Mental health nursing is a specialty area for those with a desire to help serve those suffering from psychiatric and mental health challenges. Like other nursing careers, it requires compassion, critical thinking and a passion for patient advocacy. Personal awareness of the impact of mental health disorders is sometimes the very motivation that kindles a passion for helping this vulnerable community.
If you’re reading this blog, chances are you may be a working BSN or MSN-prepared nurse who is considering an advanced practice role in a mental health nursing specialty but are unsure if this path forward is right for you. In this article, we explore the responsibilities specific to advanced practice nurses in mental health care and help you determine whether you may find fulfillment in this in-demand nursing specialty.
Nurse practitioners who choose to specialize in caring for patients experiencing mental health disorders may enjoy practice independence depending on the location of service, potential salary increases and security in the positive outlook for job growth. A career working as a psychiatric mental health nurse practitioner (PMHNP) affords this opportunity and can be extremely rewarding, despite the sometimes difficult and complex nature of the work.
Mental Health Providers are Needed
Statistics provided by Mental Health America estimate that approximately 46 percent of individuals in the U.S. will have a diagnosable mental health condition at some point during their lifetime, although these individuals may meet the criteria for diagnosis but never receive a formal evaluation and diagnosis by a health care provider. Similarly, a mental health facts report states that in any given year, nearly one in five adult Americans will have a diagnosable mental health condition. These are staggering numbers.
Relative to the COVID-19 pandemic, rates of anxiety and depression in the U.S. have increased. Before this public health crisis, 10 to 20 percent of people self-reported experiencing symptoms of anxiety and depression. In 2021, this increased to approximately 33 percent due to the pandemic and related stressors, such as:
- Loneliness and isolation from reductions in open businesses and stay-at-home orders
- Uncertainties and financial concerns related to job security and related adjustments
- Grief from the loss of loved ones and restrictions for visiting family in health care facilities
The Health Resources and Services Administration has projected a 15 percent increase in the demand for nurse practitioners in the behavioral health arena from 2017 to 2030. Mental health providers are already needed urgently and recruitment will only increase in the years ahead, making now a great time to become a psychiatric mental health nurse practitioner.
What Exactly Does a PMHNP Do?
A psychiatric mental health nurse practitioner cares for patients and families of all ages throughout their lifespan. The PMHNP specializes in treating mental health disorders, including problems with substance abuse, using a holistic model of care. The assessment, planning, diagnosis, treatment intervention(s) and evaluation of the goals of care are included in the PMHNP scope of practice.
There are many practice settings where PMHNPs are employed, including:
- Primary care clinics and private practices
- Community health centers and schools
- Telemedicine (remote clinical services)
- Hospitals and nursing home facilities
- Public health facilities and academia
The focus of a PMHNP is on the mental health aspects of a patient care plan, including the prescription and monitoring of psychotropic drugs. A family nurse practitioner may care for some mental health disorders but is limited in this area. The scope of practice for a psychiatric mental health nurse practitioner is also holistic in nature, where patient advocacy is at the heart of every interaction. Mental health nurse practitioners coordinate and facilitate psychotherapy, counseling, teaching and other behavioral health strategies such as:
- Implementation of cognitive behavioral therapy
- Group and family counseling
- Addictions treatment and case management
- Trauma-informed practice and interdisciplinary approaches to care
So, how do you know if mental health nursing is right for you? If you find your strengths and passions align with the skills and characteristics necessary for success in the field, you may want to consider how to become a psychiatric mental health nurse practitioner. Next, let’s explore some of the most important qualities for a PMHNP to be successful in the field.
Essential Skills for Mental Health Nurse Practitioners
Mental health nurse practitioners work in advanced practice roles and share the unique ability to maintain composure and strength while persevering through emotionally challenging health care situations. Character traits common to many excellent mental health nurse practitioners are tested in the mental health care arena because these skills must be maintained in environments that can be unpredictable.
It takes great courage and fortitude to enter into professional relationships with patients and families who may be enduring the stigma associated with mental health disorders. It also takes knowledge and wisdom to do this in a way that simultaneously encourages and fosters hope for all involved. PMHNPs are uniquely gifted in the ability to balance many personal strengths and engage these characteristics appropriately in a variety of case scenarios.
Like other patient populations, patients who share similar diagnoses are not all alike in mental health nursing. Each patient may have individual dynamics that require creative approaches to achieve positive outcomes, so flexibility and a willingness to think outside of the box while applying evidence-based protocols are valuable. Next, let’s take a look at five additional skills that are essential for success in clinical practice as a PMHNP.
Skill #1: Excellent Communication
Awareness of both how you carry yourself verbally and non-verbally, and ensuring you speak with appropriate word choice, tone, volume and clarity, is an essential skill for a mental health nurse. PMHNPs are required to give patients education and instructions, and there may be times when emotions escalate. The ability to calm or motivate a patient and promote understanding throughout their treatment is refined with experience.
The assessment phase of the nursing process requires thorough history-taking and interviewing skills. Active listening is part of excellent communication and can be fostered by knowing when to ask open and closed-ended questions, and sometimes when silence is the most helpful choice to serve patients and families well. Communication skills are imperative for the psychiatric mental health nurse practitioner when providing cognitive behavioral therapy or other methods of psychotherapy included in this advanced practice role.
Skill #2: Empathy and Reasoning
You may worry that the ability to relate or place yourself in the shoes of a patient or their family may not come naturally if you have not experienced substantial mental health challenges yourself. However, empathy skills can be learned and successfully demonstrated by a caring PMHNP if they engage in active listening with the goal of understanding what a patient is experiencing.
Patients tend to respond better when it’s evident that you are truly invested in them and their recovery. To balance the emotional side of empathy, it is also good to have a strong sense of reasoning so that you do not become led by your feelings alone. Reasoning is essential to maintain professionalism and to make the sometimes difficult choices that are in the best interest of patients and their families.
Skill #3: Healthy Boundaries and Self-Care
The choice to work as a PMHNP can have substantial rewards when you are a person with healthy boundaries. These boundaries begin with your ability to maintain your own well-being, balancing work and personal life, engagement with the job and time away to rest.
Knowing when you need self-care and the ability to actually give yourself the care you need when you need it most is important for working in nursing and particularly in mental health nursing. Patients and families need the work you do, but you need to keep yourself healthy and strong to serve them to the best of your ability. Fatigue and burnout may become issues if you are someone who struggles with investing yourself in others while failing to make your own needs a priority.
Skill #4: Patience and Resilience
It is important to realize that many mental health disorders are chronic and the therapeutic journey has ups and downs. Working together towards short-term and long-term treatment goals requires patience and commitment from both the health care provider and the patient. As their provider, a mental health patient may look to you as their source of strength and resilience. The partnership a PMHNP and a patient and family can develop has the potential to be meaningful and fulfilling, especially when care is continued over time and therapeutic relationships meet their goals.
Skill #5: Emotional Intelligence
Another essential skill for working in the mental health field is emotional intelligence — the ability to be self-aware, take stock of your own emotions and take into consideration the perceptive and the emotional state of others. You may need to recognize times of manipulation, passive aggression, personal biases and other dynamics that can arise. Introspection and practices of self-reflection along with the ability to mix and relate well to others are helpful when pursuing an advanced practice role in mental health nursing.
PMHNP Degree Paths at Marymount University
As you read about the skills required for success as a PMHNP, it may be helpful to think back on your experiences in life and work thus far. Have you been told you have a strength in communication or teaching others? When thinking about your most meaningful patient interactions, do you remember strong empathy paired with reasoning and patience that led toward the achievement of patient care goals?
If you answered “yes” to these questions and you know the importance of healthy boundaries and self-care, a career in mental health nursing might be a great fit for you. Marymount University is here to help foster your skills into true professional excellence as you learn to apply your strengths and gain resilience in the mental health care setting.
If you want to practice as a PMHNP, consider one of Marymount University Online’s three PMHNP degree paths. The first is an online MSN-PMHNP program that can be completed in just over two years. The MSN program focuses on taking you from your BSN degree into advanced clinical practice by teaching you to apply theory and critical thinking in the mental health care of patients and families across the lifespan.
There is also a BSN to DNP-PMHNP option for BSN-prepared nurses who wish to take their education to the doctoral level. The doctoral program includes an additional focus on leadership and the translation of research evidence into practice along with the development of new approaches to care.
A Post-Master's PMHNP Certificate is also available for those who already hold an MSN and wish to receive training to become an advanced practice nurse in the mental health specialty.
Your passion to help care for those with mental illness is a true gift to those who need it most. If you’re interested in becoming a PMHNP at Marymount, contact one of our student advisors to discuss which pathway is right for you.