Doctor of Nursing Practice Specialty Overview: Psychiatric/Mental Health Nurse Practitioner

The many DNP specialties empower nurses to help populations and solve problems they are passionate about. One of those specialties is the Psychiatric/Mental Health Nurse Practitioner (PMHNP). PMHNPs provide primary mental health care services across the lifespan. Primary mental health care includes the promotion of optimal mental health through assessment, prevention, treatment and health maintenance in relation to psychiatric, mental health and addictions disorders.

Below, our Psychiatric/Mental Health Nurse Practitioner Program Coordinator Alyssa Hamel, DNP, RN, PMHNP-BC, provides an overview of the specialty and discusses a common misconception about PMHNPs.

PMHNPs treat individuals with psychiatric, neurocognitive and behavioral disorders across the lifespan.

While my specialty is in eating disorder treatment, I primarily work with adults with a wide variety of mental health disorders, including severe and persistently mentally ill individuals. I see a great deal of PTSD and trauma/stressor-related disorders. The setting I work in is a small community behavioral health clinic in Buffalo. I also have experience treating under-represented and refugee patient populations.

Patients are treated in hospital settings (inpatient), emergency psychiatric settings, outpatient clinics, non-traditional venues (home health, crisis outreach and assertive community treatment), schools and residential areas. PMHNPs can also provide psychiatric consultation on medical services, open an independent practice and provide psychotherapy.

Before becoming a PMHNP, one must first become a registered nurse. Graduates may then continue to specialize in mental health by choosing an advanced program of study. It's encouraged to become board certified by the ANCC in Psychiatry (PMHNP-BC).

I currently practice in a small community behavioral health clinic in Buffalo. I see approximately 12 patients per day for psychiatric evaluation and medication management. I also provide some psychotherapy, but patients primarily see a counselor for a full course of psychotherapy.

I coordinate with primary care providers and specialists (predominantly neuropsychologists and neurologists) and order bloodwork, toxicology screens and EKGs for medical and drug monitoring.

Communication with the entire care team is crucial to remain up to date on the patient’s condition. Sometimes, I evaluate patients and then refer them to a higher level of care, such as partial hospitalization or personalized recovery oriented services. Guiding patients to cultivate more adaptive and positive behaviors and thought processes is a vital component of our work. 

Nurse practitioners are required to obtain 3,600 hours of practice with a collaborating physician before becoming independent. The novice practitioner still has a great deal of autonomy, as the collaborating physician serves as a mentor during those first few years of practice. PMHNPs can establish their own psychiatric mental health practice or join other providers in an existing practice.  

PMHNPs are well-versed in the physiology of the brain and behavior. While we are specialists in mental and behavioral health, PMHNPs need to take the entire human body into account when developing the treatment plan. A psychotropic medication could potentially alter one’s cardiac rhythm, so we need to be competent in ordering EKGs and know what to look for before prescribing this particular medication. The brain and the body are integrated, so it’s critical to train in a holistic approach that includes all body systems. We have increasing literature on trauma and the nervous system and how so many psychiatric disorders affect the entire body. 

A common misconception about nurse practitioners is that they do not have the same responsibilities as medical doctors. In 22 states and Washington D.C., nurse practitioners have full practice authority. This means that they can evaluate patients, order and interpret diagnostic tests, create and manage treatment plans, and prescribe medications without physician oversight. 

Our Post-BS to DNP Program PMHNP specialty develops advanced practice nurses who can deliver compassionate primary care to all adults, from young adults to seniors. Visit our Post-BS to DNP program page to learn more.