psychiatric mental health nurse practitioner essay

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Why I Want to Be a Psychiatric Nurse Practitioner

• Categories: Why Did You Choose Nursing Why I Want To Be A Nurse

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Words: 693 |

Updated: 13 December, 2023

Words: 693 | Pages: 2 | 4 min read

Works Cited

• American Psychological Association. (2010). Publication manual of the American Psychological Association (6th ed.). Author.
• Brinkworth, M., & Watson, K. (2016). A comparative study of high and low achieving university students: motivation, study strategies and academic performance. Higher Education Research & Development, 35(1), 1-14.
• Csikszentmihalyi, M. (1996). Creativity: Flow and the psychology of discovery and invention. Harper Collins.
• Deci, E. L., Koestner, R., & Ryan, R. M. (1999). A meta-analytic review of experiments examining the effects of extrinsic rewards on intrinsic motivation. Psychological Bulletin, 125(6), 627-668.
• Dweck, C. S. (2006). Mindset: The new psychology of success. Random House.
• Johnson, W. (2009). Why I hate school but love education. Spoken Word Poem. Youtube.
• Paunesku, D., Walton, G. M., Romero, C., Smith, E. N., Yeager, D. S., & Dweck, C. S. (2015). Mind-set interventions are a scalable treatment for academic underachievement. Psychological Science, 26(6), 784-793.
• Pham, L. B., Taylor, S. E., & Seibert, P. S. (2012). Mindfulness and intellectual achievement: A moderated mediation model of academic self-efficacy. Mindfulness, 3(3), 212-222.
• Silverman, L. K. (1993). The highly gifted. ERIC Digest.
• Tough, P. (2012). How children succeed: Grit, curiosity, and the hidden power of character. Houghton Mifflin Harcourt.

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A Mental Health Nurse Practitioner Specialty Essay

Introduction.

Building a career is a process full of challenges, especially when the individual is faced with the task of making a choice. The desire to choose the best option from various possibilities, taking into account personal abilities and interests, can provoke stress and other difficulties. Therefore, it is crucial to carefully evaluate individuals’ experiences and learn more about options to make an informed decision. For the Master of Science in Nursing (MSN) program, I chose the Mental Health Nurse Practitioner (MHNP) specialty. Despite the difficulties of choice, at the moment, I am confident that this opportunity is in line with my goals and interests.

One of the choices a nurse makes is a decision on how to progress in a career. MSN is one of the opportunities to advance qualification and educational level to continue the professional journey. Moreover, the program is a step toward the objective of the role of an advanced registered nurse practice (APRN) (Schlette, n.d.). I was confident in the desire to get a higher degree, as my goal is to contribute significantly to health care. However, I had some difficulties in choosing a direction for development. In particular, my professional plan was not clear and determined enough. Moreover, I am interested in several areas of medicine where I would like to prove myself. I also wanted to take into account my experience in a mother-baby and labor unit. The time allocated to assess my goals, interests, and values helped me choose.

Since the goal of obtaining a degree and moving toward the role of APRN prompted me to study in the MSN program, the primary choice was the specialty. My interest in mental health was a key driver in my decision to become an MHNP. I have always been inclined towards this field, and although my experience has been in a different direction, which has also been interesting to me, it has helped me realize the importance of mental health support. Moreover, the demand for highly skilled mental health service providers is growing (Delaney & Vanderhoef, 2019). After choosing a specialty, I set more precise goals aligned with the MHNP role. My educational goal is to obtain the MSN degree to achieve professional goals – providing mental health care, protecting the vulnerable population, influencing mental health policy, and helping patients with mental problems live their fullest lives. Continued education and self-development will help me achieve my goals and benefit patients.

One of the factors contributing to career development is participation in professional organizations. MHNPs may join several associations, such as the American Association of Nurse Practitioners (AANP), American Psychiatric Nurses Association (APNA), International Society of Psychiatric-Mental Health Nurses (ISPN), and other organizations (“Psychiatric-mental health,” n.d.). For example, to become a member of APNA, you need to fill out the corresponding application and make a membership fee (APNA, n.d.). Participation in organizations contributes to networking, helps in ongoing education, provides resources for development, and provides other benefits.

In conclusion, individual choice determines the direction for career development. Due to the many opportunities and interests, people may face difficulties when making decisions. However, gathering information and carefully assessing personal abilities and values can help. I chose the MHNP specialty, which aligned with my early interests and goals, and helped establish new ones. The MSN program will assist me in acquiring the necessary skills and knowledge to advance my career. Another important factor helping to achieve the goals is participation in organizations, which supports nurses in training and professional development.

American Psychiatric Nurses Association. (n.d.). Rates & how to join or renew .

Delaney, K. R., & Vanderhoef, D. (2019). The psychiatric mental health advanced practice registered nurse workforce: Charting the future. Journal of the American Psychiatric Nurses Association , 25 (1), 11-18.

Psychiatric-mental health nurse practitioner: Associations . (n.d.). Vanderbilt University School of Nursing.

Schlette, J. (n.d.). Types of MSN specialties – Which one is right for you? Nursingprocess.org.

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LEAVITT SCHOOL OF HEALTH | ADMISSION REQUIREMENTS

Directions for Completing PMHNP Application Documents

Application essay.

The purpose of the application essay is to demonstrate to the Admissions Committee your understanding of the psychiatric mental health nurse practitioner (PMHNP) role, justifications for the PMHNP role in delivering high-quality and cost-effective mental health care, and how the WGU PMHNP programs might prepare you to meet the mental health care needs of your local community or population of interest. This is an opportunity for you to communicate directly with the admissions committee, highlighting how your life and professional experiences have prepared you for the transition from the role of registered nurse to psychiatric mental health nurse practitioner.   

Select at least two (2) academic resources (articles/online literature) that describe the health, social, and economic benefits related to PMHNP practice in the United States. Note: All sources are critically reviewed, documented, and formatted following standard practices of the field (APA 7th Edition) and are within a 5-year time frame of the application date.

Use the information from your sources and your own personal and professional preparation to answer the following questions in your application essay for your WGU PMHNP program:  

• How have your life and professional experiences prepared you for this WGU PMHNP program? 
• How can this WGU PMHNP program prepare you to deliver mental health care to the community in which you live?  
• Please describe the type of clinical practice you will pursue upon graduation from this WGU PMHNP program (e.g. outpatient psychiatric practice, inpatient psychiatric practice, substance abuse treatment, etc).
• How can your future clinical practice as a PMHNP affect the quality and cost of care for patients and their families? 
• Please add this statement to the bottom of your Application Essay. You may include a typed signature.   I have reviewed and understand the scope of practice of the Psychiatric Mental Health Nurse Practitioner role in my state of ____. Signature Line: __________________________

As you answer the questions above, we will examine your application essay to ensure your writing meets the following criteria: 

• Plagiarism will result in an automatic decline during the competitive selection process . 
• Originality and uniqueness are expected.  Writing is self-reflective, creative, innovative, and diverse.
• Writing directly addresses all four application essay questions.
• Writing is clear and appropriate for the purpose of the assignment. 
• All evidence and examples are used effectively and are specific and relevant. 
• Ideas are coherently and logically organized with well‐developed paragraphs and effective transitions. 
• All sentences are well written with varied sentence structure and are free of errors in grammar, punctuation, and spelling. 
• Maintains appropriate tone, diction, and vocabulary for various modes of writing. 
• Work demonstrates clear understanding of the target audience.  
• All sources are critically reviewed, documented, and formatted following standard practices of the field (APA 7th Edition) and are within a 5-year time frame of the application date.  Note:  Online blogs are not an acceptable source. 

Formatting: 

• Title Page, Abstract, Main Body, and References  
• Include header/page numbers  
• 3-4 pages (main body), double-spaced, 12-point Times New Roman font
• APA 7th Edition 

The purpose of the CV/résumé is to directly tie your previous and current life and professional experience, as noted in your résumé or CV, to the WGU PMHNP program.     

CV/Résumé Criteria

• Audience and purpose of the résumé are strong and clear.
• Format of the résumé is clear. Each major section includes required information (objective statement, names, dates, locations, etc.).
• Résumé shows a very professional appearance, tone, and style.
• Writer follows all guidelines for spelling, grammar, usage, mechanics, etc. Sentences are strong and have a varied structure.

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April 2, 2020

What Is the Role of a Psychiatric Mental Health Nurse Practitioner?

Learn how real students navigate their way through the graduate school admissions process and grad school itself with our What is Graduate School Really Like? series.

Meet Javier, a DNP student on a mission to increase mental health awareness in his community.

Javier, thank you for sharing your story with us!

What inspired you to pursue a career as a nurse practitioner?

Javier: I always knew I wanted to work in mental health as some sort of therapist. As such, I applied to social work school with the idea of becoming a licensed clinical social worker. However, while I absolutely think the social work curriculum is outstanding, I felt as if it did not place an emphasis on neurophysiology as much as I would have liked it to. 

I withdrew my application and thought to myself, What now? 

At this time, I was working for an after-school program which utilized nursing students as volunteers. One of the nursing students suggested that I become a psychiatric nurse practitioner. At the time, I was not familiar with the role of a nurse practitioner. After looking more into what the role of the psychiatric nurse practitioner entailed, I found it aligned perfectly with what I saw myself developing a career out of. 

LISTEN: Wake Up to Your Amazing Career Possibilities: How to Discover Which Job You Will Love >>

The fact that PMHNPs (psychiatric mental health nurse practitioners) are trained to provide both medication management and psychotherapy would allow me to enjoy the best of both worlds. This specialized role would allow me to treat patients holistically, both through medical management and therapy. 

With this in mind, I knew that I had to become a nurse first before becoming a nurse practitioner. I did consider staying a nurse and working in a psychiatric unit. However the role of an RN in psychiatry is different from the purpose and interest that I have: which was to be able to provide psychotherapy to clients and gain a deeper understanding of neuroanatomy and psychopharmacology. More importantly, I wanted to be able to have more autonomy over the treatment plan of the patient, which as a nurse practitioner, I would be able to have. 

Did you work at all as an RN or go straight on to begin your PMHNP training?  

Javier: I did not work as an RN prior to starting NP school. The PMHNP program at Columbia School of Nursing is a unique program. They are considered a Masters Entry into Nursing Program (MENP) program, which is designed for professionals who already possess a bachelor’s degree in an area of study other than nursing. For example, I had a bachelor of science in psychology with a focus on marriage and family therapy. As such, the program at Columbia School of nursing does not require RN experience. Our first year is considered the Master Direct Entry year. Throughout this time we take traditional BSN courses. However, given that it is a Masters program, we take additional courses that BSN nurses do not take. These courses include advanced pharmacology, advanced pathophysiology, advanced physical assessment, and care coordination. Completing this program allows us to sit for our RN licensing exam (NCLEX), before seamlessly transitioning into our NP specialty program. 

Is it common for students to work as nurses before NP school? How about during NP school?

Javier: As a very academically demanding full-time program, it is very difficult to work throughout our DNP, but there are a few folks that do work as an RN while in the DNP portion, especially those in the Acute Care specialty, as that specialty requires students to work during their program in order to gain experience. 

All in all, though it is common for students to work as RNs first and then move toward the advanced practice registered nurse (APRN) role, it is no longer a requirement. 

To this point, there have been times where I have received negative attention for taking this route. I have heard things like, “You’re going to become an NP without working as an RN first?” or “You can’t be a good NP without bedside experience.” I disagree. I think in the case of the PMHNP specialty, bedside nursing experience does not necessarily equate to developing the skills necessary for excellent patient-centered holistic care. 

In my case, while I do not have any bedside RN experience in psych, my previous academic background in psychology has given me a foundation in psychiatry. More importantly, working as a case manager also provided me with invaluable experience, given that most of my clients had some sort of DSM-5 diagnosis. 

Additionally, throughout my RN curriculum, I was able to secure a preceptorship inside a high acuity inpatient psychiatric unit here in the City of New York. This added experience was in addition to the psychiatric rotation that all nurses have to complete. 

How does your program divide students’ time between classroom learning and clinical encounters? Are you happy with the breakdown?

Javier: Our program currently has us taking didactic courses such as individual psychotherapy theory, group psychotherapy theory, and family psychotherapy theory. In addition, we complete hundreds of hours of clinical time focusing on these three modalities. We have classes three days out of the week and clinicals on the other days. At times it can feel overwhelming, however it does make it easier to apply what we are learning in the classroom to our clients. 

Did you ever consider becoming a physician assistant? How are the fields different?

Javier: I did not consider becoming a physician assistant (PA) for a few reasons. One of these reasons is the fact that PAs get trained broadly in medicine, similar to the education of a medical doctor (MD, DO) and do not really specialize until they have graduated and found an area they would like to work in. In contrast, the training that NPs receive is very specialized with the exception of a few specialties that focus on primary care health. 

I really wanted to focus in psychiatry and decided that having a focused education would be a better fit for me. In addition, as of now in all 50 states, PAs are required to have physician oversight or some sort of collaborating agreement with a physician at all times. However, for nurse practitioners, depending on the legislation of the state, there are different scopes of practice. In other words, some states require NPs to have physician oversight, while others do not require physician oversight at all. This depends on the state and the type of organization you work for. 

Lastly, the biggest differences are the educational models that we are trained under. PAs are trained closely using the medical model of care while nurse practitioners are trained under the nursing model of care, which stresses patient-centered care and places a huge emphasis on holistic care as well as culturally competent care.

What is the gender breakdown of your NP class? Have you encountered gender bias as a male NP student?

Javier: Throughout my experience in nursing school, males are definitely the minority when it comes to gender representation. However there are currently six men and twenty women in my NP cohort. That said, there is definitely gender bias in nursing. For example, there have been times where I have walked into a patient’s room and been called a physician- while my female peers have been confused with nurses. This is interesting given that we all have the same role and give similar introductions when we walk into a patient’s room. 

At what point does an NP student select their specialty track? Is it common to choose more than one track? Is it possible to switch tracks, either as a student or later as a practicing professional?

Javier: In order to apply to NP school, you must select a specialty track from the very beginning. For example, I applied to the Psychiatric Mental Health Nurse Practitioner specialty. In general, it is uncommon for students to pick more than one track unless they are in a program that simultaneously satisfies the requirements for more than one track. For example, some programs have a combined nurse midwifery (CNMW) and women’s health nurse practitioner (WHNP) track or a family nurse practitioner (FNP) and psychiatric mental health nurse practitioner (PMHNP) track. 

Once you sit for your boards and become certified as an NP, if you wanted to switch specialties you would be required to apply to the additional specialty. Luckily, you do not have to start from scratch again. Most of your credits from your previous NP training will transfer, such as advanced pharmacology, advanced pathophysiology, and advanced physical assessment. However, you would be responsible for the specialty courses and clinical hours within that specialty, and of course you would be required to sit for your boards in the specialty.

What sparked your interest in psychiatry as a specialty?

Javier: I absolutely love psychiatry, I think most of my interest came from having personal experience with close family members having psychiatric conditions. Additionally, I do remember taking a high school psychology course and absolutely falling in love with it. In fact, I ended up majoring in psychology in college. 

it was really my abnormal psychology class which covered DSM-5 disorders that really sold me on it. I remember just being in complete awe when I learned about personality disorders and the role of trauma in our lives. After taking that course and other courses throughout college I was able to understand people from a different perspective. 

The following year I took neuropharmacology and neurophysiology. Understanding the physiology of the brain was so complex and intriguing, it kept me engaged even outside of the classroom. Even more so, learning how different medications interact in different areas of the brain with different receptors was beyond fascinating. 

Outside of the classroom I began to notice that there was truly a huge need for psychiatric services. It was during this time that my classmates began emerging with complaints of anxiety and depression and I was able to provide support using the skills I had learned. I was able to support friends who needed help, and provided them with resources for them to utilize should they find themselves in crisis. 

I also noticed in them a common theme and complaint. That is, many of them were blamed for their current symptoms or told to be stronger by another individual. As a result, I realized that mental health was a topic that was not prioritized in families, let alone the community around us. For this reason, I knew my purpose was to increase awareness in our community regarding mental health. 

Do you see yourself focusing more on psychopharmacology or psychotherapy as a practicing NP?

Javier: As a practicing NP, I will most likely be focusing on medication management, as psychotherapy is often left to other mental health professionals who focus solely on therapy. However, we do receive training in psychotherapy while in school. It is often standard practice to incorporate psychotherapy interventions in your sessions regardless. This may involve asking the client to track negative thoughts throughout the day (CBT), or to focus on their senses when feeling overwhelmed (mindfulness). Another approach would be to perhaps ask the client to hold ice cubes in their hand when they feel like engaging in self harming behaviors. However, if I am able to find a job that allows me to do both, I would definitely prioritize that over a job that only allows me to do medication management. 

Ultimately I would like to own a private practice where I can do both medication management and psychotherapy. I am particularly interested in cluster-B personality disorders such as borderline personality disorder (BPD). Clients with this diagnosis require intensive therapy and at times benefit from medication therapy.

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The Role of a Psychiatric Mental Health Nurse Practitioner (PMHNP)

Published on: september 27, 2023, written by usd nursing.

According to the National Institute of Mental Health , it’s estimated that more than 1 in 5 U.S. adults live with a mental illness. 

This statistic totaled about 57.8 million people in 2021 and includes both those with any mental illness (AMI) and those with serious mental illness (SMI), which is a mental illness that inhibits a person’s daily living. In addition to mental illness in the adult population, 1 in 10 youth in the U.S. are experiencing depression that’s severely limiting their ability to function. 

Despite these numbers, of those 57.8 million adults, only 47.2% —less than half—received mental health services in the last year. A third of adults reported they weren’t able to receive the treatment they needed, and 42% of adults with AMI couldn’t afford care. Almost 60% of youth with major depression don’t receive any mental health treatment at all. 

While there is a vital need for mental health care, there are a limited number of professionals able to deliver such care. There are an estimated 350 individuals for every one mental health provider, although the number of active mental health professionals may be overrepresented here; some may be no longer practicing or not accepting new patients.

This is where a psychiatric mental health nurse practitioner (PMHNP) can make a big difference. PMHNPs are leaders in mental health care across the healthcare system. Their knowledge of mental illnesses and psychiatric treatments provides patients in all healthcare environments with the necessary care to live vibrant, healthy lives. 

Whether you’ve been looking to work in mental health services or you’ve been wondering, “ What can you do with a doctorate in nursing ?” — the PMHNP position might be right for you. Let’s dig into the details of this in-demand medical career.

What is a PMHNP?

A PMHNP is a specialized nurse practitioner position. As experts on mental health illnesses, PMHNPs assess, diagnose, and treat the psychiatric needs of patients. They take a holistic approach to medical care and understand the connections between mental and physical health. PMHNPs work both as individuals and as part of professional teams to ensure patients from all backgrounds receive optimal psychiatric care. While PMHNPs carry out many similar duties to other nurse practitioners, they also have a number of unique roles and specialties that make them integral to a well-functioning healthcare system. Every day, their experience aids the constantly changing world of healthcare in bettering practices for people with various mental illnesses and mind-and-body needs.

What does a psychiatric nurse practitioner do?

Psychiatric nurse practitioners perform a wide range of services for a wide range of people. No demographic is without mental health needs, so PMHNPs can be found working with all ages, genders, and populations.

The roles of a PMHNP can vary slightly depending on where they work and whether they have a more acute specialty, but there are a few key duties psychiatric nurse practitioners consistently carry out. On a regular basis, PMHNPs:

• Assess, diagnose, and treat mental illnesses
• Conduct both physical and psychosocial assessments and provide treatments such as therapy, prescription medications, and emergency psychiatric care
• Track patient recoveries through treatment effectiveness evaluations

PMHNPs give professional, practical, and emotional support throughout every patient’s medical health journey. The care of psychiatric nurse practitioners is essential to anyone’s mental recovery and rehabilitation.

A psychiatric nurse practitioner vs psychiatrist

At first glance, psychiatric nurse practitioners and psychiatrists could seem like interchangeable job titles. Both jobs care for mental health needs and work in the medical field. Despite their similarities, though, there are a number of differences between the two careers:

What are some sub-specialties?

With the range of illnesses and populations that PMHNPs serve, the psychiatric mental health nurse practitioner scope of practice is a wide one. PMHNPs might specialize in providing psychotherapy to individuals, groups, or families. They may focus on coordinating care with a team of professionals, or on evaluating patients’ non-psychiatric needs in addition to their mental health care. 

Some specializations require specific training. Here are three title specializations in the PMHNP realm:

• Child Adolescent PMHNP : These professionals work with youth psychiatric, learning and behavioral disorders. They assess, diagnose, and treat conditions such as ADHD, autism, depression, anxiety, or eating disorders. 
• Geriatric PMHNP : NPs in this specialty work with older adults and their families to help with the aging process. Geriatric populations often battle depression and anxiety surrounding feelings of isolation, grief, and fear of death. PHMNPs in this realm also often treat Alzheimer’s disease and its symptoms.
• Addiction Disorder PMHNP : Addiction Disorder Psychiatric Nurses diagnose and treat addictive behaviors of all types, from drugs and alcohol to food and gambling. In addition to the typical settings for PMHNPs, these specialists often work in places like outpatient addiction centers, detoxification centers, halfway houses, and addiction recovery centers. 

What is it like to be a psychiatric nurse practitioner?

Psychiatric nurse practitioners are compassionate, emotionally intelligent healthcare professionals. Their specific roles can vary depending on the environment they work in. PMHNPs in doctor’s offices and hospitals find themselves supporting psychiatrists and physicians by performing tests, assisting and monitoring patient resource needs, and tracking patient progress. In mental health clinics and private practices, PMHNPs tend to work more with personally diagnosing and treating patients. No matter where PMHNPs go or what tasks they take on daily, one thing is the same: psychiatric mental health nurse practitioners are confident, efficient, empathetic leaders in the healthcare world.

What is the demand for psychiatric nurse practitioner jobs?

Mental health awareness has become a growing topic in today’s world. As more people learn about the heavy impact of mental illness and the importance of seeking professional help for mental disorders, the need for psychiatric nurses rises.

The number of psychiatric nurse practitioner jobs in the country is expected to grow 26% between 2018-2028 . In addition to this rapid rate, the national average psychiatric nurse practitioner salary is $105,403. For PMHNP jobs in California, however, the average salary is around $128,724. 

How to become a psychiatric mental health nurse practitioner

PMHNPS have expert knowledge in their field as a combination of both in-depth practical experience and education through graduate degrees. 

PMHNPs gain experience working as an RN before obtaining either an MSN or a DNP with a focus on psychiatric mental health. Psychiatric nurse practitioners must get board-certified in psychiatric nursing, which happens through obtaining a graduate degree.

The University of San Diego Hahn School of Nursing and Health Science offers one of the most robust PMHNP programs in California. Both the Masters of Science in Nursing program and the BSN to DNP program offer tracks for a psychiatric mental health nurse practitioner certification, giving nurses the opportunity to explore different paths toward specializing in psychiatric health. The classes for PMHNP students prepare future nurses with knowledge and firsthand experience so they can serve patients of all backgrounds with confidence and competence. 

At USD, we empower nurses to lead in the healthcare world. If you want to learn more about how USD SON will help hone the skills you need to thrive in your career, we invite you to request more information about our programs today. 

You can also download our MSN Guide or DNP Guide to read more about our uniquely designed psychiatric mental health nurse practitioner programs.

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Part One What is a Psychiatric Mental-Health Nurse Practitioner (PMHNP)?

Psychiatric mental health nurse practitioners (PMHNPs), also known as psychiatric nurse practitioners, are nurse practitioners who specialize in mental health treatment. They help patients suffering from mental illnesses, disorders, or substance abuse problems by assessing, diagnosing, and providing treatment plans to them. 

In this guide, we’ll explain how to become a psychiatric nurse practitioner, what they do, the average psychiatric nurse practitioner's salary, and more. 

Part Two What Do Psychiatric Mental Health Nurse Practitioners Do?

PMHNPs take care of patients suffering from a variety of mental illnesses and disorders. Psychiatric nurse practitioner duties will vary based on where they work, but they often  include: 

• Diagnosing and treating common acute psychiatric problems, illnesses, and crises
• Psychopharmacologic management in collaboration with a psychiatrist
• Providing individual, group, and family psychotherapy
• Caring for and counseling clients with commonly identified chronic psychiatric conditions
• Coordinating and integrating multidisciplinary services for clients with complex psychiatric problems
• Monitoring common healthcare problems and referring to specialized medical treatment as needed
• Providing comprehensive family psychiatric-mental health education
• Performing or recommending age-appropriate screening procedures
• Promoting wellness-oriented self-care
• Being an advocate for family psychiatric-mental health clients and their families

Illnesses and Disorders that Psychiatric Nurse Practitioners Treat

Psychiatric nurse practitioners treat a wide variety of mental illnesses and disorders, including:

• Bipolar, manic-depressive states
• Eating disorders
• Obsessive-Compulsive Disorder
• Attention deficit hyperactivity disorder
• Substance abuse 
• Panic Disorders
• Autism Spectrum Disorder 
• Schizophrenia
• Personality disorders
• Trauma, PTSD, adjustment disorders

>> Show Me Online Psychiatric Nurse Practitioner Programs

Part Three How to Become a Psychiatric Mental-Health Nurse Practitioner 

To become a psychiatric nurse Practitioner, you’ll need to complete the following steps. 

Step 1: Attend Nursing School

You’ll need to earn either an ADN or a BSN from an accredited nursing program in order to take the first steps to becoming a registered nurse. ADN-prepared nurses will need to take the additional step of either completing their BSN degree or entering into an accelerated RN to MSN program, which will let them earn their BSN and MSN at the same time.

Step 2: Pass the NCLEX-RN

Become a Registered Nurse by passing the NCLEX examination .

Step 3: Gain Experience or Continue Your Education

Nurses can choose to gain some nursing experience before going back to school or go directly into an MSN program, depending on their unique situation. Most NP programs will require a minimum of TWO years of relevant work experience.

Step 4: Graduate With Your Psychiatric Mental Health Nurse Practitioner Degree From an Accredited Nursing Program

Enter into an MSN/NP program that offers a path to becoming a Psychiatric Mental Health Nurse Practitioner. You can select from several in-person or online PMHNP programs nationwide to suit your specific needs.

If you already have a nurse practitioner degree, you can attend a PMHNP certificate program instead. These programs allow NPs to further specialize in mental health. Check out our guide to learn more about the shortest online PMHNP certificate programs .

Step 5: Become Certified

The American Nurses Credentialing Center offers the Psychiatric-Mental Health Nurse Practitioner (Across the Lifespan) Certification (PMHNP-BC) .

Step 6: Get a Job as a Psychiatric Nurse Practitioner

Now you’re ready to start working as a Psychiatric Nurse Practitioner!

Part Four  PMHNP Jobs

Psychiatric Mental Health Nurse Practitioners can work in a variety of locations, including:

• Community Mental Health Centers (urban and rural)
• Consulting with businesses and communities
• Correctional Facilities
• Domestic Violence Shelters
• Government Agency
• Home Health Agencies
• In-patient Psychiatric Facilities
• Primary Healthcare Clinics
• Private Psychiatric Practices
• Psychopharmacology Clinic
• Psychiatric Consult Services
• Public health agencies
• Residential Substance Abuse Facilities
• State Psychiatric Facilities
• Student Health Clinics
• Urban Nurse-Managed Clinic
• Veterans Administration Psychiatric Facilities

Part Five Psychiatric Nurse Practitioner Salary

As with other types of nurse practitioners, Psychiatric NPS can expect to earn salaries on the higher end of the spectrum. According to the Bureau of Labor Statistics , the median pay for nurse practitioners is $121,610 per year as of May 2022.

However, the BLS does not differentiate between different types of Nurse Practitioners. But, according to Indeed, the average psychiatric nurse practitioner salary is $139,261.

Psychiatric Nurse Practitioner Salary by Years of Experience

Psychiatric NPs can earn a higher annual salary with increased years of experience. Per  Payscale.com , this is how much people are earning at different levels of experience in 2022: 

• Less than 1 years of experience earn an average salary of $105,794
• 1-4 years of experience earn an average salary of  $118,742
• 5-9 years of experience earns an average salary of $121,830
• 10-19 years of experience earns an average salary of $120,601

Highest Paying Cities for Psychiatric Nurse Practitioners

In 2022, the highest-paying cities for Psychiatric NPs, according to Indeed , are:

• New York, NY - $161,313
• San Diego, CA - $148,806
• Philadelphia, PA - $146,897
• San Angelo, TX - $121,099

Psychiatric Nurse Practitioner Job Benefits

Regardless of workplace setting, full-time and part-time nurses enjoy similar benefits. While actual benefits may vary depending on the institution, most include the following:

• Health insurance
• Certification Reimbursement      
• Retirement Options
• Holiday Pay
• Family Leave of Absence
• Maternity Leave
• Dental Insurance
• Dependent health insurance coverage
• Life Insurance
• Paid time off
• Relocation assistance
• Bereavement leave       
• Vision Insurance        
• Discounts on extracurricular activities      
• Continuing Education Reimbursement
• Relocation packages
• Attendance at nursing conferences

Part Six Psychiatric Mental Health Nurse Practitioner Programs

We’ve rounded up some of the top Psychiatric Nurse Practitioner programs, also called Psychiatric Mental Health Nurse Practitioner (PMHNP) programs. Below are five of the top programs available for getting your PMHNP education. Check out our article on the  Top Psychiatric Nurse Practitioner Programs  for the full list and more information. 

• 1. University of Pennsylvania
• 2. Rush University
• 3. University of Washington
• 4. University of California – San Francisco
• 5. Yale University

Part Seven PMHNP Continuing Education Requirements

PMHNP CEU hours will vary based on the state of licensure. For each state an individual is licensed, CEU hours will be required. Generally, NPs are required a minimum of 75 contact hours of continuing education in the specialty area (psychiatric nursing).

Additionally, even though they are functioning in an APRN role, they must maintain their RN certification.  In order for an individual to renew their RN license, they will need to fill out an application, complete a specific number of CEU hours, and pay a nominal fee. Each state has specific requirements, and it is important to check with the board of nursing prior to applying for license renewal.

A detailed look at Continuing Nurse Education hours can be found here . 

Part Eight  Psychiatric Nurse Practitioner Career Outlook

According to the U.S. Bureau of Labor Statistics (BLS) , the career outlook for NPs is excellent. From 2022 to 2032 there is predicted to be a 38% growth in employment for NPs, which is MUCH faster than the average for all occupations.  

The American Association of Nurse Practitioners estimates that there are approximately 15,275 or 4.7% NPs certified in psychiatric mental health. As mental health disorders continue to rise in the United States, Psychiatric Mental Health NPs continue to be needed. 

Part Nine Resources

• Top Psychiatric Nurse Practitioner Programs
• How to Become a Psychiatric Nurse
• Psychiatric Nurse Practitioner Salary Guide 

Part Ten  Other Nurse Practitioner Specialties

• General Nurse Practitioner
• Family Nurse Practitioner
• Aesthetic Nurse Practitioner
• Pediatric Nurse Practitioner
• Acute Care Nurse Practitioner
• Neonatal Nurse Practitioner
• Women's Health Nurse Practitioner
• Orthopedic Nurse Practitioner
• Emergency Nurse Practitioner
• Adult-Gerontology Nurse Practitioner
• Oncology Nurse Practitioner

Part Eleven  FAQs

How long does it take to become a psychiatric nurse practitioner.

• There are numerous steps to becoming a Psychiatric Mental Health NP. Typically, from the start of undergraduate education to the completion of an Advanced Practice NP degree, an individual can expect it to take a minimum of 10 years. Earning a BSN is roughly four years from start to finish. Gaining relevant bedside experience is essential prior to starting a nurse practitioner program. Most programs want a minimum of two years of experience. An NP program typically takes three years to complete. 

What can you do as a Psychiatric Nurse Practitioner?

• Psychiatric NPs assess and diagnose patients suffering from mental illnesses, disorders, and substance abuse problems. They are involved in psychotherapy, can prescribe medication, educate patients and families about their diagnosis, and manage their treatment plans. PMHNP can expect to treat patients suffering from the following conditions: anxiety, depression, bipolar disorder, substance abuse, PTSD, obsessive-compulsive disorder, eating disorders, and personality disorders. 

How much do Psychiatric Nurse Practitioners make?

• According to Indeed, the average Psychiatric Nurse Practitioner salary is $139,261 per year.

What is the difference between a Psychiatrist and a Psychiatric Nurse Practitioner?

• A psychiatrist is a physician who attended medical school and completed a fellowship in psychiatry. A Psychiatric Nurse Practitioner or PMHNP is an advanced practice nurse who has completed an advanced nursing program specializing in psychiatry. 

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Working as a Psychiatric-Mental Health Nurse Practitioner

September 26, 2020

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Psychiatric-mental health nurse practitioners (PMHNPs) work with individuals, families and communities to address mental health needs, including diagnosing patients and implementing plans of care. They focus on mental illness, substance abuse and mental health in vulnerable populations.

PMHNPs are advanced practice nurses who assess, diagnose and treat mental health needs. Working as a Psychiatric-Mental Health Nurse Practitioner means helping a largely underserved population and meeting the rising demand for quality mental health services nationwide.

“The psychiatric mental health nurse practitioner role serves every facet of health care because health cannot exist without mental health,” the American Association of Nurse Practitioners (AANP) said in “Are You Considering a Career as Psychiatric Mental Health Nurse Practitioner?”. “The title embraces its definition: PMHNPs serve the public by preventing, identifying and treating psychiatric conditions through holistic approaches in many ways. PMHNPs assure mental health from pre-conception through the lifespan to end-of-life care and grief.”

Indeed, psychiatric mental health nurse practitioners fill a widening gap in the healthcare system. Registered nurses (RNs) enrolled in Duquesne University’s Psychiatric-Mental Health Nurse Practitioner MSN program, including the online master’s in nursing program , can develop the skills necessary to help patients with mental disorders.

Why Become a Psychiatric Mental Health Nurse Practitioner?

Nationwide, the shortage of mental health providers has left many patients without much-needed care. According to the U.S. Department of Health & Human Services (HHS), more than 5,500 geographic areas, population groups and facilities (such as prisons and tribal clinics) have been designated mental health Health Professional Shortage Areas (HPSAs). As of June 2020, only 27% of mental-health needs are being met in the HPSAs.

The Mental Health America advocacy group found that only 28.2% of youth with severe mental health disorders were receiving consistent treatment and more than 10 million adults had unmet mental health needs.

In its State of Mental Health in America 2020, Mental Health America also noted that:

• Youth mental health is getting worse:  From 2012 to 2017, the prevalence of major depressive episodes among youth ages 12 to 17 increased from 8.66% to 13.01%.
• Adult prevalence of mental health problems remained relatively fixed, but suicidal ideations increased:  The frequency of mental illness among adults increased from 18.19% in 2012 to 18.57% in 2017. Suicidal ideations have increased from 3.77% to 4.19% in the same time period.
• Substance abuse disorders have decreased in both youth and adults:  Small but notable decreases have been seen in both youth and adults due to large-scale public health prevention campaigns.

Psychiatric Mental Health Nurse Practitioners Addressing Mental Health Needs

As nurse practitioners who are trained to specifically address mental health problems, PMHNPs help a wide range of patients. According to the American Psychiatric Nurses Association (APNA), PMHNPs play a pivotal role in healthcare in several ways:

• Screen, diagnose and provide care for mental-health and substance-abuse disorders
• Perform interventions to aid those in crisis
• Educate families, caregivers and the community
• Coordinate patient care with other providers
• Prescribe medications
• Perform psychotherapy

In many states, PMHNPs are able to practice independent of a physician’s oversight, akin to regular NPs.

Psychiatric Mental Health Nurse Practitioners Career Outlook

According to the AANP, PMHNPs work in a variety of settings but the most common is a psychiatric mental health facility. PMHNPs most commonly treat depression, anxiety, insomnia and dementia and see about 13 patients per day. On average, a full-time PMHNP earns about $131,500 per year.

The U.S. Bureau of Labor Statistics said the job outlook for NPs, in general, is very good. Overall, the employment of NPs is projected to grow by 26% from 2018 to 2028, which is much faster than average for all occupations.

Before beginning work as a PMHNP, RNs must complete advanced training in mental health and substance abuse. At Duquesne University, RNs study topics related to mental health and substance abuse diagnoses and treatment, policy development, healthcare reforms and quality improvements for patients.

Through Duquesne University’s online PMHNP-MSN program, students take coursework to learn about pharmacology, serious mental disorders, substance use disorders and healthcare ethics, among other topics.

About Duquesne University’s Online Master of Science in Nursing

Duquesne University’s online MSN programs prepare RNs to work as next-generation caregivers. The classes are presented online so nurses can continue their careers and personal lives while pursuing their educational goals. The university’s online PMHNP-MSN program prepares graduates to take the PMHNP certification exam.

The university also offers MSN degrees in other tracks:

• Family (Individual Across the Lifespan) Nurse Practitioner
• Executive Nurse Leadership & Health Care Management
• Nurse Education and Faculty Role

AANP, “Are You Considering a Career as a Psychiatric Mental Health Nurse Practitioner? “ HHS, “Designated Health Professional Shortage Areas Statistics” Mental Health America, “The State Of Mental Health In America” APNA, “Psychiatric-Mental Health Nurses” APNA, “Psychiatric-Mental Health Nurses Pivotal in Improving Patient Access To Care

Online Psychiatric-Mental Health Nurse Practitioner program admissions

Apply to the Yale School of Nursing online Psychiatric-Mental Health Nurse Practitioner (PMHNP) specialty of the Master of Science in Nursing (MSN) with confidence. Review the admissions criteria, application requirements, and how to connect with a dedicated enrollment advisor.

How to apply to the online Psychiatric-Mental Health Nurse Practitioner program 

Registered nurses who are passionate about supporting mental health care in their communities are encouraged to connect with an enrollment advisor ahead of submitting their application to the Yale School of Nursing online Psychiatric-Mental Health Nurse Practitioner program.

Program eligibility 

To be considered for the online Master of Science in Nursing Psychiatric-Mental Health Nurse Practitioner specialty, applicants must be a U.S. citizen or permanent resident, have earned a Bachelor’s degree with a minimum 3.0 GPA and possess an active RN license. Applicants with a cumulative undergraduate GPA below 3.0 must supply GRE scores at the fiftieth percentile or higher on all sections with their application. Students currently finishing nursing programs are welcome to apply, and if admitted, must obtain their RN license by the time of enrollment at YSN.

The online PMHNP program is currently not being offered to students residing in New York, Tennessee, or foreign countries. RN licenses must be from other accepted states.

Application materials

All YSN online PMHNP program applicants must complete and submit an online application and pay a nonrefundable application fee. A completed application must include the following elements: 

• Current resume/CV 
• Three letters of recommendation from those in a supervisory capacity in either an academic, professional, or clinical setting 
• Official transcripts for any postsecondary institutions attended, including institutions where transfer credits were received 
• World Education Services (WES) evaluations of any coursework taken outside of the United States or Canada
• English language proficiency exam results (TOEFL or IELTS) for all applicants whose native language is not English and who did not receive the equivalent of a US bachelor’s degree at an institution where English is the primary language of instruction
• Personal statement of 600 words and short-answer essays of 200 words that address prompts provided in the online application   

If required to submit a GRE result, please order the test result to be sent using YSN’s GRE code of 1115. The official test results must be received by the application deadline for your application to be considered complete.  

GRE results are not valid if older than five years and must be sent directly from ETS to YSN using code 1115. As it can take time for the results to be transmitted, please arrange to take the exam far enough in advance to ensure that the results are received at YSN by the application deadline.

TOEFL scores are valid for two years after the test date.

Do you have questions about your application to the Yale School of Nursing?

Schedule time with an enrollment advisor today., admissions frequently asked questions.

Applicants to the online Master of Science in Nursing, Psychiatric-Mental Health Nurse Practitioner program must have a Bachelor’s degree from an accredited institution, graduation from a school of nursing approved by the licensing board of the state in which it is located, and active Registered Nurse (RN) licensure. For a full list of application requirements and admissions criteria, visit our admissions page. The online PMHNP program is currently not being offered to students residing in New York, Tennessee, or foreign countries.

There is no set clinical experience requirement to apply to the online Master of Science in Nursing Psychiatric-Mental Health Nurse Practitioner specialty. However, the strongest applicants typically have a basic exposure to psychiatric settings and a demonstrated interest in caring for individuals with mental health needs.

No, applicants to the online Psychiatric-Mental Health Nurse Practitioner program do not need an existing master’s degree to be considered. Applicants must have a Bachelor’s degree and an active RN license to apply.

The application process for the online PMHNP involves submitting and completing your thorough program application, including, but not limited to, essays, letters of recommendation, and transcripts. All applications must be submitted by the cohort’s final deadline. At this point, the YSN admissions committee convenes to begin their initial application review.

From the time of admission, students typically have two weeks to accept their offer of admission. Although not guaranteed, extensions may be requested by admitted students who require more time to decide.

Applicants to the Psychiatric-Mental Health Nurse Practitioner program who are not admitted may reapply in the next available application cycle. Applicants may apply a maximum of three times to the same program.

The YSN Admissions committee requests three letters of recommendation from applicants. These recommendations must come from individuals who supervised your work in either an academic, professional, or clinical setting. Examples may include a professor or academic advisor from your nursing program, current nursing supervisor, or clinical manager. Reach out to your enrollment advisor with questions.

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• Nursing Practice: Psychiatric Mental Health Nurse Practitioner, DNP

This is a named option with the Nursing Practice, DNP .

Hybrid course delivery

Nurse Practitioner

ANCC Psychiatric-Mental Health NP

Please consult the table below for key information about this degree program’s admissions requirements. The program may have more detailed admissions requirements, which can be found below the table or on the program’s website.

Graduate admissions is a two-step process between academic programs and the Graduate School. Applicants must meet the minimum requirements of the Graduate School as well as the program(s). Once you have researched the graduate program(s) you are interested in, apply online .

Admission requirements for the DNP program (post-baccalaureate) are:

• Graduation from an accredited baccalaureate program in nursing
• GPA of 3.0 on the last 60 credits for the baccalaureate degree
• One year of professional nursing experience
• Grade of B or better in a approved statistics course within the last 5 years. (Note: The course does not need to be taken before applying, but must be successfully completed prior to the start of the fall term.)
• Application essay (see School of Nursing website for specific criteria)
• Three letters of recommendation
• Curriculum vitae or resume
• English proficiency scores: Applicants whose native language is not English, or whose undergraduate instruction was not in English, must provide an English proficiency test score. Scores are accepted if they are within two years of the start of the admission term. See the Graduate School's Admission Requirements for more information on the English proficiency requirement.

Post-BS applicants have a bachelor’s degree in nursing. Applicants who have a non-APN master’s degree (i.e., nurse education) are considered post-B.S. applicants and are able to waive up to 18 credits based on previous graduate coursework, pending review of syllabi.

Admission requirements for the DNP program (post-master's) are:

• Master’s degree in a specialty track from an accredited nursing program
• GPA of 3.5 for the master’s degree
• Certification as an advanced practice nurse
• Grade of B or better in a graduate level statistics course within the last 5 years. (Note: The course does not need to be taken before applying, but must be successfully completed prior to the start of the fall term.)
• Application essay (see  School of Nursing website  for specific criteria)
• English proficiency scores: Applicants whose native language is not English, or whose undergraduate instruction was not in English, must provide an English proficiency test score. Scores are accepted if they are within two years of the start of the admission term. See the Graduate School's  Admission Requirements  for more information on the English proficiency requirement.

Additional admission requirements for international applicants are:

• CGFNS Certification
• TOEFL (600 PBT, 100 iBT)

All application materials must be received by December 1 for admission in the fall semester.

Graduate School Resources

Resources to help you afford graduate study might include assistantships, fellowships, traineeships, and financial aid.  Further funding information is available from the Graduate School. Be sure to check with your program for individual policies and restrictions related to funding.

Program Resources

Several forms of financial aid are available for graduate students in the School of Nursing. These include fellowships, scholarships, project and teaching assistantships, and loans. Most graduate assistantships cover the cost of tuition and provide a monthly stipend. Awards are made in the spring for the following academic year.

Graduate Research Scholars (GRS) fellowships are designed to support highly qualified underrepresented students in the doctoral programs. Doctoral students who are preparing to be full-time faculty in nursing programs are also eligible for the Nurse Faculty Loan Program (NFLP). These loans, supported by the federal government, are available to cover tuition and other educational expenses. When graduates become full-time faculty members, up to 85 percent of the NFLP loan will be canceled over a four-year period.

Additional information on financial aid including application procedures is available in the School of Nursing Academic Affairs Office.

Minimum Graduate School Requirements

Named option requirements.

Review the Graduate School minimum academic progress and degree requirements , in addition to the program requirements listed below.

MODE OF INSTRUCTION

Mode of instruction definitions.

Accelerated: Accelerated programs are offered at a fast pace that condenses the time to completion. Students typically take enough credits aimed at completing the program in a year or two.

Evening/Weekend: ​Courses meet on the UW–Madison campus only in evenings and/or on weekends to accommodate typical business schedules.  Students have the advantages of face-to-face courses with the flexibility to keep work and other life commitments.

Face-to-Face: Courses typically meet during weekdays on the UW-Madison Campus.

Hybrid: These programs combine face-to-face and online learning formats.  Contact the program for more specific information.

Online: These programs are offered 100% online.  Some programs may require an on-campus orientation or residency experience, but the courses will be facilitated in an online format.

CURRICULAR REQUIREMENTS

Required courses, post-baccalaureate option.

6 total credits required; 10 credit maximum. Taken for 2 credits per term (other credit amounts allowed only via faculty approval). 

Students in the Psychiatric Mental Health Nurse Practitioner named option must take these courses with a section number of 060.

Post-Baccalaureate Three-Year Program Plan

 See Pre-approved elective options. Additional options may be approved by program director.

 Psych/Mental Health NP students must take NURSING 590 Contemporary Practices in Nursing Pediatric Assessment for Mental Health APNs (1cr) the summer prior to NURSING 726 Foundations for APN Clinical Practice I / NURSING 728 Advanced Practice Clinical Application and Role Development I .

Post-Baccalaureate Four-Year Program Plan

Psych/Mental Health NP students must take NURSING 590 Contemporary Practices in Nursing (1cr) the summer prior to NURSING 726 Foundations for APN Clinical Practice I / NURSING 728 Advanced Practice Clinical Application and Role Development I .

Post-Master's Option

Post-master's program plan.

See Pre-approved elective options. Additional options may be approved by program director.

Pre-approved elective options

Graduate school policies.

The  Graduate School’s Academic Policies and Procedures  provide essential information regarding general university policies. Program authority to set degree policies beyond the minimum required by the Graduate School lies with the degree program faculty. Policies set by the academic degree program can be found below.

Named Option-Specific Policies

Prior coursework, graduate work from other institutions.

Post–B.S.: With program approval, students are allowed to count up to 18 credits of graduate coursework from other institutions. Graduate work should be less than five years old to be considered; additional justification and/or documentation are needed for work taken between five and tens years. Work more than ten years old will not be considered.

Post–M.S.: With program approval, students are allowed to count up to 19 credits of graduate coursework from other institutions. Graduate work should be less than five years old to be considered; additional justification and/or documentation are needed for work taken between five and tens years. Work more than ten years old will not be considered unless students are board certified advanced practice nurses (APN) and have continuous practice as an APN.

UW–Madison Undergraduate

No undergraduate coursework will be allowed to count toward DNP requirements.

UW–Madison University Special

With program approval, students are allowed to count no more than 9 credits of coursework numbered 300 or above taken as a UW–Madison University Special student. These credits are considered part of the total allowable credits available for a student to transfer. coursework should be less than five years old to be considered; additional justification and/or documentation is needed for work taken between five and ten years. Work more than ten years old will not be considered.

A semester GPA below 3.0 will result in the student being placed on academic probation. If a student has not returned to satisfactory progress by the determined deadline, a decision about whether the student will be permitted to continue will be made by the graduate programs committee (or appropriate subcommittee) with input from the student’s advisor.

ADVISOR / COMMITTEE

Progression is reviewed each semester by academic affairs office staff and advisors.

CREDITS PER TERM ALLOWED

Time constraints.

Post–B.S.: Students must complete the requirements within six years of admission. Upon the advisor’s recommendation, the associate dean for academic programs may grant a one-year extension.

Post–M.S.: Students must complete the requirements within four years of admission to the program. Upon the advisor’s recommendation, the associate dean for academic programs may grant a one-year extension.

grievances and appeals

These resources may be helpful in addressing your concerns:

• Bias or Hate Reporting  
• Graduate Assistantship Policies and Procedures
• Office of the Provost for Faculty and Staff Affairs
• Dean of Students Office (for all students to seek grievance assistance and support)
• Employee Assistance (for personal counseling and workplace consultation around communication and conflict involving graduate assistants and other employees, post-doctoral students, faculty and staff)
• Employee Disability Resource Office (for qualified employees or applicants with disabilities to have equal employment opportunities)
• Graduate School (for informal advice at any level of review and for official appeals of program/departmental or school/college grievance decisions)
• Office of Compliance (for class harassment and discrimination, including sexual harassment and sexual violence)
• Office of Student Conduct and Community Standards (for conflicts involving students)
• Ombuds Office for Faculty and Staff (for employed graduate students and post-docs, as well as faculty and staff)
• Title IX (for concerns about discrimination)

Student Appeals and Grievance Procedures

Students who feel that they have been treated unfairly have the right to question this treatment and receive prompt hearing of the grievance. Before instituting an appeal or grievance, students should discuss their particular situations with an appropriate staff member, e.g., faculty member, assistant dean, associate dean, or adviser.

Section One: Appeals

Appeals are limited to requests to continue in the curriculum after being dropped from the program for academic reasons.

Procedure Filing Appeal

Graduate Student: A written appeal must be filed with the Assistant Dean for Academic Affairs within 10 working days of the date of the letter notifying the student of the decision to discontinue the student in the program, or the right to appeal is waived. The appellant (student) must submit to the Assistant Dean the following information:

• Precise grounds on which the appeal is based.
• Circumstances associated with the need to appeal.
• Arguments supporting the appeal.
• Description of proposed remedial actions to be taken to improve the student's academic performance.
• The appellant may also submit letters of support from persons knowledgeable about the appellant's current and/or past academic work and/or other matters related to the appellant's academic performance. Any such letters must be submitted to the Assistant Dean by the same deadline.

Appeals Committee

Graduate Student: For the purposes of hearing the appeal, the Assistant Dean will arrange an appeals committee that consists of at least three School of Nursing faculty members and that includes at least one member of the Graduate Programs Committee. The Assistant Dean will collect the information relative to the appellant's academic situation and forward the information to the Appeals Committee.

Appeals Committee Meeting

• Within 15 working days of the filing of the appeal, the Appeals Committee will schedule a meeting date for the purposes of hearing the appeal.
• Appellant must appear before the Appeals Committee to present the appeal. Appellant may have a support person accompany him or her to the meeting with the Appeals Committee. Appellant must address the Appeals Committee under all circumstances. Appellant's chosen support person is limited to providing advice and support to appellant. No fewer than three working days prior to the meeting with the Appeals Committee, the appellant shall identify to the Committee the individual’s appellant wishes to be present at the meeting for the purpose of providing the Appeals Committee with information about the appeal.

The Appeals Committee is authorized to decide the appeal and is responsible for the following:

• Reviewing all data presented by the Appellant and others.
• Discussing the argument presented by Appellant and inviting Appellant to contribute to the discussion.
• Action taken by the Appeals Committee
• Rationale for decision
• Names of individuals present at the hearing
• Notice of appellant's right to appeal the Appeals Committee decision to the Associate Dean for Academic Affairs.

4. If the appeal is granted, the Appeals Committee will discuss with the Appellant any stipulations (binding) and recommendations (non-binding) for continuation in the program.

Review of Appeals Committee Decision

• A written request for review of the Appeals Committee Decision by the Dean of the School of Nursing or the Dean's designee must be submitted to the Associate Dean for Academic Affairs within 20 working days of the date of notification of the Committee's initial decision. The request must state the specific grounds for appeal which are limited to:
• School policies were incorrectly applied;
• Decision is contrary to state or federal law;
• Proper appeal procedures were not followed; or
• Unfounded, arbitrary, or irrelevant assumptions of fact regarding the appellant's performance were made by the Appeals Committee. Appellant must also identify the specific aspects of the Committee decision that he or she believes meet the criteria cited as a basis for appeal.

The Dean of the Dean's designee may meet with the appellant to discuss the request for review.

a. Copies of the information submitted to the Appeals Committee and the Appeals Committee decision shall be provided to the Dean or the Dean's designee for review. Only facts and information presented to the Appeals Committee may be introduced to and considered by the Dean or the Dean's designee.

b. The burden of proof shall be on the student to demonstrate by a preponderance of the evidence that the Appeals Committee's decision was the result of one or more of the above bases for appeal.

c. The Dean or the Dean's designee shall notify Appellant and the Appeals Committee in writing within 30 working days of receipt of the request for review of the Appeals Committee decision or the appellant's meeting with the Dean's or Dean's designee, whichever is later, stating the action on the appeal and the grounds for the action taken.

d. The decision by the Dean or the Dean's designee on review is final.

e. Graduate students may seek Graduate School Procedural Review of the decision by the Dean or the Dean's designee. Please contact The Graduate School Office of Academic Services & Fellowship Administration in 217 Bascom Hall or at 608-262-2433 for information regarding this process.

Note: Deadlines referenced herein may only be altered by mutual agreement of the parties. Any such agreement must be in writing.

Section Two: Grievances

Informal Resolution

Any student in the School of Nursing who believes that he or she has been treated inequitably is encouraged to resolve the matter informally. The student should first talk with the person or group at whom the grievance is directed in an attempt to resolve the issue informally. The student may contact the Associate Dean for Academic Affairs for assistance in resolving the matter informally. The student may also contact the following groups for assistance in reaching an informal resolution and/or information regarding other possible formal procedures to resolve the matter.

• Contact the UW-Madison Equity and Diversity Resource Center for information and assistance regarding discrimination or disability issues.
• Contact the Dean of Students for information about resources for addressing student concerns.

School of Nursing Grievance Procedure:

The grievance procedure is available to resolve student concerns regarding inequitable treatment that have not been satisfactorily resolved through the informal resolution process or where the student believes that informal resolution would not be productive. The grievance procedure is described below. Through the grievance process, the student may be accompanied by a support person. The use of this grievance procedure shall not prevent the student from seeking redress through another administrative or legal process.

• To initiate the formal grievance procedure, the student must submit his or her grievance, in writing, to the Associate Dean for Academic Affairs.
• The written grievance shall include:
• a statement that the student wishes a review of the situation by a Grievance Committee;
• the identification of the person or group at whom the grievance is directed;
• the specifics of the perceived inequitable treatment;
• evidence in support of the student's belief that he or she has been treated inequitably; and
• the outcome or resolution desired by the student.

3. A grievance must be initiated no later than 20 calendar days from the time the student knew or could reasonably have been expected to have known of the circumstances giving rise to the grievance. Initiation of the informal procedure described above within the 20- day period will extend the deadline for initiating the grievance to 40 calendar days from the time the student knew or could reasonably have been expected to have known of the circumstances giving rise to the grievance.

4. Within 30 calendar days after receiving the grievance, the Associate Dean for Academic Affairs shall arrange for a committee meeting. The Committee may request a written response from the person or group at whom the grievance is directed, may ask for additional information from any or all parties involved, may request that the parties involved appear before the Committee, and/or may take other steps in attempting to resolve the grievance.

5. Within 60 calendar days after receiving the grievance from the Associate Dean for Academic Affairs, the Committee shall send a written report of the Committee's recommendations to the Associate Dean for Academic Affairs. The student will also receive a copy of the report. The report shall include notice to the student of his or her right to appeal the Committee's recommendation to the Dean of the School of Nursing.

6. A student wishing to appeal the Committee's recommendation to the Dean of the School of Nursing must submit a written appeal to the Dean within 10 calendar days of the date of the Committee's report. The request must state the specific bases for appeal and identify the specific aspects of the Committee's recommendation that he or she believes are the subject of the bases for appeal. Where an appeal is filed with the Dean, a copy of the Committee's report shall be provided to the Dean for review. Only facts presented to the Committee may be introduced to and considered by the Dean. The Dean shall notify the appellant and the Committee in writing within 30 calendar days of receiving the written appeal stating the action on the appeal and the grounds for the action taken.

Section Three: Course Grade Appeals Process

If a student believes s/he has been awarded a grade for a course that does not adequately represent her/his performance in the course, they should speak with the course faculty member in an effort to attempt to resolve the issue informally. This must be done within 10 working days of receipt of the grade. During this informal process both student and faculty may consult with the Associate Dean for Academic Affairs to seek resolution of the issue.

If the student remains dissatisfied with the grade, the student has the option to initiate the formal Grievance procedure. To do this, the student must submit the grievance, in writing, to the Associate Dean for Academic Affairs within 10 working days. The Associate Dean will appoint a committee to hear the grievance. The decision of the committee is final. There is no further appeal.

Several forms of financial aid are available for graduate students: traineeships, fellowships, scholarships, research and teaching assistantships, and loans.

Take advantage of the Graduate School's  professional development resources to build skills, thrive academically, and launch your career. 

Career advising, funding, and professional development opportunities are shared with all students by a member of the School of Nursing Academic Affairs staff. Information on these support services can be found on the Student Site .

School of Nursing Faculty Directory

Administration

Linda d. scott, phd, rn, nea-bc, faan.

Dean and Professor [email protected]

Barbara Pinkenstein, DNP, RN-BC, FAAN

Interim Associate Dean for Academic Affairs, Professor [email protected]

Katie Bleier

Assistant Dean for Academic Affairs (Academic Dean) [email protected] 608-263-5172

Pamela McGranahan, DNP, PHNA-BC, PMHNP-BC

DNP Program Director, Clinical Associate Professor [email protected] 608-263-5337

Kristine Kwekkeboom, PhD, RN, FAAN

PhD Program Director, Professor [email protected] 608-263-5168

Advising and Student Services

Darby sugar.

Director of Advising & Student Services [email protected] 608-263-5172

Mariah Allen

Graduate Academic Services Coordinator [email protected] 608-263-5258

Admissions and Recruitment

Director of Admissions & Recruitment [email protected] 608-263-5261

Graduate Admissions & Recruitment Coordinator [email protected] 608-263-5183

• Requirements
• Professional Development

Contact Information

Nursing School of Nursing nursing.wisc.edu

Contact Us Sign up here to receive more information

Mariah Allen, Graduate Academic Services Coordinator [email protected]

Pamela McGranahan, DNP Program Director [email protected] 4131 Signe Skott Cooper Hall 701 Highland Avenue, Madison, WI 53705

Graduate Admissions [email protected]

Graduate Program Handbook View Here

Graduate School grad.wisc.edu

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Empowering Psych Nurse Practitioners Like Me to Strengthen Patient Relationships to Optimize Outcomes

As a psychiatric mental health nurse practitioner (PMHNP), I’m challenged to continually learn—evolving my approach to nursing care and growing my knowledge base to ensure I am meeting the needs of those I am treating. I often think of someone who was ahead of her time, Hildegard Peplau, as she prioritized the patient and revolutionized what it means to be a nurse practitioner (NP). Peplau is often thought of as the “mother of psychiatric nursing” as she was a true pioneer in the development of the theory and practice of psychiatric and mental health nursing. Peplau introduced the “nurse-patient relationship” in her Theory of Interpersonal Relations , which she developed in 1952, a time when patients did not actively participate in their own care. 1 Peplau proposed that the therapeutic relationship established between the nurse and the patient forms the basis of nursing care, a concept now weaved into virtually all nursing specialties, which can be broken down into 3 phases: orientation, working, and resolution. 1

Communication is a key component of the nurse-patient relationship. As a PMNHP, I see the vital role each member of the treatment team plays. For nurse practitioners (NPs), our greatest power is prioritizing the patient and fostering strong relationships, rooted in caring, to champion for their management and care to ensure it’s the best possible treatment plan for them, based on their goals and aspirations. However, in my experience, it is especially critical in the relationships we have with our adult patients who have a diagnosis of schizophrenia. In my opinion, adults living with schizophrenia require individualized treatment plans to meet their unique symptom needs and individual priorities. While clinicians are experts of the illness, our adult patients are experts of themselves, and the contributions that they bring to the decision-making process should be recognized and considered. To construct a strong therapeutic alliance, open conversations, trust, and respect play fundamental roles, with the ultimate goal being to establish a partnership to optimize patient outcomes. 2

Orientation Phase

During the orientation phase of the nurse-patient relationship, the psychiatric nurse begins to gain essential information, establish rapport, and develop trust, while also helping the patient living with schizophrenia to recognize and understand their diagnosis. 1 Here we define the purpose, roles, and framework for assessing a patient’s needs. 1

When working with adults living with schizophrenia, establishing the right treatment plan, including medication, is very important. Adults living with schizophrenia tend to have the lowest rates of adherence to medication compared to other major psychiatric illnesses. 3 Research has consistently found a link between poor adherence and relapse. 4,5 Fortunately, other studies have demonstrated significantly increased adherence in patients who receive their medication by way of a long-acting injectable (LAI) antipsychotic and less-frequent relapses than in patients receiving oral medications. 6, 7, 8, 9

Given the pervasive problem of nonadherence or partial adherence, it is imperative, in my view, to establish early on and maintain open communication around an adult’s faithfulness to their treatment regimen. 10 In the orientation phase, I assess levels of adherence and insight to determine an adult’s understanding of their condition, the importance of medication, and how often they have forgotten medications or how often they can take medications regularly without being prompted. I also find it’s necessary to consider values, beliefs, culture, past experiences, expectations, and preconceived ideas to understand where the patient comes from and what informs their knowledge base and views.

The answers tend to give me a solid baseline understanding of the patient’s insight, helping me provide relevant and appropriate care based on the individual’s beliefs, views, and aspects of identity. Not knowing what the medication is for or describing only taking it when they are symptomatic is a strong indicator of limited insight.

Working Phase

The working phase is the problem-solving phase, when nurses and adults with lived experience take the problems and issues that are identified and put the plans created to address these into action. 1 During the working phase, the patient attempts to cope with their diagnosis, and is encouraged to participate in care to promote personal acceptance and satisfaction, while also setting goals for the future. 1 This is a time when the adult living with schizophrenia begins to feel capable and empowered to acknowledge and address their symptoms, thereby decreasing their feelings of helplessness and hopelessness. 1

Motivational interviewing and shared decision making are modalities that promote effective communication, collaboration, choice, and empowerment. 2 I find my patients are less hesitant and more agreeable to considering an LAI during the working phase, when we are working together to implement the plans we’ve established, including therapeutic goals. I have also found adults are open to considering an LAI when it is offered in the company of a family member or trusted team member, as it can be helpful for them to have a secondary (and perhaps more trusted opinion) to take into consideration.

Treatment conversations should occur throughout the management and care journey. The use of motivational interviewing and shared decision making can be effective in evoking and increasing the patient’s motivation over time, especially as the therapeutic relationship strengthens and we learn more about the patient’s unique motivating factors. 2 These factors can be rooted in the importance of adherence and can showcase to patients the possibilities that may be open to them with their symptoms managed, including improved relationships with family members, opportunities to have more freedom, and ownership over the things that are important to them.

These techniques can be effective when suggesting treatment evolutions, like LAIs.

Resolution Phase

During the resolution phase, the patient reviews what has been learned and plans for the future, adopting new goals. 1

Peplau defined health as “a word symbol that implies forward movement of personality and other ongoing human processes in the direction of creative, constructive, productive, personal and community living.” 11 Within this phase, we can plan for the future, revisiting the goals and aspirations a patient had established, like going back to school, starting a job, volunteering, or maintaining relationships with friends and family, because of the symptom stability they’ve achieved. 11

Education on the importance of medication adherence is a key part of planning for the lifelong trajectory of schizophrenia. LAIs can be a compelling intervention as they provide greater assurance that patients will receive their medication continuously, since LAIs are professionally administered. With symptoms under control, the adult patient is able to focus on new goals that previously seemed like longshots due to unmanaged symptoms and subsequent relapses.

For additional PMHNP perspectives on the management and care of schizophrenia, visit PEERspectives on TalkingLAIs.com.

This article reflects my own experience and opinions and was developed in joint collaboration by Janssen Pharmaceuticals, Inc., and myself. I have been paid an honorarium for my time.

1 Peplau HE. Interpersonal relations: a theoretical framework for application in nursing practice. Nurs Sci Q . 1992;5:13-8.

2 Mucci A, Kawohl W, Maria C et al. Treating schizophrenia: open conversations and stronger relationships through psychoeducation and shared decision-making. Front Psychiatry . 2020;11:761. doi:10.3389/fpsyt.2020.00761

3 Semahegn A, Torpey K, Manu A, et al. Psychotropic medication non-adherence and its associated factors among patients with major psychiatric disorders: a systematic review and meta-analysis. Syst Rev . 2020;9:17. doi.10.1186/s13643-020-1274-3

4 National Council for Mental Wellbeing. Guide to Long-acting Medications. National Council for Mental Wellbeing website. Accessed September 28, 2022. Available at: https://www.thenationalcouncil.org/topics/long-acting-medications/

5 Morken G, Widen JH, Grawe RW. Non-adherence to antipsychotic medication, relapse and rehospitalisation in recent-onset schizophrenia. BMC Psychiatry . 2008;8:32. doi:10.1186/1471-244X-8-32

6 Greene M, Yan T, Chang E et al. Medication adherence and discontinuation of long-acting injectable versus oral antipshoticis in patients with schizophrenia or bipolar disorder. J Med Econ . 2018;21(2):127-134. doi:10.1080/13696998.2017.1379412

7 Marcus S, Zummo J, Pettit A et al. Antipsychotic adherence and rehospitalization in schizophrenia patients receiving oral versus long-acting injectable antipsychotics following hospital discharge. J Manag Care Spec Pharm . 2015 Sep;21(9):754-68. doi:10.18553/jmcp.2015.21.9.754

8 Offord S, Wong B, Mirski D, et al. Healthcare resource usage of schizophrenia patients initiating long-acting injectable antipsychotics vs oral. J Med Econ . 2013;16(2):231-239. doi:10.3111/13696998.2012.751025

9 Joshi K, Muser E, Xu Y, et al. Adherence and economic impact of paliperidone palmitate versus oral atypical antipsychotics in a Medicare population. J Comp Eff Res. 2018;7(8):723-735. doi:10.2217/cer-2018-0003

10 Bright CE. Measuring medication adherence in patients with schizophrenia: an integrative review. Arch Psychiatr Nurs. 2017;31:99-110.

11 Martin P. Peplau’s interpersonal model: clinical applications. In: Reynolds W, ed. Psychiatric and Mental Health Nursing. Boston, MA: Springer Science+Business Media Dordrecht; 1990:261-278.

1 Comment . Leave new

Thanks for taking us back to the basics! It’s the reason I love Psychiatric Mental Health Nursing! It’s what we learned in our Nursing Education!

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Psychiatric Mental Health Nurse Practitioner

Admits only in the fall

The Psychiatric Mental Health Nurse Practitioner (PMHNP) program provides educational content and clinical experiences that focus on complex psychiatric nursing assessments and interventions for acute and chronic mental health conditions in children, adolescents, adults, and older adults. The curriculum has an emphasis on holistic care, integrated mental health, cultural sensitivity, and substance treatment. Coursework includes psychotherapy, neurobiology, and psychopharmacology content for patients across the lifespan. The PMHNP faculty are experts in the field with a broad range of clinical and research expertise. There is a high demand for PMHNPs in Colorado and across the country. The PMHNP program prepares graduates to provide a full range of psychiatric services and work in a variety of practice settings.

PMHNP Program Highlights

• Online and blended coursework with on-campus intensives
• Cohort model encourages student connections and community building
• Clinical placements are provided for students who live in the Denver metro area
• PMHNP faculty are highly experienced with a broad range of practice specialties, successful research agendas, and mental health policy influence
• Numerous Substance Abuse and Mental Health Services Administration (SAMHSA) Minority Fellows
• Outstanding record of first-time pass rates on the PMHNP ANCC national certification exam
• Graduates are in high demand and find employment quickly

Graduates of this specialty track are eligible to apply for national certification by examination. You will learn more about the certification organizations appropriate for this specialty during the completion of your program. Upon successful completion of the certification examination, Psychiatric Mental Health Nurse Practitioners are eligible for licensure in all 50 states, including Colorado (visit the Colorado Board of Nursing APRN application forms page), where licensure is granted as an Advanced Practice Registered Nurse (APRN) and is required for practice.

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Psychiatric Mental Health Nurse Practitioner Current Plans of Study

• MS: Plan of Study (PDF)
• BS to DNP: Plan of Study (PDF)
• Post-Graduate Certificate: Plan of Study (PDF)
• Master's requirements
• BS to DNP requirements
• Post-Graduate Certificate requirements

A post-graduate certificate is available in this specialty.

Gainful Employment and Program Statistics for Post-Graduate Certificate

For more information regarding graduation rates, the median debt of students completing our certificate programs, and other important information, please visit the University of Colorado Denver Office of Institutional Research and Effectiveness .

American Psychiatric Nurses Association 12/2022: Psychiatric-Mental Health Nurses Are Key to Addressing the Nation’s Mental Health Crisis

American Association of Nurse Practitioners 12/2019: Are You Considering a Career as Psychiatric Mental Health Nurse Practitioner?

How long will it take to complete the PMHNP program?

• PMHNP MSN program is 52 credits and is typically completed in 7 semesters (2.5 years)
• PMHNP DNP program is 64 credits and is typically completed in 10 semesters (4.5 years)
• PMHNP post-graduate certificate is 29 credits and is typically completed in 4 semesters (1.5 years).

Does this program have a clinical requirement?

Yes. The PMHNP requires 14 credits of clinical experience which equals 630 contact hours.

Is the PMHNP program offered completely on-line or in-class?

Will i be required to travel to colorado, will this program prepare me to sit for the ancc certification as a psychiatric mental health nurse practitioner, can i take a course before i apply, are there any expectations outside of the classroom.

The PMHNP program is rigorous, challenging, and very rewarding. During the clinical courses, it is strongly recommended that students do not work or work as little as possible.

The National Organization of Nurse Practitioner Faculty (NONPF) has published core competencies in each specialty for students to achieve. Students may need to increase their clinical credits if they do not achieve these competencies within the required clinical credits.

All students are required to have a current and unencumbered RN license, current immunizations, and basic life support.

Embracing a Caregiver Role

CU Nursing student Stuart Eynon is focused on getting to know his patients.

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What Does a Psychiatric Nurse Do?

Psychiatric nurses work in the mental health nursing field to care for and support patients with mental illnesses. Discover what it takes to become a psychiatric nurse in this guide.

A psychiatric nurse provides care and supports the physical and mental health of individuals, groups, families, and communities with and affected by mental health conditions. Sometimes referred to as psychiatric mental health nurses or psych nurses, these professionals receive specialised training that helps prepare them to take on additional responsibilities to care for people with psychological and behavioural problems. 

As a psychiatric nurse, your tasks will depend on where you work, your training, and your patients' needs. Typical duties include observing patients, administering medications, and helping with self-care and general physical health. It can be a varied and rewarding career requiring neurobiological, psychosocial, and nursing expertise.

To ensure it’s a good fit for you, it helps to understand what employers might expect from you as a psychiatric nurse and where it might take you as a career option.

Where do psychiatric nurses work, and what do they do?

As a psychiatric nurse, you might work in many different settings, evaluating and supporting your patients’ mental health needs and working with doctors to execute care plans. As a mental health nurse, you won't treat mental health conditions alone. You'll work with a team of health professionals, including psychiatrists, psychotherapists, and social workers, to create, implement, and monitor treatment and care plans.

A few of the everyday things you might do in this role include:

Conducting intake screening and evaluation

Working with interdisciplinary teams

Educating patients and their families

Providing community education

Practising crisis intervention

Providing case management

Promoting general/overall health 

Administering and monitoring treatment regimes

Teaching self-care and helping patients achieve individual goals

As a psychiatric nurse, you can expect to promote mental health in various ways. You might work with children exposed to trauma, soldiers coming home from combat, supporting adults and teenagers with mental illness, and more.

Your day-to-day duties will depend largely on where you choose to work. Psych nurses may work in any mental health service setting, including federal agencies, schools, rehabilitation centres, hospitals, and clinics. You might work in one or more of three typical settings, including hospitals, correctional facilities, and assisted living facilities.

Mental health disorders affect approximately 7.5 percent of the population in India, with 20 percent of the population suffering from some form of mental disorder [ 1 ]. The World Health Organisation estimates that the economic cost of mental health conditions in India surpasses 1 trillion USD, with an age-adjusted suicide rate of 21.1 per 100,000 people [ 2 ]. While the severity ranges from mild to severe, and many people with mental illness won’t require inpatient care, hospitalisation is an available treatment option.

You'll likely work closely with other care team members if you work as a psychiatric nurse in an inpatient treatment centre or hospital. You’ll closely monitor patients, ensuring they receive an accurate diagnosis and subsequently adjust or stabilise their medications. Other everyday tasks include performing safety and risk assessments, managing meds, and assisting with patients' grooming and bathing.

Correctional facilities

A December 2021 report from the National Crime Records Bureau revealed a 22 percent increase in mentally ill inmates, with up to 9,180 jailed individuals who have mental illness [ 3 ]. These statistics underscore the need for psychiatric nurses in jail and prison settings. Should you pursue a role in a correctional facility, you may work as part of an inpatient psychiatric unit within the facility or as an outpatient psych nurse providing evaluations, interventions, and counselling to inmates who reside in the general population.

Assisted living facilities

Patients in long-term care facilities typically have serious health problems and may be dealing with forms of dementia, which is commonly associated with forms of depression and anxiety. As a psych nurse in a nursing home or assisted living facility, you will likely consult with health professionals and psychiatrists to manage patients' mental and physical health, create and monitor treatment plans, and manage medications.

What does it take to be successful as a psychiatric nurse?

To be successful as a psych nurse, you’ll need a combination of education and experience to develop essential skills and the passion and drive to work in a potentially stressful environment. In addition to having a solid foundation in general nursing and holding an active licence as a registered nurse, it’s also helpful to cultivate skills such as: 

Critical thinking: Every patient has unique psychological needs. As a psych nurse, you'll need to approach each patient personally based on assessments and psychiatric nursing techniques.

Compassion and empathy: As a psych nurse, you must never forget you're treating a person's mind in addition to their emotions and personality. You'll need to be able to listen, try to understand patients' points of view, and use interpersonal skills to build rapport with patients and their families.

Interest in mental health nursing: To succeed in this role, you must be passionate about and interested in what you're doing. Psychiatric nursing isn't just a job you choose for the paycheck. It would be best if you had a passion for helping others with their mental health struggles, a drive to understand and continue learning about the brain and mental illnesses, and the desire to help impact change in mental health care.

Reliability and consistency: Your patients and coworkers will rely on you to provide a steady quality of care and maintain constant professionalism.

Advancing your career as a psychiatric nurse

Several options are available if you want to expand the scope of your mental health nursing career. One way is to specialise. You may choose an area of focus such as child and adolescent mental health, acute care, military mental health, substance use disorders, or psychiatric care for the elderly. You might also move into an advanced nurse practitioner position, which requires advanced education and registering with the Indian Nursing Council. It involves tasks like consulting or working as a liaison, providing consultations and mental health services to patients and families, and collaborating with integrated health care providers. 

Psychiatric nurse vs psychiatric nurse practitioner

As a psychiatric nurse, you'll be essential in caring for patients with mental and behavioural health needs. You'll work with psychiatrists, social workers, and psychiatric nurse practitioners who oversee cases, determine diagnoses, and order treatments. The level of care you provide differs when you choose to advance your career and become a psych nurse practitioner. As a psych nurse practitioner, you can:

Write prescriptions

Perform advanced assessments

Design and order treatment and care plans

Diagnose conditions

Provide psychotherapy or counselling

Pros and cons

Nursing, in general, is a challenging field. It requires long hours, and there's a level of stress that comes with taking care of other people. Working as a psychiatric nurse has its unique challenges. It also has its rewards. A few of the pros and cons of working as a psychiatric nurse include:

Pro: Higher pay and increased job satisfaction

Con: Increased need for patience, attentiveness, and endurance

Pro: Potential for job growth and security

Con: You may work in volatile, higher-risk settings

Pro: You can work in a variety of settings  

Career outlook for psychiatric nurses

A recent report from the World Health Organisation discovered that a global shortage of mental health nurses is costing millions of people adequate care. Experts warn that India’s next health crisis may come in the form of a severe nursing shortage [ 4 ], which suggests nurses of all types will continue experiencing demand. Given that nurses comprise approximately 44 percent of worldwide mental health workers, you can expect ongoing demand for psychiatric nurses in India and worldwide [ 5 ].

There’s a strong demand for psych nurses. There’s also a strong earning potential, which may be impacted by where you work and if you choose to specialise. Across India, psychiatric nurses make an average monthly salary of ₹5,08,752, according to Glassdoor in India [ 6 ]. 

Steps to becoming a psychiatric nurse

To be a psychiatric nurse, you must first get your registered nurse (RN) licence. To become an RN, you need to graduate with at least a diploma in auxiliary nursing and midwifery, but more commonly, a diploma in general nursing, a bachelor's degree, or a master's degree in nursing. Register with the Indian Nursing Council or the State Nursing Councils.

Education: 2, 3, and 4-year program options

Your education is an excellent starting point for becoming a psychiatric nurse. To qualify to register with the Indian Nursing Council,  you must graduate from a nursing program. Some of the most common options include:

Completing a two-year diploma in auxiliary nursing and midwifery

Completing a 3.5-year diploma in general nursing and midwifery 

Completing a four-year Bachelor of Science in Nursing degree program

Completing a two-year post-basic Bachelor of Science in Nursing program

Completing a one- or two-year master’s program in nursing

Completing a three- to five-year PhD in Nursing program

Completing a one-year post-basic diploma in psychiatric nursing

Clinical experience and continuing education

Many programs in mental health nursing require a set number of years of experience working in general nursing for admittance. For certification, you'll need experience working as an RN, including at least 2,000 hours of clinical nursing in a mental health environment. Additionally, you'll be expected to complete 30 hours of relevant continuing education within every three years to maintain your licence.

If you’re considering a career in mental health nursing, you may want to read or take some courses to become familiar with the conditions, behaviours, and issues you’re likely to face. Consider exploring Psychological First Aid by Johns Hopkins on Coursera.

To be successful in this role, you should be passionate about helping people with mental health issues and confident in your knowledge of nursing practices and how the brain works. Once you’ve gained clinical experience, you may consider earning a master’s or doctoral degree to become a psychiatric nurse practitioner to advance your career. 

Article sources

Kashmir Reader. “ Psychiatric Nurse: A Specialised Job , https://kashmirreader.com/2021/02/06/psychiatric-nurse-a-specialised-job/.” Accessed March 21, 2024.

World Health Organisation. “ Mental Health , https://www.who.int/india/health-topics/mental-health” Accessed March 21, 2024.

The Times of India. “ 22% Rise in Number of Mentally Ill Jail Inmates: NCRB , https://timesofindia.indiatimes.com/india/22-rise-in-number-of-mentally-ill-jail-inmates-ncrb/articleshow/94124324.cms.” Accessed March 21, 2024.

The Times of India. “ 'Shortage of Nurses is Next Health Crisis , https://timesofindia.indiatimes.com/city/bengaluru/shortage-of-nurses-is-next-health-crisis/articleshow/95313773.cmsy.” Accessed March 21, 2024. 

Nursing Times. “ More Mental Health Nurses Urgently Needed Around the World , https://www.nursingtimes.net/news/mental-health/more-mental-health-nurses-urgently-needed-around-the-world-21-06-2022/.” Accessed March 21, 2024.

Glassdoor. “ Psychiatric Nurse Salaries in United Kingdom , https://www.glassdoor.co.in/Salaries/india-psychiatric-nurse-salary-SRCH_IL.0,5_IN115_KO6,23.htm?clickSource=searchBtn.” Accessed March 21, 2024. 

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Getting Help From Psychiatric Meds: Then, Now, Maybe Forever

A personal perspective: recognizing when it might be time to consider treatment..

Posted March 25, 2024 | Reviewed by Michelle Quirk

• What Is Depression?
• Find a therapist to overcome depression
• Some people may think psychiatric meds are "not for them."
• While mental health stigma has decreased, medication is still stigmatized. Evidence shows benefits and safety.
• In women's mental health—even pregnancy and postpartum—SSRIs have generally been found safe.

Long ago and far away, I was married to a family physician. I had two sparkly-eyed, adorable daughters, aged almost 2 and 5. I still breastfed the younger and was privileged to stay home. Both girls were born at home, in rural Oregon with a nurse-midwife. Our house was perched atop a hill overlooking a valley ablaze with flowering cherry, pear, and apple trees in spring, with lush and weighty fruit ripening in summer. The neighbors spanned the next hill, wine grapes covering their verdant turf. This was the early ‘90s, and that house was my beautiful prison.

I felt anxious, obsessively so, and miserable— depressed. I woke each day after my husband left for clinic, my daughters clambering up to my bed in frilly cotton nightgowns, ready for their day and full of energy. I wondered how I could make it through each endless dreary hour until bedtime came that night.

As a nurse-midwife, I knew most of what there was to know about women’s reproductive health—or so I thought. But no one had taught mental health. At Yale, where I graduated with a master’s in nursing, one of my most brilliant faculty had faced mental health issues following a first birth. Her illness (or its treatment) proved so severe her face became lax and erased of expression, and she appeared zombie-like and eerie, compared to her prior vivacious spirit. Then, she disappeared from teaching with scarce a trace. Swssh swssh, it was whispered, no one knowing the true story. Postpartum mood and anxiety had all but no evidence base or treatment back then. Ergo, in modern medicine, it didn’t exist. There was little room for women’s experience if it hadn’t been “proven” by the (mostly white, male) canon of medicine.

Anxiety, insomnia , and depression wracked me in the last trimester with Rivkah, my second (I’d later learn late pregnancy symptoms signaled a high risk of postpartum issues). My husband’s colleague Tina, a warm family doc, prescribed sleep aids known to be OK in pregnancy. I assumed I would feel better after the birth, but my baby was colicky. I grew anxious, irritable, obsessed about what I’d said (or not) to the clerk in the Safeway, and often too wound up to sleep, waking in the dark hours with a pounding heart, panicked for no reason.

My then-husband’s only answer (he was doing the best he could) was to work roughly 12 hours or more each day and, when I cried or anguished, insist, “It’ll get better!” It’s amazing how long I believed him. As if he had some special foreknowledge or prescience about the future, and could guarantee improvement. He was depressed, too, a lifelong, intergenerational condition he “treated” with workaholism. It took me years to realize, “It’ll get better!” was all he knew and not the truth.

To escape the house, I leveraged connections in our small-town medical community and wrangled a part-time job seeing outpatients at the practice where my husband worked. As the sole female provider joining a group of male family physicians, women flocked to me for annual exams. We would dispense with the physical part of the exam rather quickly but spend a long time talking. Talking about where these women were in their lives and where they wanted to go. What obstacles lay in their path, and how they could clear them. I failed to see parallels in my own life, simply caring for others as I always had.

Work helped, but I still obsessed about inconsequential patient details or what I’d said to a friend. And the lack of sleep was mind-numbing, beyond cranky-making. Life was not fun—not at all. I worried how my moodiness and irritability could affect my kids—I obsessed about this, actually. I was obsessed about obsessing! I didn’t know to call this anxiety or depression. Wasn’t depression when you couldn’t get out of bed? On the contrary, I could hardly stay in bed, was going to work and taking care of kids, “functioning.” It just all felt like a big grey slog.

I started to see something intriguing at work. One physician (who, hush-hush, not to be shared and I don’t know how I knew) had a history of depression and tried and benefitted from Prozac. He subsequently put a number of patients on selective serotonin reuptake inhibitors (SSRIs). (By this point, 1996-ish, Zoloft, Paxil, and Luvox had also hit the market.) I started recognizing depression in my patients and prescribing SSRIs. I watched people get better. Like, way better. “I feel like myself on a good day, almost every day,” they would tell me. The societal Kool-Aid associating mental health issues with weakness and shame no longer made sense. This was a bona fide disorder that responded to treatment as well as infections, hypertension, or asthma. I saw it every day.

Finally, I phoned a friend in the city; someone I’d met on Labor & Delivery when she was a med student and I a nurse-midwife. She was a psychiatrist. I admitted my symptoms. “I think you’re depressed,” she said, confirming what even I now knew. She referred me to another psychiatrist who practiced women’s mental health—a nascent specialty at the intersection of psychiatry and obstetrics.

I don’t remember exactly what the psychiatrist asked in that initial visit or even my response. But I remember not making it through my first sentence without weeping, crying for a long time, spewing out my tale. The psychiatrist, petite, well-dressed, and calm, just nodded. She sat silent and affirming until I finally paused to suck in a ragged breath. A wash of relief flowed through me. I felt seen, heard.

I stopped breastfeeding that week and began antidepressants (we didn’t yet know women and babies can tolerate SSRIs just fine in lactation; even usually in pregnancy). Magically, my 5-year-old’s behavior suddenly improved. (Research shows when mothers get treated, children’s behavior and emotional issues improve. It may not be fair but is true: When Mom’s happy, everyone’s happy.)

As I recovered, one of my first realizations was, “I can leave my husband if I need to!” I was my former, energetic self, just as my patients were. I could escape my beautiful prison if it proved best for all of us. I stayed half a dozen more years, but that initial wash of wellness proved life-transforming—to feel agency and strength again, to no longer feel beaten down by misery.

That was 28 years ago. I have been on several antidepressants since. (Yes, there are sometimes side effects, but, contrary to popular belief, they can usually be ameliorated.) I tried, early on, to wean myself off—“I don’t need these, I can do this!”—and quickly regressed into that familiar, ugly, anxious sleepless pit. I learned “depression” didn’t often mean inability to get out of bed, but could mean poor sleep, lack of joy, guilt -addled poor concentration , low energy, and more. And if a person has three or more lifetime episodes of depression, maintenance meds are recommended. Also, women rarely experience depression without clinically diagnosable anxiety, for which antidepressants are the standard treatment as well. If you need meds, you need meds. No shame in that at all.

Instead, shame on anyone who tries to tell you otherwise.

The MGH Center for Women’s Mental Health. Psychiatric Disorders During Pregnancy .

The MGH Center for Women’s Mental Health. Breastfeeding and Psychiatric Medications.

Diane Solomon is an adjunct professor at OHSU and has served as a leader on the Boards of Nurse Practitioners of Oregon, the Oregon Wellness Program, the Oregon Nurses Association, The Jewish Federation of Greater Portland, and many others.

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Understanding what emotional intelligence looks like and the steps needed to improve it could light a path to a more emotionally adept world.

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Brain, Decision-Making, and Mental Health 2050

• First Online: 02 January 2023

Cite this chapter

• Nima Rezaei 3 , 4 , 5 ,
• Amene Saghazadeh 3 , 4 ,
• Ali Ercan Altınöz 6 , 7 ,
• Amer M. Burhan 8 , 9 , 10 ,
• Ana Ferreira 11 ,
• Anastasia K. Belolutskaya 12 , 13 ,
• Andrea Lavazza 14 , 15 , 16 ,
• Bernard Cadet 17 , 18 , 19 ,
• Billy A. Danday 20 , 21 ,
• Blanca Puig 22 ,
• Christoph Meinel 23 ,
• Daniela Dumitru 24 , 25 , 26 ,
• Denisa Caculidis-Tudor 27 ,
• Fernando Urcola-Pardo 28 ,
• Gabriela-Paula Florea 29 , 26 ,
• Ghsoon Reda 30 ,
• Hideki Tsumura 31 , 32 ,
• Ioana R. Podina 33 , 34 ,
• James Patience 35 ,
• Jana S. Rošker 36 , 37 ,
• Jeffrey Scheuer 38 ,
• Joana Reis 39 , 40 ,
• Joanna Salapska-Gelleri 41 , 42 ,
• Jozef Bavolar 43 ,
• Juan Carlos Olabe 44 ,
• Julia von Thienen 23 , 45 ,
• Ka Sing Paris Lai 46 ,
• Kelly Schuller 41 , 42 ,
• Margherita Benzi 47 ,
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• Marián Ambrozy 49 ,
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• Miguel Ángel Olabe 50 ,
• Minsoo Kang 51 ,
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• Myungjin Jung 54 , 51 ,
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Part of the book series: Integrated Science ((IS,volume 12))

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The authors of Barin, Decision -Making, and Mental Health were asked how they would see the future of their field 30 years later. This chapter presents the authors’ views on this subject in 2050.

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The puzzle of Brain, Decision-making, and Mental Health–Word cloud

• Decision-making
• Integrated brain sciences
• Mental health

The brain is a great integrator of information, so most parts of this organ have an input into every decision we make. It is also extremely adaptable and, like all good computers , is adept at moving information around from one area to another, depending on circumstances. Harry Barry

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Integrated Science Association (ISA), Universal Scientific Education and Research Network (USERN), Tehran, Iran

Nima Rezaei & Amene Saghazadeh

Research Center for Immunodeficiencies, Children’s Medical Center, Tehran University of Medical Sciences, Dr. Qarib St, Keshavarz Blvd, 14194, Tehran, Iran

Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran

Nima Rezaei

Department of Psychiatry, School of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey

Ali Ercan Altınöz

Integrated Science Association (ISA), Universal Scientific Education and Research Network (USERN), Eskisehir, Turkey

Department of Psychiatry, University of Toronto, Toronto, ON, Canada

Amer M. Burhan

Ontario Shores for Mental Health Sciences, Whitby, Toronto, ON, Canada

Integrated Science Association (ISA), Universal Scientific Education and Research Network (USERN), Whitby, Toronto, Canada

Interdisciplinary Centre for Social Sciences (CICS.NOVA), Faculty of Social Sciences and Humanities (NOVA FCSH), NOVA University Lisbon, Lisboa, Portugal

Ana Ferreira

Moscow City University, Moscow, Russia

Anastasia K. Belolutskaya

Moscow State Lomonosov University, Moscow, Russia

Centro Universitario Internazionale, Arezzo, Italy

Andrea Lavazza

University of Pavia, Pavia, Italy

Integrated Science Association (ISA), Universal Scientific Education and Research Network (USERN), Milan, Italy

University of Normandy, Caen, France

Bernard Cadet

University of Estremadura, Badajoz, Spain

Integrated Science Association (ISA), Universal Scientific Education and Research Network (USERN), Caen, France

Leyte Normal University, Tacloban City, Philippines

Billy A. Danday

Integrated Science Association (ISA), Universal Scientific Education and Research Network (USERN), Tacloban City, Philippines

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Blanca Puig

Hasso Plattner Institute for Digital Engineering, University of Potsdam, Brandenburg, Potsdam, Germany

Christoph Meinel & Julia von Thienen

Department of Teacher Training, Bucharest University of Economic Studies, Bucharest, Romania

Daniela Dumitru

Doctoral School of Education and Department of Philosophy, West University of Timisoara, Timișoara, Romania

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Daniela Dumitru & Gabriela-Paula Florea

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Denisa Caculidis-Tudor

Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain

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Doctoral School of Philosophy, University of Bucharest, Bucharest, Romania

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Integrated Science Association (ISA), Universal Scientific Education and Research Network (USERN), Leicester, UK

Ghsoon Reda

Graduate School of Technology, Industrial and Social Sciences, Tokushima University, Tokushima, Japan

Hideki Tsumura

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Integrated Science Association (ISA), Universal Scientific Education and Research Network (USERN), Poznań, Poland

Clinical Neuropsychiatry & Therapeutic Brain Stimulation Research, Parkwood Institute, London, ON, Canada

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Joana Reis & Rita Payan-Carreira

Department of Psychology, Florida Gulf Coast University, Fort Myers, Florida, USA

Joanna Salapska-Gelleri, Kelly Schuller, Martin Bourgeois & Todd McElroy

Integrated Science Association (ISA), Universal Scientific Education and Research Network (USERN), Fort Myers, USA

Department of Psychology, Faculty of Arts, Pavol Jozef Safarik University in Kosice, Košice, Slovakia

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Christian Brothers University, Memphis, TN, USA

Juan Carlos Olabe

Integrated Science Association (ISA), Universal Scientific Education and Research Network (USERN), Berlin, Germany

Julia von Thienen

Department of Psychiatry at Western University, Schulich School of Medicine and Dentistry, London, ON, Canada

Ka Sing Paris Lai

University of Eastern Piedmont, Vercelli, Italy

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University of Nicosia, Nicosia, Cyprus

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College of International Business ISM Slovakia, Prešov, Slovakia

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University of the Basque Country, Biscay, Bilbao, Spain

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Health and Sport Analytics Laboratory, Department of Health, Exercise Science, and Recreation Management, The University of Mississippi, University, Lafayette, MS, 38677, USA

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Innopolis University, Innopolis, Russia

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Integrated Science Association (ISA), Universal Scientific Education and Research Network (USERN), Innopolis, Russia

Exercise & Memory Laboratory, Department of Health, Exercise Science, and Recreation Management, The University of Mississippi, University, Lafayette, MS, 38677, USA

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Alexander Silberman Institute of Life Science, Hebrew University of Jerusalem, Jerusalem, Israel

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University of Insubria, Varese, Italy

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Universidad Católica Sedes Sapientiae, Lima, Peru

Integrated Science Association (ISA), Universal Scientific Education and Research Network (USERN), Torino, Italy

European Academy of Sciences and Arts (EASA), Vienna, Austria

SETI Permanent Study Group of the International Academy of Astronautics (IAA), Stockholm, Sweden

InCosmiCon International Research Center, Lima, Peru

Comprehensive Health Research Centre, Évora, Portugal

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University of the Azores, Ponta Delgada, Portugal

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LanCog Group, Centre of Philosophy of the University of Lisbon, Lisbon, Portugal

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Integrated Science Association (ISA), Universal Scientific Education and Research Network (USERN), Ankara, Turkey

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Rezaei, N. et al. (2023). Brain, Decision-Making, and Mental Health 2050. In: Rezaei, N. (eds) Brain, Decision Making and Mental Health. Integrated Science, vol 12. Springer, Cham. https://doi.org/10.1007/978-3-031-15959-6_32

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Custom-Built Mental Health: Do You Need A Psychiatrist Or Psychiatric Nurse Practitioner?

T he process of taking care of your mental health is a long and tricky one. Fortunately, plenty of professionals can help us overcome and/or cope with various mental illnesses . 

But if you want a custom-built mental health plan, there are usually two ways to go about it: seeking help from a psychiatrist or a psychiatric nurse practitioner (PMHNP). Both professionals have similar roles and responsibilities, making it difficult to choose between them.

In this article, we’ll look at the similarities and differences between a PMHNP and a psychiatrist. We’ll look at their educational requirements as well as their authority. By the end of this blog post, you can decide which professional you’ll need. 

An Overview of a Psychiatric Nurse Practitioner

A psychiatric nurse practitioner could be the professional you’re looking for, especially if you require them to take on specific nursing duties. Let’s look at what a PMHNP does.

What is a Psychiatric Nurse Practitioner (PMHNP)?

A psychiatric mental health nurse practitioner is a nurse practitioner who specializes in mental health care. A PMHNP has all the responsibilities of a nurse practitioner, except they specialize in mental health services. They can use their specialized medical knowledge to administer treatment strategies and provide diagnoses for patients of all ages and demographics. 

What Does a PMHNP Do and Where Do They Work?

A PMHNP will help people through multiple mental health issues. They'll use diagnostic criteria to connect specific physical symptoms with mental health disorders.

They're also therapists who combine counseling, medication, and education to improve a patient's general well-being. 

These professionals often work in addiction or behavioral health clinics but are sometimes called into hospitals, private practices, schools, or prisons.

A PMHNP will direct other nurse practitioners in a clinical setting and work closely with physicians, families, and the community. 

An Overview of a Clinical Psychiatrist 

When you think of getting help for mental health, your first thought is to probably go to a clinical psychiatrist. And for good reason, as these professionals are experienced in this area.

What is a Psychiatrist?

A psychiatrist is a medical doctor who specializes in mental health. They assess and diagnose the mental and physical components of psychological problems.

To do so, they will often run laboratory and psychological tests and speak to patients to help them understand their mental states. They treat patients with medication, psychopathy, and other alternative therapies.

What Does a Psychiatrist Do and Where Do They Work?

Psychiatrists will use their years of education and expertise to provide empathetic, responsive, and genuine support to patients and their families. They often combine talk therapy tactics (i.e., cognitive behavioral therapy) and medication (i.e., antidepressants) in patient care.

A psychiatrist will often specialize to better understand their clients.

Their specialty will determine where they work. For example, a child psychiatrist may work in a school or clinical setting. That said, most specialties can all be practiced in a traditional healthcare setting.

In our next section, we’ll look at how to pick between both professionals, as they seem similar at first glance.

If you want more help with this subject, we recommend checking out this article on choosing between a psychiatrist and a nurse practitioner by Path M e ntal Health .

How to Choose Between a PMHNP and a Psychiatrist

When reading both professions side by side, they don’t appear to be that different. However, it’s their differences that can help you make a decision on what professional is right for you. 

The Similarities Between PMHNPs and Psychiatrists 

Psychiatrists and PMHNPs work together in many healthcare settings, and most of their roles overlap. They both diagnose conditions, administer therapy, and prescribe medication. 

Due to the shortage of psychiatrists in the US, PMHNPs are serving as legitimate alternatives.

PMHNPs also collaborate closely with psychiatrists to reduce their workload and implement care strategies. With that said, their differences in authority make things tricky.

The Differences Between Educational Requirements

A psychiatrist is a medical doctor typically earning a bachelor's degree in chemistry, biology, or a related field before taking the MCAT.

Once they graduate from medical school, they gain a state license (which they must keep current), complete psychiatric residency, and obtain other certifications. The whole process takes 12 years and continuous education.

A PMHNP isn’t a medical doctor. However, they will earn their Bachelor of Science in Nursing, become licensed RNs, and complete a PMHNP program. After completing the required clinical hours and passing an exam, they must only renew their license every five years.

This process takes six years to complete but may take ten if they decide to go to graduate school.

Since you can become a PMHNP faster, they’re typically cheaper to hire. However, they won’t be able to perform specific tasks without the help of a practicing doctor or psychiatrist.

The Differences Between Prescribing and Administrative Authority

In 2023, both psychiatrists and PMHNPs have the authority to prescribe medications in the United States. However, in some states, a PMHNP needs to get a supervising physician’s approval first.

It’s recommended to research if your PMHNP has full authority to prescribe the type of medication you need (i.e., schedule II drugs or higher) before choosing your specialist.

Similarly, psychiatrists and PMHNPs have the authority to open their own practice. They can both conduct research and publish their studies in medical journals without much red tape.

With that said, PMHNPs often work under psychiatrists, meaning they don’t have the same administrative authority.

A psychiatrist can be a supervisor in a psychiatric hospital and review or sign off on decisions made by PMHNPs. A PMHNP can’t sign off on their own decisions.

In Conclusion, The Differences are Skin Deep 

A psychiatrist and PMHNP perform the same roles and duties as one another, but the major difference lies in their ability to sign off on medications and treatment plans.

If a PMHNP works in a state where they have more authority, then the decision comes down to cost and availability.

However, if the PMHNP has to wait for their supervising psychiatrists' approval before administering treatment, you may have to wait to get on a plan. If you’re okay with waiting, then a PMHNP is right. If not (and you have more cash flow), a psychiatrist is best. 

In the end, you need to find a professional that works best for you and your needs. This may require some trial and error, but eventually, you’ll be on your way to improved mental health.

The post Custom-Built Mental Health: Do You Need A Psychiatrist Or Psychiatric Nurse Practitioner? appeared first on Kellys Thoughts On Things .

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Celebrating a Storied History: Moscow Preobrazhenskaya Mental Hospital Marks its 245 th Anniversary

Larisa a. burygina.

Mental-health Clinic No. 4 named after P. B. Gannushkin

Sergey A. Golubev

Oksana v. filipchenko, associated data.

• 1876. 217. 1. 76. [On the 100th anniversary of the Preobrazhenskaya hospital which takes place 13th of July 1877] Central State Archive of Moscow (Moscow)

Figure S2 . «About the centenary anniversary».

In 2022, Mental-health Clinic No. 4 named after P. B. Gannushkin, one of the oldest mental health institutions in Russia known as Preobrazhenskaya Hospital before the October Revolution of 1917, celebrated its 245 th anniversary. The history of the hospital reflects all stages of the evolution of the basic principles and aspects of mental health care in Russia. On many occasions, the institution served as a platform for eminent researchers and clinicians to achieve scientific breakthroughs and their application in practice. This article is a review of the major milestones in the history of the hospital. It highlights the great achievements of its psychiatrists and presents some previously unpublished archival documents that offer a new perspective on the history of Preobrazhenskaya Hospital.

INTRODUCTION

In 2022, Mental-health Clinic No. 4 named after P. B. Gannushkin, one of the oldest mental health institutions in Russia known as Preobrazhenskaya Hospital before the October Revolution, celebrated its 245 th anniversary. This represents the number of years since Catherine the Great signed a decree establishing the Moscow House of Invalids, where several dozen beds were set aside for the mentally ill. The document, issued in 1777 [1] , laid the foundation not only for Moscow’s first specialized institution that could accommodate patients with mental disorders, but also, without exaggeration, for the entire field of Russian psychiatry.

The implementation of the Pinel reform in Russia, the introduction of the concept of “moral treatment”, the first scientific conferences and open clinical discussions, all these stages in the evolution of the basic principles and aspects of mental health care have found their reflection in the history of Preobrazhenskaya Hospital over the past 245 years. This is why Vasily Gilyarovsky poetically referred to the Hospital as “the cradle of Russian psychiatry” [2] .

Each page in the history of Preobrazhenskaya Hospital is not only an impressive list of achievements and innovations, but also a unique gallery of distinguished names [3-7] . It served as a basis for the greatest medical luminaries of the time, such as V. F. Sabler, V. R. Butzke, V. A. Gilyarovsky, N. N. Bazhenov, A. V. Snezhnevsky, D. E. Melekhov, T. I. Yudin, S. G. Zhislin, and G. Y. Avrutsky, from which to make their scientific discoveries and validate them in practice; this was also the place where such luminaries of Russian psychiatry as S. S. Korsakov, A. U. Frese, E. K. Krasnushkin, P. E. Snesarev, A. S. Tiganov, and I. Y. Gurovich, and many others, began their medical careers.

It is a well-known and undisputed fact that Preobrazhenskaya Hospital was the first (and almost only one until the end of the 19 th century) psychiatric hospital to appear in Moscow. But historians and researchers in psychiatry have spent more than 100 years trying to dig up documents that could allow them to determine the exact year of its founding.

Starting in the second half of the 19 th century, the question has frustrated many eminent physicians of Preobrazhenskaya Hospital, including S. I. Steinberg [8] , I. V. Konstantinovsky [9] , N. N. Bazhenov [10] , M. A. Dzhagarov [11] , and A. B. Alexandrovsky [12] . Their work can now help us to form a fairly comprehensive view of how the State and society gradually, step by step, developed an awareness of what such an independent institution as a psychiatric hospital was all about. They painstakingly assembled scattered documents and facts to finally pinpoint with certainty the day it all began and the events that could be considered key milestones in the hospital’s history.

FROM FIRST MENTIONS TO 19th CENTURY REFORM

The first building that hosted Preobrazhenskaya Hospital, originally known as Moscow Dolgauz, opened its doors on June 15, 1808. In the 20 th century, it became routine to trace all anniversaries of the institution back to that date. But is that right? Could the mere fact that the hospital acquired its own building be considered the seminal event of the first inpatient psychiatric hospital in Moscow?

On July 13, 1777, Catherine the Great signed a decree mandating the opening of the House of Invalids in Moscow, with one of its “wards” dedicated to the care of the mentally ill. This is the date that, 100 years later, the doctors at Preobrazhenskaya Hospital referred to as the starting point in the history of their institution [8] . One of their main arguments was the fact that, on May 17, 1792, Catherine the Great issued a decree [1] establishing for the first time the position of Special Doctor at the mental health hospital. Hence, this decree confirms that this type of social institution for people with mental disorders already existed in 1792.

According to the decree signed by Catherine the Great, the primary role in the observation of patients was assigned to the warden, who was in charge not only of the guards (retired soldiers), but also of the doctor responsible for the professional supervision of patients. In reality, however, the staff physician had to juggle work at the mental health hospital with his duties in the nursing home, the hospice, and the almshouse. As a result, his attention was limited to those patients who had a chance of recovery [13] .

When assessing the efforts of the first doctors at the mental health hospital, such as F. Raschke, then C. Pouliard, A. Blimmer, J. Karas (and all this happened long before the hospital had its own building), N. N. Bazhenov wrote in his book about Preobrazhenskaya Hospital: “It is important to note that even then there was a firm belief that the insane person was a patient, with all that such a conclusion entailed, including examination by a physician, admission to the mental health hospital for treatment (no matter how crude and primitive that treatment might have been), and finally discharge when the physician was satisfied that the goal of admission (a cure) had been achieved” [10] .

Other doctors at Preobrazhenskaya Hospital also left their mark in the history of Russian psychiatry of the 19 th century. For example, Zinovy Ivanovich Kibalchich, Chief Doctor of the hospital in 1811–1828, left us a documented description of the prevailing realities in a mental hospital at the beginning of the 19 th century. In his 1821 article “Report on the House of the Insane in Moscow and the Methods of Treatment Used There” published in the Journal of the Imperial Philanthropic Society (issue No. 11, 1821), he not only described in detail Moscow Dolgauz and the methods of treatment used there, but he was also one of the first to point out the existence of mental disorders that are now referred to as “borderline conditions” [14] .

Vasily Fedorovich Sabler, chief doctor of Preobrazhenskaya Hospital in 1828–1871, was a true “revolutionary” in the early history of psychiatric care in Russia ( Figure 1 ).

A brilliant clinician and talented scientist, V. F. Sabler provided evidence for the nosological independence of progressive paralysis, described its accompanying mental and neurological disorders, and developed humanistic principles of individual approach to patients. He was one of the first to hypothesize that some forms of illness can evolve into others, and that severe somatic illness accompanied by high body temperature (fever) can contribute to the cure of psychosis.

In the history of Preobrazhenskaya Hospital, V. F. Sabler played an equally prominent role as an outstanding manager. With a radical reform of the hospital’s management system, he ensured that the Chief Doctor would become the actual head of the institution. He supervised all areas of the hospital’s activities and prepared reports on the clinic that were published in the press (including in Europe).

This administrative reform marked a dramatic shift in attitudes toward the mentally ill. V. F. Sabler was greatly influenced by Philippe Pinel’s concept, which led him to completely overhaul the patient management system, finally replacing the chains used on violent patients with straitjackets and restraint chairs with straps.

It was the first instance when treatment was given priority over charity. This included the first patient histories (known as “case sheets”, see Figure S1 in the Supplementary File 1 ) and prescription books. Depending on the course of their disease, patients were categorized as acute or chronic and treated using a different therapeutic approaches.

The new emphasis was not only on the medical observation of the patients, but also on their moral challenges and re-education. Patients were no longer seen as “dangerous madmen” but as “unreasonable children” who needed proper care and exercise. That is why occupational therapy was considered so important. According to the instruction “On the Exercises for the Sick People Placed at the Mental Health Hospital” published in 1834, each patient was assigned a strictly individual occupation. It was then that Preobrazhenskaya Hospital established a sewing shop, a tailor’s shop, a shoemaker’s shop, a dyer’s shop, a paint shop, a plasterer’s shop, and a vegetable garden. The women could also knit socks and embroider canvas.

V. F. Sabler initiated the effort to draft legislation on the mentally ill, which provided the impetus to address a long overdue problem in the patient examination process. For centuries, medical matters had been handled by officials with no expertise in diagnosing mental illness, and during the reign of Nicholas I, the authorities began committing patients to institutions “pending further orders” rather than “pending recovery”, as had always been the case. It was not until February 18, 1835, that a decree was issued establishing a procedure for forensic psychiatric examination that required convincing evidence of mental illness from credible medical experts.

In 1841, the so-called “special patient examination procedure” was introduced and implemented for the first time at Preobrazhenskaya Hospital. If in St. Petersburg the “lunatics” continued to be transported to the Provincial Board, in Moscow the “subjects” were now sent to Preobrazhenskaya Hospital for “expert examination” and placed in a ward specially purposed for such subjects in a section of St. Catherine’s Almshouse. Membership in the Patient Examination Committee was also established at that time and did not change until 1917. It included the hospital doctor, his/her assistant, the provincial marshal of the nobility, the chief of the district police or the head of the city. Patients were discharged only after a new examination, which could take place at the end of a two-year “observation” period, and this period could be shortened only by special decision of the Senate.

The hospital owes both its name, Preobrazhenskaya, and the confirmation of its new official status as a medical institution to V. F. Sabler. It was he who on May 31, 1838, petitioned Emperor Nicholas I to sign a decree renaming the Moscow Dolgauz as the Preobrazhenskaya Mental Hospital.

Assessing the changes that took place in the hospital during the first hundred years of its existence, historians of psychiatry are quite right to note that as early as the middle of the 19 th century Preobrazhenskaya Hospital had made the transition from a “charity house” to an in-patient psychiatric institution and had evolved into “the center of not only practical but also scientific psychiatry, which became the tradition of the Moscow psychiatric school, distinguishing it from the St. Petersburg psychiatric school” [7] .

These changes, most of which were introduced during V. F. Sabler’s leadership, allowed Samuil Ivanovich Shteinberg (the hospital’s chief doctor in 1872–1877) to begin work on the institution’s first collection of scientific papers in the run-up to the centennial of Preobrazhenskaya Hospital in 1877. The preserved documents (“Preobrazhenskaya Hospital Office File on the Centennial Anniversary...”) show that the preparations for this anniversary had begun well in advance. As early as in February 1876, the chief physician, S. I. Shteinberg, wrote a letter to the trustees of Preobrazhenskaya Hospital with a detailed plan of the celebration. A circular letter was sent to the staff instructing S. S. Korsakov, N. I. Derzhavin, and V. R. Butzke to begin preparing articles identifying the major milestones in the history and development of the hospital (Figure S2 in the Supplementary File 1 ).

In the 1870s and 1880s, the hospital attracted a cadre of brilliant and exceptionally gifted young physicians who introduced the most advanced methods of patient care into existing medical practice. First of all, this applies to Sergey Sergeyevich Korsakov, the founder of the nosological branch of psychiatry, the creator of the Moscow scientific school and the author of a classic course in psychiatry [4,5] . His name is closely connected with the history of the “therapeutic revolution” at Preobrazhenskaya Hospital. The energy and reputation of S. S. Korsakov helped to complete and irretrievably establish “moral treatment” at the hospital and the “open door” policy (from 1889), followed by out-of-hospital care, which radically changed the entire approach to patients.

20 th CENTURY: TRANSFORMATIONS AND ACHIEVEMENTS

Looking back, it is impossible to ignore one obvious fact: almost all the chief doctors of Preobrazhenskaya Hospital in the period before the Russian Revolution of 1917 acted as reformers of the entire Russian psychiatric care system. An honorable place in this gallery of illustrious figures is occupied by Nikolai Nikolaevich Bazhenov, chief doctor of the hospital in 1904–1917 ( Figure 2 ).

Preobrazhenskaya Hospital owes its vast expansion and the introduction of the then — revolutionary system of “advanced care” to this fascinating figure of Russian psychiatry, outstanding clinician, ingenious manager, and respected teacher.

In the new “advanced care” system, the uneducated wardens and nannies were replaced by young medical interns and sisters of mercy. The doors to the wards were unlocked, the bars on the windows were replaced with tempered glass, and the straitjackets were displayed as museum pieces [15-17] . To ensure that patients were under continuous and competent supervision, the interns were required to live in the hospital, rotate on round-the-clock duty, welcome new admissions, and complete patient histories and observation diaries. All direct patient care was assigned to mid-level medical staff. Thirty-two sisters of mercy washed and fed the patients, gave them baths, accompanied them on walks, etc. Each ward had a head nurse who distributed medications, served lunch and dinner, was in charge of laundry, and performed other household duties. Nannies and servants were assigned only janitorial duties. In the spirit of those times, the hospital widely applied a system of moral influence, a prototype of today’s psychosocial therapy that included respectful treatment and support of patients, their socialization, and involvement in various activities.

At the beginning of the 20 th century, with N. N. Bazhenov’s contribution, the hospital was transformed into a research and treatment institution, which became a center of advanced psychiatric knowledge. The scope of N. N. Bazhenov’s innovations is quite impressive: in just a few years the clinic, where at the turn of the century treatment of patients resembled more that in a prison than in a medical institution, was transformed into a modern hospital, on par with the best that Europe could offer [15-17] .

Preobrazhenskaya Hospital was also the place where the Law on the Mentally Ill, a revolutionary act for its time, was proposed 80 years before the adoption of the Russian Federal Law on Psychiatric Care in 1992. The legal principles outlined by N. N. Bazhenov at the first congress of the Russian Union of Neuropathologists and Psychiatrists in 1911 are still relevant today:

“The following issues need to be brought to the forefront of mental health care and legislated:

• The principle of extending state care to all mentally ill people in the country, and specifying the measures to implement this task and the central and local authorities responsible for these tasks.
• Conditions for allowing treatment at home in the patient’s own family.
• Sufficient safeguards must be in place to ensure that the principles of inviolability of the person and individual liberty can only be violated when the mental illness of the person in question makes this imperative” [18] .

N. Bazhenov is also connected with the first commemoration of the foundation of the hospital celebrated in the 20 th century. In December 1909 the 100 th anniversary of the opening of the first building hosting Preobrazhenskaya Hospital on Matrosskaya Tishina Street was commemorated in gushing but solemn fashion, with the participation of the general public.

By that time the clinic had already received a plot of 11 dessiatins of land with the two and three-story buildings of the former Kotov factory (known as “Kotov’s Half”) ( Figure 3 ).

The factory buildings were refurbished, and a dormitory for the staff was equipped with ventilation, plumbing, and even central heating, which allowed N. N. Bazhenov to write proudly that “now Preobrazhenskaya Hospital has such premises for the staff that few Russian or even Western European hospital institutions can boast of” [10] .

However, the problem of overcrowding could be solved only by the construction of new buildings on Kotov’s Half, which required additional funds. So, N. N. Bazhenov decided to organize a gala evening for the city’s dignitaries on the former Kotov estate.

The day of the anniversary celebration was packed with events, including a solemn liturgy and breakfast for 300 guests; in the afternoon, there was a large concert by professional musicians from Moscow; a festive tea ceremony for patients, distribution of anniversary souvenirs, such as cups with the hospital insignia; and in the evening a banquet for 200 guests was held at the Kotov’s cottage located in a picturesque setting on the border of the Preobrazhenskaya and Sokolnicheskaya groves.

In addition to the concert, the highlight of the “cultural program” was the exhibition, for which N. N. Bazhenov selected not only everyday objects from psychiatric hospitals of different centuries (straitjacket, restraint chair, and “case sheets”), but also the creative works of patients (paintings and caricatures, wood and paper crafts, embroidery, and knitting). The models of Preobrazhenskaya Hospital and the Eiffel Tower were particularly popular with the public, because of their size and resemblance to the originals.

In addition to the gala dinner, the guests were treated to a theatrical performance, which included an act from the play “The Marriage of Krechinsky”, with a reference to Preobrazhenskaya Hospital, and, at the end of the evening, fireworks from an area near the buildings in Kotov’s Half — N. N. Bazhenov did not miss a single opportunity to draw the attention of the patrons and city authorities to the matter of financing the future construction. In 1910–1914, his work culminated in the successful completion of three new buildings and repairs to the old factory facilities on Kotov’s Half.

But let’s take a closer look at the year of this anniversary: Why was it celebrated in 1909? For a long time, 1809 was mistakenly considered the year in which the first specialized hospital for the mentally ill was opened. It was mentioned both in the Historical Essay on the Imperial St. Catherine’s Almshouse by V. Molnar [13] and in the Historical Essay on Preobrazhenskaya Hospital by I. V. Konstantinovsky [9] . For this reason, the anniversary was celebrated in 1909 and the following plaque was installed on the facade of the building: “1809–1909: To the centenary of the Preobrazhenskaya Mental Hospital, the first in Moscow designed specifically for psychiatric purposes”.

Only later, while working on the manuscript of his book “The Moscow Dolgauz” or “Essays on the History of Preobrazhenskaya Hospital” did N. N. Bazhenov study the documents in the hospital archives and found out that the new mental health hospital in Preobrazhenskoye was opened earlier, in June 1808, when 53 patients from the house of the former Secret Expedition were transferred to the building on Matrosskaya Tishina 1 [10] .

By the beginning of the 20 th century, the records had cemented all three major milestones in the history of the establishment of Preobrazhenskaya Hospital: 1777, 1808, and 1838. One might think that this would have settled the question of the first dates for future celebrations once and for all.

However, the revolution of 1917 and the subsequent division of the hospitals sowed confusion into the “question of anniversaries”. In the spirit of Soviet traditions, Preobrazhenskaya Hospital was stripped of its former name in 1920 and became Moscow City Hospital No. 1. What’s more, in 1931, it was divided into two independent medical institutions with different goals and missions. The hospitals kept changing names, numbers, internal organizational structure, and overall scope of activities, and only relatively recently, in 2017, did the two hospitals return to their historical roots by merging under the name of P.B. Gannushkin Mental-health Clinic No. 4 ( Figure 4 ).

Over the next 100 years, Kotov’s half of Preobrazhenskaya Hospital acquired a different, but equally illustrious, name — Gannushkin Hospital. In the second half of the 20 th century, it maintained its position as an advanced center of research and practice, with many pioneering milestones in the history of Russian psychiatry:

• It developed the system of maintenance therapy, which is so important in preventing relapses.
• For the first time in the USSR, it began to use insulin shock therapy (under the direction of M. Y. Sereisky), as well as electroconvulsive therapy (with the contribution of G. A. Rotshtein).
• It also marked the beginning of the “psychopharmacological treatment era in psychiatry” with the trials of many medications that were subsequently integrated into mainstream clinical practice.

RECENT DEVELOPMENTS

Reflecting on the title of this article, “Celebrating a Storied History”, one may note that in 2022 the institution historically known as Preobrazhenskaya Hospital will celebrate its anniversary for the first time in more than a century since that memorable evening organized by N. N. Bazhenov at the former Kotov estate. How does Gannushkin Hospital, the illustrious heir to the great traditions established by Preobrazhenskaya Hospital, look at the new generation in the year of its 245 th anniversary?

More recently, just 3–4 years ago, it got a facelift after extensive repair and construction work to restore the buildings dating back to the early 20 th century. Most importantly, the reorganization allowed for more streamlined psychiatric care, created a common information space, rationalized territorial localization, and brought patient treatment and routing patterns into a consolidated format.

With four specialized clinics in operation since 2020, the hospital now has several new structural units, including a clinic for affective and suicidal disorders, a clinic for borderline conditions, a clinic for first psychotic episodes, a clinic for pharmacoresistant conditions, and a clinic for mental disorders that are compounded by substance abuse. The Mental Health Counseling Center, opened in 2021, provides outpatient care for individuals suffering from various mental disorders including somatoform, stress-related, and neurotic disorders.

Today Gannushkin Hospital boasts a center for complex diagnostics, a clinical and diagnostic department with specialized clinics (such as dentistry, ophthalmology, gynecology, ENT, ultrasound), an anesthesiology and intensive care unit, a clinical and diagnostic laboratory, a psychological and psychotherapeutic center, a social and legal assistance center, as well as a physiotherapy department (including a transcranial magnetic stimulation room and xenon therapy room), pharmacy, X-ray rooms, and a physiotherapy room.

At the moment, the hospital has 9 outpatient branches known as Psychoneurological Dispensaries (PNDs), some of which have a history spanning more than 100 years. 2 Three Memory Clinics were founded on the basis of PND. These medical and rehabilitation units are designed to help elderly patients with early signs of dementia and mild cognitive decline.

The staff of the oldest psychiatric hospital in Moscow has carefully passed down to younger generations traditions that combine the utmost sense of humanity and the highest level of professionalism in helping patients with mental disorders. These traditions are the cornerstone that enables the team at Mental-health Clinic No. 4 named after P. B. Gannushkin to live its mission every day by providing personalized and comprehensive mental health care based on the principles of partnership and trust, with the aim of restoring and maintaining a high quality of life for its patients.

Authors’ contribution

All the authors made a significant contribution to the article.

The research was carried out without additional funding.

Conflict of interest

The authors declare no conflicts of interest.

Supplementary data

Supplementary material related to this article can be found in the online version at doi: 10.17816/CP3704

Supplementary File 1

Figure S1 . «Case sheets».

1 The house on Myasnitskaya Street, formerly owned by the Secret Expedition, was transferred to the Public Charity Office in the early 19 th century. This is where the patients of the House of Invalids and the Madhouse were accommodated in 1801.

2 PND No. 8, for example, was founded in 1919 and made psychiatric history as the prototype of the emerging district-level psychiatric care in Soviet Russia.

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