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Psychiatric Mental Health Nurse Practitioners: Filling the Gaps in Mental Health Care

April 2014

With an increasing shortage of mental health professionals across America, the demand for mental health services often exceeds the availability of mental health providers in many parts of the country. In fact, as of January 1, 2014, the U.S. Department of Health and Human Services reported that there were approximately 3,900 Mental Health, Health Professional Shortage Areas (HPSAs), defined as areas or populations that have an identified shortage of mental health professionals. 

This gap will continue to worsen if steps are not taken to address the mental health workforce shortage – and that’s where nurses can step in, according to Michael Rice, Ph.D., APRN-NP, FAAN, professor and endowed chair of psychiatric nursing at the University of Colorado College of Nursing in Aurora, Colo.

“Nurses can help fill a major gap in the availability of mental health professionals across the country, particularly in rural areas where mental health nurses and physicians are often in short supply,” said Rice. “As an advanced practice psychiatric nurse, you can help provide the primary mental health services that so many patients across the country need.”

Psychiatric mental health nurse practitioners (PMHNP) provide care to individuals, families or populations who are at risk of developing or who have common, acute or chronic mental health problems or illnesses. They have many of the same responsibilities as psychiatrists, including diagnosing mental illness and prescribing medication, and often act as therapists, helping patients with depression, anxiety and other conditions that can be remedied with counseling.

“Psychiatric nurse practitioners primarily focus on health promotion, pathophysiology, psychopharmacology and physical diagnosis – those are the basic building blocks,” said Rice. “They also provide short-term psychotherapy and psycho education for their patients, among other primary mental health services.”

PMHNPs may work with children, adolescents, adults and the elderly in a variety of settings, including community mental health clinics, public health departments, hospitals and outpatient mental health clinics, as well as health maintenance organizations, government facilities, schools of nursing and independent private practices.

According to Rice, the role of PMHNPs has evolved in the past decade to become more evidence-based. While a major portion of the evidence-based practice movement is directed toward developing clinical guidelines, a critical element for mental health focuses on the therapeutic relationship and clinical judgment associated with providing care.

“The psychiatric nurse practitioner role now has a lot more to do with the science of evidence-based care and practice,” said Rice. “Knowing what the evidence-based guidelines are and how to implement them is very important for effective assessment and response to the psychiatric, psychosocial and psychoeducational needs of individuals, families and groups.”

The American Psychiatric Association (APA) provides clinical practice guidelines with evidence-based recommendations for the assessment and treatment of psychiatric disorders, including acute stress disorder, bipolar disorder, panic disorder and substance use disorders, among others. Additionally, the Journal of the American Psychiatric Nurses Association (JAPNA) provides peer-reviewed articles with the newest and most effective evidence-based nursing practices and innovative therapeutic approaches.

Through application of evidence-based research skills, PMHNPs can evaluate systems of care, design evidence-based practice solutions and work in collaboration with the multidisciplinary team, which may include psychiatrists and other mental health professionals. Together with the treatment team, PMHNPs can develop detailed plans to provide the comprehensive care patients need to live their best lives.

“The collaborative approach in mental health is especially important when caring for severe chronic conditions,” said Rice. “Team members can work together to provide appropriate care and monitor the patient’s progress.”

Interested in becoming a PMHNP? Currently, completion of an accredited master’s or doctoral advanced practice nursing program is required to become a PMHNP. Requirements for entry into these programs typically include a bachelor’s of science in nursing (BSN) and a valid registered nurses license. Each certified PMHNP must also pass a national certification examination. To maintain certification, every five years PMHNPs must complete 75 to 150 continuing education credits and accrue 1,000 practice hours.

“It’s important for nurses in this field to have what I call ‘lightning in a bottle’ – it’s a mix of scientific skill and a relational capacity. We spend a lot of time relating to people and looking at relationships and interactions, so it’s important for psychiatric nurse practitioners to be relationship-minded and be interested in helping people improve their mental health and relationships with others.”

For more information about psychiatric mental health nurse practitioners, visit www.discovernursing.com

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