Where Do Psychiatric Nurse Practitioners Work?

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In any given year, 1 in 5 Americans will experience some form of mental illness. Mental illnesses can be the result of numerous factors, including physical or emotional trauma, chronic medical conditions or chemical imbalances in the brain.

Two health care professionals talk while walking in a hospital corridor.

Since the COVID-19 pandemic, the increase in mental illness has concerned many psychiatric health professionals, and many are reporting their treatment facilities are understaffed, according to a report by Kaiser Health News. This illuminates the pressing need for more mental health professionals.

Advanced practice nurses called psychiatric-mental health nurse practitioners (PMHNPs) play a critical role in meeting this need. PMHNPs can work in a variety of environments, from clinics to psychiatric hospitals, taking on a range of roles from primary mental health provider to a more advisory role. Knowing the core competencies and education each setting requires can position future PMHNPs for careers that suit their own objectives and the needs of the health care system.

After obtaining a degree in nursing and becoming a licensed RN, nurses who pursue an advanced degree such as a Master of Science in Nursing (M.S.N.) can find numerous opportunities in the mental health system while also addressing the shortage of psychiatric professionals.

Psychiatric Nurse Practitioners in Clinical Settings

Nurses with an M.S.N. can pursue a number of specializations as nurse practitioners. Those who pursue careers in psychiatric nursing by becoming PMHNPs have the ability to work in clinical or nonclinical settings.

Where do psychiatric nurse practitioners work? Common clinical settings that employ psychiatric nurses include hospitals, family practice or pediatric clinics, psychiatric and behavioral treatment centers, residential treatment facilities and private practices. In hospitals or clinics, PMHNPs are likely to see many patients and encounter a variety of different mental disorders or behavioral issues each day. Their responsibilities typically include interviewing, assessing and diagnosing patients; developing care plans, often in collaboration with physicians and other care providers; administering medications; monitoring care plans and treatment regimens; and counseling both patients and their families.

PMHNPs working in these settings will likely have extensive interactions with other medical professionals, such as physicians and psychiatrists. Another common responsibility is continued communication with patients and their families as they work to develop and monitor a holistic care plan.

Nearly half of U.S. states grant Full Practice Authority (FPA) to nurse practitioners. This allows nurse practitioners to evaluate patients, diagnose illness, conduct medical tests and even prescribe medication. In these states, PMHNPs can open their own private practices.

States without FPA limit the autonomy nurse practitioners have. States with reduced practice authority require nurse practitioners to collaborate with other medical professionals like physicians and doctors to prescribe and administer medication. States with restricted practice authority require nurse practitioners to be under the direction of a physician to practice.

Psychiatric Nurse Practitioners in Nonclinical Settings

Some psychiatric nurse practitioners work outside medical facilities and alongside professionals in other industries. Some nonclinical settings include correctional facilities, public health agencies, corporations, the military and home care. In these settings, PMHNPs require an approach to mental health that comes from a broader, communal perspective that adheres to specific policies or responds to new program developments. Their ability to work with nonmedical professionals is crucial to the success of their careers.

A number of public service roles offer psychiatric nurse practitioners a means of using their skills and experience in unique ways. For example, some PMHNPs pursue forensic psychiatry, which focuses on employing mental health knowledge in the legal system. Forensic psychiatry allows PMHNPs to provide expert testimony to judges during trials and offer expertise in criminal responsibility and juvenile issues.

Another nonclinical role common for PMHNPs is in addiction medicine. This specialty focuses on the assessment of individuals suffering from addiction and the diagnosis and treatment of their illness. While some of these specialists work in clinical settings like hospitals and outpatient clinics, others work in halfway houses or recovery centers.

Psychiatric Nurse Practitioner Skill Set

Regardless of where psychiatric nurse practitioners work, they should be competent in a number of skills. Some core competencies include:

  • Communication and interpersonal skills
  • Critical thinking skills
  • Analytical abilities
  • Teaching and coaching abilities

What makes a PMHNP’s role most unique is their ability to take a holistic approach to patient care, which is based on an understanding of how physical, emotional and environmental factors are intertwined in mental health. As such, common duties may include:

  • Educating patients on their mental health
  • Working with other medical professionals and pharmacists to develop treatment plans
  • Counseling patients and their families
  • Researching and communicating information about their community’s nonmedical services and programs for mental health support

PMHNPs who open up their own practice should also be well-versed in entrepreneurial strategy and leadership, and PMHNPs working in nonclinical settings like private organizations should have some degree of business acumen to understand how their role aligns with an organization’s bottom line.

Make a Difference in the Lives of Others

Many nurses enter the field of psychiatric medicine in hopes of bringing mental wellness and stability to those in need. Recent developments such as the COVID-19 pandemic and the opioid crisis have highlighted the importance of that mission. Given the increased demand for mental health professionals, those interested in becoming a psychiatric nurse practitioner can expect a rewarding career with strong growth in clinical and nonclinical job opportunities.

If you are interested in becoming a psychiatric-mental health nurse practitioner, you can better position yourself for success by enrolling in a graduate program tailored to this profession. Learn more about the University of North Dakota’s online Master of Science in Nursing program, which offers a specialization in psychiatric-mental health studies.

Recommended Readings

5 Skills Needed to Be a Nurse

Supporting Mental Health for Nurses: Why It Matters

How to Start a Nurse Practitioner Private Practice


American Association of Nurse Practitioners, “Issues at a Glance: Full Practice Authority”

CDC, “About Mental Health”

BMC Nursing, “Nurses’ Experiences of the Cause of Their Lack of Interest in Working in Psychiatric Wards: A Qualitative Study”

Health eCareers, “6 Subspecialties for Psychiatric Nurse Practitioners”

Houston Chronicle, “What Skills are Pertinent to Psychiatric Nursing?”

Indeed, What Is a Psychiatric Nurse?

Johnson & Johnson Nursing, Psychiatric Nurse Practitioner at a Glance

Kaiser Health News, “Understaffed State Psychiatric Facilities Leave Mental Health Patients in Limbo

Medical News Today, “What to Know About Psychiatric Nurses”