Psychiatric Nurse Practitioner vs. Psychiatrist

According to the National Alliance on Mental Illness (NAMI), 1 in 5 U.S. adults experience mental illness each year, and 1 in 20 U.S. adults experience serious mental illness each year. The need for licensed psychiatric providers is essential. 

Two major types of psychiatric providers are psychiatric mental health nurse practitioners (PMHNPs) and psychiatrists. But what are the differences between these two roles? Keep reading to find out. 

Psychiatric Nurse Practitioner vs. Psychiatrist: What’s the Difference?

Psychiatric mental health nurse practitioners (PMHNPs), also known as psychiatric nurse practitioners, are nurse practitioners who specialize in treating, diagnosing, and counseling patients suffering from mental health treatment and substance abuse. 

Psychiatrists are licensed medical doctors who have completed medical school and a specific residency in psychiatry. 

While a PMHNP and a psychiatrist have similar work settings and scope of practice and treat similar patients, there is one huge difference. A PMHNP is an Advanced Practice Registered Nurse (APRN), and a psychiatrist is a Medical Doctor (MD). 

This difference is seen in their salary but also in education and licensure requirements.

Salary Differences

Psychiatric Nurse Practitioner

According to Payscale, the average annual salary for a PMHNP is $119,377 per year, or $67.87 per hour, much lower than a psychiatrist.

Psychiatrist 

Payscale reports the average annual salary for a psychiatrist as $240,622 a year or $148.90 per hour, much higher than a psychiatric NP.

Education Differences 

Psychiatric Nurse Practitioner Education Requirements

• Graduate from an accredited Bachelor of Science in Nursing (BSN) program
• Gain at least two years of bedside experience working with patients suffering from psychiatric or mental health disorders
• Complete an accredited psychiatric nurse practitioner program
• Sit for your Psychiatric-Mental Health Nurse Practitioner Certification (PMHNP-BC) and state licensure

Psychiatrist Education Requirements

• Earn a Bachelor’s Degree in Pre-Med or a relevant field. 
• Take the Medical College Admission Tests (MCATs)
• Attend medical school
• Complete a four-year residency in psychiatry. 
• Ssit for board certification in Psychiatry by the American Board of Psychiatry and Neurology (ABPN)

Job Duties Differences 

Psychiatric Nurse Practitioner

In general, PMHNPs do the following:

• Assess, diagnose, and treat patients with mental illness or disorders
• Prescribe medication
• Provide therapy and counseling
• Collaborate with MD staff
• Educate patients and families on the resources available

Psychiatrist 

Psychiatrists' job duties can include: 

• Assess, diagnose, and treat patients with mental illness or disorders
• Prescribe medication
• Provide therapy and counseling
• Monitor and titrate medication effectiveness

Psychiatrists can also complete a fellowship program after residency to become specialized in a specific area of psychiatry. Certified by the Accreditation Council on Graduate Medical Education (ACGME), fellowships include:

• Addiction psychiatry or addiction medicine
• Child and adolescent psychiatry
• Consultation-liaison psychiatry
• Forensic psychiatry 
• Geriatric psychiatry
• Hospice and palliative medicine 
• Pain medicine
• Sleep medicine

Scope of Practice Differences

Psychiatric Nurse Practitioner

The scope of practice for NPs is dependent on the state of practice. It differs across states due to varying regulations. 

There are three levels of practice authority granted to nurse practitioners in the US. These include full, reduced, and restricted practice. 

The AANP’s Interactive State Practice Environment map shows NP practice authority in every U.S. state, including Washington D.C. and all U.S. territories.

Psychiatrist 

Psychiatrists have full practice autonomy because of their education, training, and licensure. Unlike PMHNPs, psychiatrists do not focus as much on education and the development of educational resources for patients. 

Work Setting Differences 

Psychiatric Nurse Practitioner

PMHNPs can work in a multitude of settings, both clinical and non-clinical, which can include the following:

• Correctional facilities
• Domestic violence shelters
• Academia
• Hospitals
• Clinics
• Psychiatric hospitals
• Government agencies
• Substance abuse clinics
• Mental health centers
• Assisted-living facilities
• Correctional facilities
• Ambulatory care facilities
• Nursing homes
• Hospice

Psychiatrist 

Psychiatrists can work in a variety of settings, which can include the following:

• Private practice
• Clinics
• Hospitals
• Community mental health centers
• Psychiatric hospitals
• Academia
• Correctional facilities
• Drug/alcohol rehabilitation centers
• Emergency rooms
• Hospice
• Government agencies
• Military
• Court/Legal system
• Nursing homes

Psychiatric NP vs Psychiatrist: Which Career is Right For You?

The decision to become a PMHNP or a psychiatrist should not be taken lightly. Both require years of schooling, advanced training, and licensure. Unfortunately, the decision usually has to be made during undergraduate schooling. 

Why exactly is that? Well, if you are planning on becoming a psychiatrist, then you will need to major in pre-med, take your MCATS, and apply to medical school specifically to become a psychiatrist. 

On the other hand, if you know that you want to become a PMHNP, then you will need to earn your BSN through an accredited nursing program, gain relevant bedside experience, and then apply for a PMHNP program and certification. 

FAQs

Can a Nurse Practitioner Diagnose Mental Illnesses?

Yes! A PMHNP is an advanced practitioner with the proper education and certifications to diagnose and treat an individual with mental illness. 

What is the Difference Between a PMHNP and a PMHNP-BC?

Adding BC after your credentials indicates that you are Board-Certified (BC) by the American Nurses Credentialing Center (ANCC). This is vital for licensure and job opportunities. 

Is a Psychiatric Nurse Practitioner as Good as a Psychiatrist?

Both can diagnose, treat, and counsel patients suffering from mental health disorders and substance abuse problems. However, one is a Medical Doctor (MD) and one is an Advanced Practice Registered Nurse (APRN).