Psychiatric mental health nursing is a highly specialized field of nursing that registered nurses have the opportunity to move into as they continue their training and advance their qualifications post-licensure. A psychiatric nurse works with individuals, groups, or families and can perform mental health assessments, diagnose mental illnesses, prescribe and deliver therapies.
Unlike many other nurses based in wards or hospitals, a mental health nurse has the chance to work closely with their patients over a longer period of time. Nurses qualified to the nurse practitioner level may deal directly with patients without being under a doctor or a psychiatrist, performing follow-up appointments, assessing the recovery of the patient, and helping them find appropriate ways of coping with their issues
There are many issues that a psychiatric nurse might deal with, including substance abuse, eating disorders, anxiety, depression, stress, and PTSD. These nurses may work alongside a social worker, psychiatrist, doctors, and other health professionals as a part of an interdisciplinary team.
A registered nurse can choose to focus on psychiatric-mental health and work in that field under supervision, but those who are committed to that career often choose to become a Psychiatric Nurse Practitioner. The title of Psychiatric NP is an important one because it indicates the nurse has a significant amount of clinical experience and a high level of academic training. These nurses fill an important role in primary care and the community, offering access to mental health services to those who might not otherwise be able to take advantage of them.
Responsibilities of a psychiatric nurse
Psychiatric nurses have the opportunity to work in community settings, providing support and advice to individuals with a variety of mental health issues, and in some cases supporting their family members and loved ones too. Depending on the level of certification the nurse has, they may find themselves assisting other health care professionals or working more independently, diagnosing and treating mental health issues.
These nurses provide help in the form of short-term interventions and long-term care. This means they get the satisfaction of seeing a patient get their lives back on track and learn to cope with the challenges their mental health condition had given them.
What are the roles and duties of a psychiatric nurse?
Mental health nursing involves a variety of duties, including:
- Assessing patients and diagnosing them based on their mental health symptoms
- Monitoring patients if they work at an inpatient facility
- Educating family members so they can understand how to support a loved one
- Advising family members on care plans
- Working with psychiatric doctors to provide a comprehensive care plan
- Working with patients to set short-term and long-term goals
- Prescribing medications (in states where this is permitted)
What conditions do psychiatric nurses treat?
Psychiatric nurses may work in a community setting, working with people who have many different types of mental health issues. Alternatively, they may choose to focus on one specific area of mental health, for example working at a substance abuse rehabilitation facility, eating disorder clinic or a center for veterans coping with post-traumatic stress disorder.
Some examples of the psychiatric disorders a nurse may assist with include:
- Bipolar disorder
- Substance abuse
- Eating disorders
- Alzheimer’s or Dementia
- Autistic spectrum disorder
- Other developmental disorders
Who do psychiatric nurses work with?
Mental health nursing can involve working with diverse populations. Some nurses serve as psychiatric aides and assist social workers or other care providers. A registered nurse with some training in psychiatric-mental health may work in a care facility, educational setting, or for a large corporation and provide limited mental health nursing services as a part of their wider role.
Psychiatric nurse practitioners specialize in mental health and have more freedom, within their scope of practice, to diagnose, prescribe, review patient care plans, monitor their progress, log records and make decisions about what treatments recommend.
The scope of practice of a Psychiatric Nurse Practitioner depends on the regulations in the state in which they’re licensed. Each state has different licensing requirements and limitations for nurses. Some states allow full practice for all registered nurses, which means an advanced practice registered nurse can practice without physician involvement. Some, such as Utah and Connecticut, require a nurse practitioner to have been practicing for a set number of years under supervision before they can operate independently.
Nurses who are qualified to the RN level will need to be supervised by a physician and are more likely to serve as a psychiatric aide or technician in a bigger clinic.
How much a psychiatric nurse can make
The potential earnings for a psychiatric nurse can vary significantly depending on whether they are qualified to the nurse practitioner level or are working as an assistant or technician. A registered nurse who has taken even some entry-level certifications can expect to earn more than a nurse at the start of their career who has only passed the NCLEX-RN.
According to the Bureau of Labor Statistics, the average pay for a registered nurse is $73,300 per year. This figure is for Bachelor’s prepared nurses and includes all nurses holding the RN title. Those who are at the start of their career will earn less than this, and salaries vary depending on the setting the nurse works in, too.
For example, a registered nurse working in a residential care facility can expect to earn around $66,250 per year, while a nurse working in a government facility could expect an average salary of $79,790.
Earning a specialization increases earnings significantly, and those who hold the title of Psychiatric Nurse Practitioner or Clinical Nurse Specialist can expect to earn far more than a registered nurse. The average salary of a nurse with postgraduate education and certification is $115,800 per year. This figure covers a range of Advanced Practice nurses, not just psychiatric NPs, but nurse practitioners can expect salaries close to that figure, especially if they are working in hospitals or outpatient care facilities.
Where do the highest-paid psych nurses work?
Salaries for psychiatric nurses vary significantly depending on the setting in which the nurse is providing care and also the city and state they’re based in. According to one market survey conducted by Indeed, which looked at the average salary of psychiatric nurses (not nurse practitioners), the city offering the highest pay for nurses in that position was Washington, D.C. ($124,587).
Denver, Colorado also offers high salaries for psychiatric nurses, with an average reported pay of $121,403. In third place is Philadelphia, with salaries of $118,856. This is in comparison to the reported average salary of $76,138 per year for a registered nurse with a specialization in psychiatric-mental health.
According to this survey, psychiatric nurses typically have the opportunity to earn $12,125 from overtime each year. The availability of overtime and level of compensation offered will vary depending on whether the nurse is working in a corporate setting, care facility, or clinic.
What is the job outlook for psychiatric nurses?
Mental health nurses are very much in demand at the moment and that trend looks set to continue in the next few years. As the population of the United States increases, nurse practitioners across all specializations are going to be required to fill the gaps in health care availability.
There are currently 290,000 licensed nurse practitioners, of which just 1.8% have made mental health their primary focus of practice. There’s a shortage of Psychiatric NPs, and the Health Resources and Services Administration lists this field of practice as one of its Health Professional Shortage Areas (HPSAs), stating there’s a need for 6,500 new Psychiatric NPs to fill the gap in the industry.
It typically takes six to eight years for someone who is considering entering nursing as a career to train to become a psychiatric nurse practitioner, and there are many nurses who are currently nearing retirement age. Because of this, it’s likely demand for nurse practitioners will remain high for many years to come.
How experience affects psychiatric nurse salaries
Experience is an important consideration when it comes to working out the expected salaries of nurses in the mental health sector. There are many different job titles in the mental health and psychiatric nursing space, and it can be difficult to tell the difference between them.
Psychiatric nurse practitioners command the highest salaries since they have thousands of hours of clinical experience and are educated to the postgraduate level. At the registered nurse level there are two types of nurses that provide mental health services; the psychiatric nurse, and the mental health nurse.
Psychiatric nurses are registered nurses and tend to earn similar salaries to other registered nurses, giving them an average income of $73,300 per year. These nurses are required to complete an undergraduate-level course of education, pass the NCLEX-RN, then earn a psychiatric mental health certification from the American Nurses Credentialing Center.
Psychiatric nurses may have to work long hours, with 12-hour shifts not being uncommon for nurses working in a hospital environment. They offer crisis intervention services and can work with a variety of patients. A nurse at a clinic may support patients dealing with anxiety, phobias, or trauma. One working in a residential care facility may offer more hands-on care for a senior patient with dementia.
Qualifying as a psychiatric nurse requires two years of clinical experience and 2,000 hours of experience in psychiatric nursing practice. Nurses who have a master’s degree may earn the title of nurse practitioner, giving them more freedom in their scope of practice and higher earning potential too.
Mental health nurses
Mental health nurses fill a similar role to psychiatric nurses. However, their focus is more on providing practical treatments. They work as a part of an interdisciplinary team, but are usually closely supervised and do not diagnose or provide counseling to patients directly.
Mental health nurses often find themselves administering medication and offering advice and guidance to family members to help them understand how best to support a loved one who has recently been diagnosed with a mental health disorder. Pediatric mental health nurses in particular will find they spend a lot of time advising family members about how to cope with children with behavioral issues.
It’s possible to train to become a mental health nurse as a Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN). These are nurses who have completed a short diploma and certification, and who have a much more limited scope of practice than registered nurses. The average salary of a nurse trained to this level is $47,480 per year.
Most mental health nurses pick up more certifications and continue their education with the goal of advancing their careers. Those who are qualified to the LVN/LPN level can take a bridge course to become a BSN and earn their Registered Nurse license, then take further certifications, specializing in pediatric mental health or other areas, or even continuing their studies with the goal of becoming an APRN.
How can you know if you are being paid fairly as a psychiatric nurse?
Because salaries vary so much from state to state, and even between non-profit and commercial hospitals, it can be hard to feel confident that the compensation your employer’s offering you is fair. The average earnings provided by the Bureau of Labor Statistics are for broad categories of the health care profession and don’t take into account seniority or geographic differences.
Figuring out whether your salary is fair will take some research and careful consideration. Take a look at the average salaries for nurses in your state and also look at other job advertisements from your employer.
Try to take into account working conditions, qualifications, hours, and the scope of practice of the job in question. Someone who works as a psychiatric nurse in a hospital may earn more than a person working at an eating disorder clinic because the hospital worker is expected to do 12-hour shifts, whereas the nurse at the clinic works more standard office hours.
In contrast, a psychiatric nurse working office hours at an outreach clinic providing group and family therapy may receive lower compensation than someone working in a memory care facility. The nurse at the memory care facility may have to work with patients who are prone to aggressive outbursts and may deliver a lot of hands-on nursing care as well as therapy sessions.
Another thing to consider is other perks of the job. Some positions offer overtime, health insurance, vehicles, staff discounts or other bonuses that could make up for the lower base pay. Make sure you’re taking the full compensation package into account when deciding whether a job is worthwhile or not.
Schooling costs to become a psychiatric nurse
If you’re interested in becoming a psychiatric mental health nurse practitioner, you’ll first need to train to become a Registered Nurse. There are several pathways into the nursing profession, allowing people to enter the field later in life even if they studied a degree that was not nursing-related, and making it possible for people who perhaps struggled academically in high school to come into nursing via vocational training.
The traditional route into nursing is for a person to study for an Associate’s Degree in Nursing (ADN) or a Bachelor of Science in Nursing (BSN), then take the licensing exam. This allows a person to call themselves a Registered Nurse and work in a variety of healthcare settings.
Taking an ADN is the quickest way to become a Registered Nurse since this qualification takes just two years. However, most hospitals prefer to employ BSN-prepared nurses, because of the higher standard of care they can offer. New York State has introduced a law requiring all Registered Nurses to pass the BSN within ten years of earning their licenses and other states are considering introducing similar laws because statistics show that hospitals with a higher percentage of BSN-holding nurses have lower death rates and shorter average patient stays than hospitals with a high number of ADN nurses.
The BSN is a degree that gives would-be nurses a broad understanding of the field. This degree covers anatomy and physiology, pharmacology, ethics, safety, and patient care, but it does not go into great detail about specific areas of nursing because it wouldn’t be possible to cover every field in-depth in a four-year time span.
That’s why nurses who wish to move to the next level of their careers, becoming an Advanced Practice Registered Nurse, are expected to have thousands of hours of experience in the area they’d like to focus on. In addition, APRNs must earn a postgraduate qualification focused on their chosen specialization.
What degree do you need to become a psychiatric nurse practitioner?
To become a Psychiatric Nurse Practitioner you will need a postgraduate qualification with a focus on psychiatric-mental health. It’s possible to earn the Nurse Practitioner title with a Master’s Degree, but there is a campaign to raise the requirement for Advanced Practice Nurses (in particular Nurse Practitioners) to doctoral level.
The role of the nurse practitioner has expanded significantly over the last several years, and for the benefit and protection of patients, the National Organization of Nurse Practitioner Faculties would like to see all entry-level nurse practitioner programs move to the DNP level as of 2025.
Other organizations, including the American Association of the Colleges of Nursing, have expressed similar sentiments over the years, however, if this change happens it will not invalidate the qualifications of anyone who already has the Nurse Practitioner title.
Entry routes onto nurse practitioner postgraduate courses
If you’re an LPN or an LVN who would like to become a psychiatric nurse practitioner, the first step would be to take an LPN to RN course or go to university part-time to study the BSN.
If you’re a Registered Nurse with an ADN, you have the choice of either studying for the BSN or taking an RN to MSN bridge course. Many online universities offer this for nurses who have a lot of clinical experience. These courses require intensive study because they include some catch-up content to bring ADN-prepared nurses up to speed before covering the MSN content.
BSN-prepared nurses can take an MSN or, in some cases, go straight to the Doctor of Nursing Practice course. The MSN takes two years of full-time study. The length of time a DNP takes depends on the institution, and also whether or not the student already holds an MSN. Courses can be three to four years of part-time study.
If a nurse enrolls on a DNP without having completed a master’s degree beforehand, the institution will expect them to take some catch-up classes to cover essential content from the master’s degree such as evidence-based practice and nursing leadership.
There are approximately 400 institutions in the United States offering NP programs with various specializations. Entry onto advanced practice degrees is competitive, but institutions have the freedom to set their own criteria for admissions. In general, a university will want students beginning an MSN to have:
- A BSN and valid nursing license
- Extensive clinical experience
- A GPA of at least 3.0 at the undergraduate level, including for science courses
- A written Statement of Purpose
Students who struggled with the science courses at the undergraduate level may be able to re-take those courses, or graduate-level science courses before applying for the MSN. Some institutions, such as Johns Hopkins University, offer alternative entry routes such as an MSN for people who studied a non-nursing degree at Bachelor’s level. This qualification allows someone to prepare for the NCLEX-RN and start a career as a nurse, while also preparing them for doctoral-level study and advanced practice in the near future.
What costs besides tuition are associated with becoming a psychiatric nurse?
In addition to the cost of any university degree, nurses will have to consider the cost of certifications. The cost of certifications varies, but most ANCC certifications cost around $395, with a discount for ANA members.
You may also want to consider the cost of practice exams, textbooks, and other study materials to help you prepare for the test, plus the cost of travel to a test center if this is required. There’s usually a fee for re-tests, so it’s worth considering the possibility of needing to take the test a second time if you’re someone who gets nervous when it comes to examinations.
How much does it cost to go to school to become a psychiatric nurse?
Costs for a BSN degree can vary from $40,000 to over $100,000, depending on the university chosen. The average cost of studying for a doctoral-level qualification to become a psychiatric nurse practitioner is around $30,000 for an online, in-state degree.
Costs may be higher if you choose to study at a traditional university or as an out-of-state student. You may be able to reduce the cost of the degree by applying for scholarships or bursaries. In addition, if you are already in employment as a nurse, your hospital or clinic may be willing to fund some or all of your studies in return for continued service.
Scholarships are available for nurses at all levels of study, from baccalaureate to doctoral level. Some examples of organizations offering scholarships include the AfterCollege AACN Fund, the A.T. Anderson Scholarship, and Johnson & Johnson Nursing’s minority student scholarship.
Nurses who are planning to work in nonprofit clinics may be able to take advantage of student loan forgiveness programs after several years of service. Another option is the Nurse Corps, which offers full-tuition scholarships for U.S. citizens in return for a period of service upon graduation. Reasonable additional expenses, such as uniforms and equipment, are included in this scholarship.
Studying to become a psychiatric nurse can be expensive, but the cost is worthwhile for those who are planning to be in the profession for several years. The extra earning potential enjoyed by someone who is educated to nurse practitioner level means they’ll recoup the cost of training within just a few years. Even entry-level nurses can command a salary that is almost double the national median wage, making nursing a financially rewarding profession to get into.
Of course, for most psychiatric nurses, it’s the job satisfaction that truly makes a difference. Psychiatric NPs have the opportunity to work closely with patients over a longer period of time. This gives them a chance to bond with their patients in a way that those who work in fast-moving clinics cannot. Being able to see someone go from struggling with a mental illness to learning to cope with it and live a productive life makes all of the study, long hours and hard work required to get to Nurse Practitioner level worthwhile.