HomeFeaturesPros and Cons of Being a Psychiatric-Mental Health NP

Pros and Cons of Being a Psychiatric-Mental Health NP

Psychiatric-mental health nurse practitioners (PMHNP) or psych NPs specialize and are board-certified in psychiatric and mental health conditions. They are competent in assessing, diagnosing, and providing ongoing care to patients with diverse mental health disorders. They prescribe treatments such as medications and educate both patients and families.

Psych NPs require empathy, integrity, and a good understanding of medicine and healthcare. They can work in various settings such as hospitals, mental health centers, corrections, addiction centers, or private practice. Depending on the state, psych NPs can work autonomously or in collaboration with a supervising physician. There are many advantages and disadvantages of working as a psych NP.

Advantages

The Job is Rewarding

Working as a psych NP is very rewarding, as they are able to positively impact patients’ lives. They care for people suffering from emotional and mental distress, which can range from eating disorders to drug addiction to mood disorders. Psych NPs are able to help others during the most difficult times of their lives. Patients need someone who is caring and compassionate and who attempts to understand their situation. Psych NPs find satisfaction in helping patients when they are most vulnerable.

Improving mental health is a critical factor in well-being. Psych NPs are vital in alleviating suffering and helping patients with the necessary care. They can work one-on-one with patients and provide individualized treatment. This allows for psych NPs to build long term relationships with patients and eventually see them make progress.

Great Pay

Psych NPs have amazing earning potential. According to GlassDoor (2024), the average psych NP makes $153,000 per year. The salary can range from $129,000 to $183,000 per year. Psych NPs can make even more in higher-paying states such as California and Massachusetts. Working in locum tenens, where psych NPs provide temporary coverage, can earn them at least $120/hour.

Further, entrepreneurial psych NPs who start their own practices can easily advance their salaries. They can expect their income to grow over time as the need for mental health practitioners continues to rise.

Flexibility

Being a psych NP allows for plenty of flexibility. Unlike primary care, where a physical exam is typically required, mental health treatment usually only involves a dialogue between provider and patient. As a result, psych NPs can work remotely. They can work in telemedicine and see their patients virtually. Nowadays, most patients prefer seeing their mental health provider virtually. It removes barriers such as travel and taking time off from work. Psych NPs can also work remotely in care management. This is where they provide curbside consults, in which they review PCP notes and offer feedback and insight into the patient’s treatment plan.

Not only is there flexibility in working remotely, but there is also flexibility in a psych NP’s schedule. Since they do not need to conform to regular office hours, they can choose to work evenings and/or weekends. This is especially helpful to working parents who may want to be available to their children during normal working hours.

These hours also allow flexibility for patients. For psych NPs who are not interested in working remotely, they have many options in selecting a workplace setting. They can work in inpatient psychiatric unit hospitals, crisis centers, outpatient primary care offices, or addiction or rehabilitation centers.

Increasing Mental Health Awareness and Access to Care

In the past, there was a lot of stigma associated with mental illness, which prevented people from seeking help. Fortunately, that trend has changed, and more and more people are obtaining mental health care. Self-care is fundamental for overall well-being. There has been an upward trend of more and more people prioritizing their mental health.

Psych NPs increase mental health awareness and empower the community to seek help when needed. People are learning that when they care for their mental health, their emotional and physical health improves. They can manage life stressors in a healthy and uplifting way.

Psych NPs working in community-based or primary care clinics improve access to mental health care. Even working via telemedicine on online platforms can increase accessibility to care and decrease out-of-pocket expenses for patients. It also allows providers to spend more time with patients. Telemedicine closes treatment gaps and strengthens crisis response.

Specialty is in Demand

Mental healthcare is one of the most in-demand fields in healthcare. According to the National Institute of Mental Health, one in five adults undergoes mental illness each year. Since there is a current shortage of mental health workers, there is excellent job security working as a psych NP. The need for psych NPs will only grow with time.

The U.S. Bureau of Labor Statistics (2024) predicts that overall employment for nurse practitioners will grow by 46 percent between 2023 and 2033. Society has learned that mental health can greatly impact physical health and wellness. Younger generations, such as Millennials and Gen Z, have sought out mental health care from an early age. Doing therapy has become as common as exercising. With more people seeking mental health care services, the need for more psych NPs will continue to expand. Consequently, long-term job prospects for PMHNPs are favorable.

Challenges

Empathy Fatigue

Being a psych NP involves managing patients with complex mental health disorders, traumatic events, and personal crises. They treat both chronic and acute mental health conditions in addition to neurodevelopmental disorders. Some of the most common disorders they treat are anxiety, depression, insomnia, mood disorders, personality disorders, and psychotic illness. They also manage patients with post-traumatic stress disorder, attention deficit hyperactivity, autism, substance use disorders, and eating disorders.

Psych NPs spend countless hours listening to patients confide in them with all of their problems. It can be emotionally exhausting listening to patients “complain” all day or witnessing them cry as they talk about their struggles. It can be challenging to reorient patients to facts and help them focus on having a positive mindset.

Unfortunately, being a psych NP can be a thankless job. Patients sometimes lack gratitude and can even displace their feelings and frustrations on their provider. Once patients are doing better, the NP may never hear from them again or know that their hard work has paid off.

Difficulty Finding a Work-life Balance

Working in mental health can be stressful. Psych NPs have to listen to patients talk about negative feelings and experiences all day. Since there is limited access to mental health services, the quantity of patients seen per day can be high. Psych NPs spend a lot of time documenting each visit. There can be more paperwork to complete, which is time-consuming.

As a result, psych NPs may require a significant amount of time to decompress after a work day. Sometimes, they must be on-call and available to patients with acute crises. Due to the above burdens, psych NPs may need help to focus on other aspects of their lives, even during their free time. They are at increased risk of burnout.

Maintaining Appropriate Boundaries

A major challenge for psych NPs is that it is easy to become emotionally invested in patients and their progress. NPs come from a nursing background and care about their patients. It is possible for psych NPs to get emotionally attached to their patients. So, if a patient has a relapse or an exacerbation of their symptoms, the psych NP may feel discouraged. They may also take it personally and contemplate what they could have done differently for their client.

It can be difficult for psych NPs to maintain appropriate boundaries with their patients. They may be available 24/7, and the patient may become dependent on them. As nurses, they see patients holistically and help them with other aspects of their health. For example, they may go out of their way to make sure patients have certain comforts, such as socialization, or basic needs, such as food.

High-risk Work Setting

Being a psych NP involves working in high-risk work settings. This includes working in psychiatric hospitals or corrections where patients are not allowed to have any item that can be used as a weapon. Sometimes, they will have to deal with aggressive or violent patients. They will have to remain calm and avoid triggering patients.

Psych NPs should be prepared to manage angry patients that may sometimes lead to physical confrontations. Security is typically available, but psych NPs will need to try to get the aggressive situation under control while waiting for security to arrive.

Sophia Khawly, MSN

Writer

Sophia Khawly is a traveling nurse practitioner from Miami, Florida. She has been a nurse for 14 years and has worked in nine different states. She likes to travel in her spare time and has visited over 40 countries.

Being a traveling nurse practitioner allows her to combine her love of learning, travel, and serving others. Learn more about Sophia at www.travelingNP.com.