In recent years there has been a steep increase in demand for Nurse Practitioners who have a specialization in Psychiatric Mental Health Nursing. This is partly due to the greater value now being placed on this part of the US healthcare system. This has contributed to making psychiatric mental health nursing one of the fastest-growing medical professions in the US.
Psychiatric mental health nurse practitioners (PMHNPs) fulfill a vital role in the mental health care sector, working closely with other medical professionals and patients to develop treatment plans and deliver nursing and medical care. PMHNPs help clients to recover from or manage a wide range of mental health problems, from anxiety and depression to eating disorders and psychosis.
When mental health care services are not available to patients, it has a severe impact on their quality of life. For some patients, lack of support may mean they are unable to work, socialize, or perform day-to-day activities.
There is already a shortfall in the number of PMHNPs in the US, and the forecast is for demand to increase further still. The number of PMHNPs increased by 162% between 2011 and 2019, and growth is projected to continue until at least 2030, with an average increase in demand of 18% per year. This is significantly higher than the national average increase. As of 2022, there are over 9,700 PMHNPs working in the US.
At the same time, there is a shortfall in the number of psychiatrists, and fewer psychiatrists are accepting insurance, which means that more and more PMHNPs are expected to fill some of the capacity gaps. For example, increasing numbers of prescriptions are being completed by PMHNPs rather than by psychiatrists. A study published in 2022 by the Harvard Chan School of Public Health found that in rural areas, around 50% of mental health prescriber visits are being conducted by PMHNPs, rather than psychiatrists.
For many reasons, PMHNPs are playing a part in closing the gap between the demand for and the availability of mental health services in the US. The gap to be filled is considerable, with only 44% of adults and 20% of adolescents and children receiving help for mental health and substance abuse issues when they need it, according to the American Psychiatric Association.
Why is the demand for mental health care growing?
- There is greater general recognition that mental health is a public health issue.
- The Patient Protection and Affordable Care Act 2010 made health care, including mental health care, more accessible to millions of Americans. Quality mental health care services became available to and used by populations who had previously been unable to afford them.
- There is more visibility of some mental health conditions, such as PTSD.
- The topic of mental health is discussed in the mainstream media, and mental health issues are presented in TV and movies.
- Increased insurer acceptance
- The Covid-19 pandemic and associated issues have led to a marked increase in mental health problems.
An estimated one in five Americans was suffering from mental health problems in 2019, equating to 51.5 million people. This was prior to the Covid-19 pandemic. The impacts of the pandemic have made this situation considerably worse. However, access to care is limited, and millions of US citizens are not able to get the support they need to deal with their mental health issues. The pandemic and associated lockdowns resulted in dramatic increases in levels of anxiety and depression. At the peak of the pandemic, 40% of adults reported experiencing symptoms of anxiety and depression. Pre-Covid, the figure stood at 11%. Key drivers were:
- Fear of contracting the virus
- Loss of loved ones
- Social isolation due to lockdowns
- Economic hardship
Research conducted by the American Psychological Association from August to September 2021 and previously from August to September 2020 found that demand for mental health services had increased significantly since the start of the Covid-19 pandemic. 74% of psychologists questioned in 2020 reported an increase in demand for treatment for anxiety. This figure rose to 84% when the study was repeated in 2021. Similarly, demand for treatment for depression had risen by the summer of 2020, with 60% of participants reporting an increase in demand. By the summer of 2021, 72% of psychologists had seen increased demand for depression treatment. Other areas where demand for support had increased included obsessive-compulsive disorders, sleep-wake disorders, and substance abuse. 68% of participants who had a waitlist for patients to access services reported that it had grown longer since the previous year. In 2020, 30% said that demand for mental health services could not be met, while by 2021, this had grown to 41%.
According to the Association of American Medical Colleges (AAMC), 150 million Americans live in areas that have been classified as mental health professional shortage areas. The shortage of psychiatrists is forecast to get worse as demand increases and the number of newly graduated psychiatrists joining the workforce continues to fall short. This puts more pressure on PMHNPs, who are already overstretched, to fill the gap by undertaking some of the tasks which would have been performed by psychiatrists. Increasingly, mental health nurses are taking on clinical responsibilities in treating patients with mental health disorders. The scope of practice for PHMNPs varies from state to state, so in some states, mental health nurses’ roles and responsibilities can help to cover more of what was traditionally the psychiatrist’s role.
What does a PMHNP do?
PMHNPs treat individuals or families who have psychiatric disorders.
- Performing psychiatric assessments
- Diagnosing mental health problems
- Arranging emergency psychiatric care where needed
- Preparing a treatment plan for patients
- Prescribing medication (in states where this is permitted)
- Maintaining medical records
- Providing psychotherapy and other therapies
- Arranging crisis intervention when needed
- Providing support to families and carers
- Educating patients and families or carers on how to manage conditions
What skills are required by PMHNPs?
PMHNPs need to have an in-depth understanding of medical science and neurobiology as it relates to psychiatric disorders, available treatments, and how to manage psychiatric conditions. In addition to the medical knowledge required for the role, there are many soft skills that a PMHNP will need to be able to draw on.
- Compassion and sensitivity
- Ability to be non-judgmental
- Confidentiality
- Emotional stability and self-awareness
- Communication skills
- Ability to form effective relationships with and collaborate with colleagues and patients
- Strong time management
- Managing changing priorities
- Attention to detail
- Critical thinking
- Problem-solving skills
Mental health nurses need to be caring and compassionate to deal with patients who are often in a vulnerable emotional state. Communication skills must be highly developed so that practitioners know how to adapt their tone of voice, volume, and body language for each situation.
Mental health problems and behavioral conditions can affect people of all ages, all socioeconomic backgrounds, and all ethnic origins. In most roles, mental health nurses will need to work with patients from a wide range of populations.
Where do PMHNPs work?
There are many different settings with roles for mental health nurses, including:
- Hospitals
- Outpatient care centers
- Ambulatory health services
- Residential care facilities
- Educational services
- Telehealth
Compensation can depend on the role and the setting. For example, average salaries for roles based in hospitals tend to be higher than for those in residential care facilities. The hours worked and shift patterns also vary depending on where you are working. Private practices and community agencies are more likely to operate in regular daytime hours, whereas hospitals and some round-the-clock practices may be looking for practitioners who can work a shift pattern. Whether you want regular daytime hours or are happy to work a range of shifts, you are sure to find a role to suit your preferences and circumstances with the high demand in the mental health sector.
Online nursing degrees are an ideal way to advance your career. A Master of Science in Nursing degree is designed to develop your skills and knowledge in a range of subjects. The online BSN to MSN-NP degrees offered by Spring Arbor University has several degree specialization options, including the Psychiatric Mental Health Nurse program. This degree will prepare you to progress in your career in psychiatric nursing. If you are a bachelor’s graduate, you can expect to need at least a year of work experience before you can embark on this master’s degree.
A talented faculty delivers all coursework online in a fully flexible asynchronous format, with the exception of a 3-day residency, which is an on-campus event held during the second year. This program allows you to continue to work full-time if you choose to. Your work placement will be arranged as close to your home as possible to avoid disruption to your work pattern and other commitments. With six intakes every year, you can start your studies without delay.
With a median total annual income of $137,000, including bonus payments, mental health nurses are well compensated financially. In addition to this, the job is highly rewarding as you are making a positive difference in people’s lives every day, helping them towards recovery from or better management of their mental health conditions.
