a four-year degree in a non-nursing field have plenty of options to pivot into a nursing career.
For example, Herzing University offers a three-year, part-time online pre-licensure (also called direct-entry) bachelor of science in nursing. RNs can also register for this program and earn a BSN in just one year. Students in the 120-credit pre-licensure program are eligible to sit for the NCLEX exam.
- Duration: One to three years
- Clinical hours: Eight clinical courses
- Required courses: Nursing pathophysiology; health assessment; pharmacology
- Transfer credits: Up to 90 credits
Step 3: Get Licensed as a Registered Nurse (Timeline Varies)
After earning an ADN or BSN degree, graduates will need to obtain a license as a registered nurse from their state nursing board. All states require applicants to pass the National Council Licensure Examination for Registered Nurses (NCLEX-RN). This comprehensive exam evaluates a candidate’s readiness to practice as a registered nurse.
During the exam, both knowledge and skills will be assessed to ensure a high level of competency. Other state requirements can include proof of completing a nursing education program, a background check, and a drug screening.
Step 4: Earn A Graduate Degree In Psychiatric Nursing (18 Months to Five Years)
Psychiatric nurse practitioners must complete a graduate degree. They can earn either a master of science in nursing (MSN) or a doctor of nursing practice (DNP) degree specializing in psychiatry and mental health. The length of these programs depends on previous education completed as well as the level of degree obtained. Many of these degrees are offered through distance learning and can be completed while still working full-time.
Step 4A: Complete an ADN-to-MSN: (2.5 to Three Years)
An ADN-to-MSN (also known as an RN-to-MSN) program is designed for registered nurses with an associate’s degree in nursing (ADN) and awards both a BSN and MSN degree, or in some cases, an MSN only.
Many programs, such as the RN-to-BSN-to-MSN Upward Mobility program offered at Regis College, offer psychiatric-mental health nurse practitioner specialization tracks. The GRE is not required for this 49-credit program and students can complete the program in 2.5 to three years with a two-year or four-year degree.
- Duration: 28 to 36 months
- Clinical hours: 500 or more
- Required courses: Advanced psychopharmacology (PMHNP track only)
- Transfer credits: No; students can take two part-time classes before applying to the program
Step 4B: Complete an ADN-to-DNP (Five Years)
Nurses with associate’s degrees can enroll in an ADN-to-DNP program and earn one or more undergraduate or graduate degrees in less time than it would take to earn them separately.
For example, Otterbein University offers an online PMHNP “ADN2(MSN+1)=DNP,” which is designed for registered nurses with an ADN degree to earn an MSN and DNP degrees. This program includes 13 undergraduate and 77 graduate credits.
Students must maintain a 3.0 GPA throughout the program to remain admitted. Courses are divided into four categories: transition, advanced practice core, doctorate of nursing practice core, and psychiatric & mental health specialty courses.
- Duration: Five years
- Clinical hours: 1,000
- Required courses: Advanced practice nurse focus; Psychopharmacology & prescribing
- Transfer credits: No
Step 4C: Complete a BSN-to-MSN (One to Two Years)
RNs with a BSN degree are primed and ready to become psychiatric-mental health nurse practitioners. In just one to two years, depending on transfer credit and part- or full-time enrollment, students can earn an MSN degree with a PMHNP specialization and start their journey toward becoming a psychiatric mental health nurse practitioner.
Walden University offers a BSN-to-MSN program with a PMHNP specialization. This fully online 63-credit program offers quarterly start dates and requires no campus visits. The GRE is not required for admission, and no campus visits are required.
- Duration: One to two years
- Clinical hours: 500 to 640, typically
- Required courses: Advanced pathophysiology; advanced pharmacology; psychopharmacologic approaches to the treatment of psychopathology
- Transfer credits: Yes
Step 4D: Complete a BSN-to-DNP (Three Years)
While an MSN is the minimum degree requirement to become a psychiatric mental health nurse practitioner, there is support for all nurse practitioners to have a DNP degree. RNs with a BSN degree can enter a DNP program and earn one or two advanced degrees (a DNP or an MSN and a DNP).
For example, Anderson University offers a BSN-to-DNP program with a PMHNP specialization track. While most of the courses are online, six required campus visits and clinical residencies must be completed in person. The 39-credit program is taught through a Christian worldview and terminates in a scholarly evidence-based project.
- Duration: Three years or more
- Clinical hours: 1,000 or more
- Required courses: Clinical epidemiology; applied informatics and change systems; faith & learning worldviews
Step 4E: Complete an MSN-to-DNP (Four Years)
In some cases, a nurse practitioner will earn a general MSN degree and choose later to specialize in an area of patient care or add on to their patient care specialties. MSN-to-DNP programs are designed for these types of nurses who want to specialize in one or more than one areas of advanced nursing practice.
An example of this type of program is the MSN-to-DNP program at Washburn University which offers a PMHNP specialty for family nurse practitioners (FNPs) and MSN degree holders who are not advanced practice registered nurses (APRNs).
The PMHNP track requires 72 credits and admits students with MSN degrees annually. While many courses are online, nine required campus visits are required. The GRE is not required for admission, and applicants must have a 3.25 GPA or higher to be considered.
- Duration: Eight semesters
- Clinical hours: 525 to 1,020 (gap analysis required)
- Required courses: Advanced pathophysiology, advanced pharmacology, psychopharmacology
Step 4F: Complete a Post-Master’s Certificate (One to Two Years)
An RN with an MSN degree can choose to specialize in psychiatric mental health via a post-master’s certificate program. These types of programs offer in-depth didactic and clinical expertise and can typically be completed in one to two years.
Purdue University Global offers an example program, which offers a post-MSN graduate nursing certificate in psychiatric mental health. This 48-credit program offers multiple start dates throughout the year and doesn’t require any campus visits. The GRE is not required for admission, nor is a minimum GPA.
- Duration: One to two years
- Clinical hours: 500 or more (gap analysis required)
- Required courses: PMHNP neuroscience and pharmacotherapeutics; PMHNP psychopathological disorders and psychotherapy
Step 5: Obtain Psychiatric-Mental Health Nurse Practitioner Certification (Timeline Varies)
Most state nursing boards require nurse practitioners to obtain national certification in their chosen specialty. For psychiatric nurse practitioners, the national certification is the Psychiatric-Mental Health Nurse Practitioner (Across the Lifespan) Certification (PMHNP-BC) from the American Nurses Credentialing Center (ANCC). The eligibility requirements for this exam include:
- An unencumbered, current, and active RN license
- A master’s, post-graduate certificate, or doctor of nursing practice (DNP) from a psychiatric-mental health nurse practitioner (PMHNP) program accredited by the Commission on Collegiate Nursing Education (CCNE) or the Accreditation Commission for Education in Nursing (ACEN), or the National League for Nursing (NLN) Commission for Nursing Education Accreditation (CNEA) and include a minimum of 500 faculty-supervised clinical hours.
- Graduate courses in advanced physiology/pathophysiology, advanced health, and advanced pharmacology
- Completed educational content in health promotion and/or maintenance and differential diagnosis and disease management, including the use and prescription of pharmacologic and nonpharmacologic interventions
- Clinical training in at least two psychotherapeutic treatment modalities
Candidates must submit an application and pay a $220 to $395 fee to sit for this exam. When eligibility has been established, a candidate will be approved to schedule their test. The exam takes four hours and covers the following topics:
- Scientific Foundation
- Advanced Practice Skills
- Diagnosis and Treatment
- Psychotherapy and Related Theories
- Ethical and Legal Principles
Step 6: Earn State License to Practice as a Psychiatric Nurse Practitioner (Timeline Varies)
Once education and certification have been completed, psychiatric nurse practitioners must apply for a license to practice from their state nursing board. The requirements will vary by state, so candidates should check with their local board to ensure they have the necessary qualifications.
For example, in California, the requirements to be a psychiatric nurse practitioner are:
- A master’s degree or higher in psychiatric and mental health nursing
- At least two years of supervised clinical experience in providing psychiatric/mental health counseling services or hold the PMHNP-BC certification
- Hold an active California Registered Nurse (RN) license
Kimmy Gustafson is a freelance writer with extensive experience writing about healthcare careers and education. She has worked in public health, at health-focused nonprofits, and as a Spanish interpreter for doctor’s offices and hospitals. She has a passion for learning and that drives her to stay up to date on the latest trends in healthcare. When not writing or researching, she can be found pursuing her passions of nutrition and an active outdoors lifestyle.