What Does a Career as a Mental Health Nurse Look Like?

by Genevieve Carlton
reviewed by Brandy Gleason MSN, MHA, BC-NC
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Mental health nurses positively change the lives of people with mental health conditions.

According to the American Psychiatric Nurses Association, 56 million Americans had a mental health or substance use disorder in 2019 — a number that has grown during the COVID-19 pandemic. Demand for mental health specialists, including mental health nurses — advanced practice mental health nurses, psychiatric mental health nurse practitioners, and mental health registered nurses — continues to grow, with 250,000 jobs projected by 2025.

Mental health nurses serve a vital need in the healthcare community. Thanks to their specialized mental health training, they help patients improve their mental health and overall wellbeing. The field of mental health nursing also offers above-average salaries and opportunities for advancement.

What Do Mental Health Nurses Do?

Mental health nurses care for patients with behavioral, psychiatric, or mental health issues. These nurses create treatment plans in concert with other mental health specialists — including psychiatric mental health nurse practitioners (PMHNPs) or advanced practice mental health nurses, who can administer medication or treatments. Depending on their career and education level, mental health nurses may also conduct assessments or even diagnose patients.

PMHNPS or advanced practice mental health nurses may also collaborate with psychiatrists in conducting psychotherapy and providing family instructions for outpatient care. Some of them may even own their own private practices.

Mental health nurses draw on compassion and patience to help individuals and families managing mental health disorders. They work with a variety of patients, including young children, veterans, and aging patients.

Mental Health Nurse Titles

Mental health nurses work under several titles, including psychiatric-mental health nurse, psychiatric-mental health nurse practitioner, and registered nurse. These titles reflect the nurse's education, nursing level, license, and certifications. Titles can also vary by state and employer, as do job responsibilities. Below are a few common types of mental health nurses.

  • Licensed practical nurse (LPN)
  • Registered nurse (RN)
  • Clinical nurse specialists (CNS)
  • Nurse practitioner (NP)
  • Advanced practice registered nurse (APRN)
  • Psychiatric-mental health nurse practitioner (PMHNP)
  • Psychiatric mental health nurse (PMHN)
  • Advanced practice psychiatric-mental health nurse (APRN-PMH)

Where Do Mental Health Nurses Work?

Mental health nurses work in a variety of settings, including hospitals, outpatient care centers, and community mental health clinics. The setting affects the schedule, job responsibilities, and pay for mental health nurses. For example, registered nurses who work in hospitals or public sector jobs earn higher average salaries than those in ambulatory health services, residential care facilities, or educational services.

Nurses working in hospitals and in-patient settings may work irregular shift schedules with night and weekend work. Those in doctor's offices or outpatient care facilities often work regular business hours. Those working in their own private practices can set their own hours.

Mental Health Nurse Specializations

Within the field of mental health nursing, nurses can specialize in subfields, including substance abuse disorders, eating disorders, and other mental health or behavioral problems. They can also specialize by demographic, such as working with children, patients in the criminal justice system, or service members.

Children and Adolescents

Mental health nurses who specialize in children and adolescents — more commonly called pediatrics — need a strong background in childhood development and children's mental health. They conduct mental health assessments and work with healthcare providers to care for children.

Addiction and Substance Abuse

Nurses with an addiction or substance abuse specialization care for patients managing alcoholism or other substance use disorders. They work in both in-patient and outpatient settings, and they may work with groups or individuals.

Eating Disorders

Nurses who specialize in eating disorders care for patients managing mental health conditions related to eating, including anorexia and bulimia. They may work in residential care or outpatient settings.

Forensics

Forensic mental health nurses work with crime victims and conduct mental health evaluations for legal purposes. They may testify in court about the mental health of an offender or victim.

Military

Mental health nurses in the military care for service members and veterans. They offer comprehensive mental healthcare and are often military members themselves.

Mental Health Nurse Skills

Soft Skills

  • Communication
  • Patience and compassion
  • Physical stamina
  • Attention to detail
  • Critical thinking

Hard Skills

  • Conducting a mental health assessment
  • Creating a plan of care
  • Administering medications
  • Evaluating care plans

Career Information

Registered nurses and nurse practitioners, common credentials for mental health nurses, both benefit from above-average salaries and strong projected job growth, according to the BLS. Nurse practitioners and other advanced practice registered nurses — such as psychiatric-mental health nurse practitioners — earn higher salaries thanks to greater professional responsibilities and a higher required education level.

Salary and Job Growth for Registered Nurses

$75,330
Median Salary

7%
Job Growth (2019-2029)

Bachelor's
Typical Entry-Level Education

Source: BLS

Highest Paying States for Registered Nurses
State Annual Mean Wage (2020)
California $120,560
Hawaii $104,830
District of Columbia $90,050
Massachusetts $96,250
Oregon $96,230

Salary and Job Growth for Nurse Practitioners

$111,680
Median Salary

45%
Job Growth (2019-2029)

Master's
Typical Entry-Level Education

Source: BLS

Highest Paying State for Nurse Practitioners
State Annual Mean Wage (2020)
California $145,970
Washington $126,480
Hawaii $118,780
New Jersey $130,890
Minnesota $118,900

How to Become a Mental Health Nurse

Mental health nurses enter the profession by earning an RN license and working as registered nurses. RNs typically earn their licenses while completing an associate or bachelor's program, where they gain practical experience through clinical practicums.

After earning a degree and working as a mental health registered nurse, healthcare providers can advance their education to pursue careers as psychiatric-mental health nurse practitioners or advanced practice psychiatric-mental health nurses. Nurse practitioners need a graduate degree and can act as primary or specialty care providers.

During a nurse practitioner program, students complete advanced coursework and clinical practicum hours. Below, you will find more details about how to become an RN or PMHNP.

Registered Nurses (RN)

Education

  • Associate degree in nursing (ADN), which usually takes 2 years, or bachelor of science in nursing (BSN), which usually takes 4 years

Clinical Experience

  • Must complete supervised clinical rotations at healthcare facilities. Required hours are set by the state.

Certification and Licensure

  • Nurses must obtain RN licensure from the state nursing board. To do this, nurses must pass the National Council Licensure Exam (NCLEX)
  • Many states require RNs to renew their licenses every two years, but some either require annual renewals or allow up to four years between renewals.
  • RNs need to complete a certain number of clinical hours and continuing education hours to renew their licenses.

Registered nurses can increase their professional responsibilities and earn higher pay by becoming nurse practitioners. The position requires a graduate degree and offers a median salary of nearly $112,000 per year.

Psychiatric-Mental Health Nurse Practitioners (PMHNP)

Education

  • Aspiring PMHNPs — also called advanced practice mental health nurses — must hold an advanced mental health nurse degree, such as master's or doctorate, that focuses on psychiatry.
    • May be a master of science in nursing degree (MSN) or a doctor of nursing practice degree (DNP). Each may take 2+ years to earn.
  • RN-to-MSN bridge programs enable RNs with an ADN to earn master's-level qualifications, getting them more quickly to master's status than if they took the time to pursue a BSN in between.
    • These bridge programs typically take 3-3.5 years to complete.

Clinical Experience

  • Aspiring PMHNPs typically need a minimum of 500 faculty-supervised hours.
    • These are included in psychiatric-mental health nurse practitioner programs.

Certification and Licensure

  • First, aspiring PMHNPs will need an RN license.
  • Then, they will need Psychiatric Mental Health Nurse-Board certification (PMH-BC™).
    • To earn this, nurses must pass the ANCC Psychiatric-Mental Health Nursing Board Certification exam.
      • Application fees are a few hundred dollars.
      • The credential is valid for 5 years.
  • PMHNPs can also pursue certifications in various therapy modalities, such as cognitive behavioral therapy (CBT) or dialectical behavior therapy (DBT).
  • In some states, PMHNPs will need to earn continuing education hours to renew their licenses.

Similar Careers

Mental health nurses aren't the only professionals who assist patients with mental health issues. There are a variety of similar careers. For example, psychiatrists and psychologists care for patients in clinical settings, while mental health counselors and therapists work with people managing behavioral, relationship, or mental health problems.

Psychiatrists are medical doctors who specialize in mental health. They attend medical school before specializing in psychiatry. In practice, psychiatrists can diagnose mental illnesses and provide treatments, such as psychotherapy and psychoanalysis. Psychiatrists can also prescribe medications to their patients. They work in hospitals, metal health clinics, and private practice. Psychologists are behavioral scientists who study human behavior and analyze social interactions. Most psychologists hold a doctorate, and some specialize in counseling psychology and provide counseling services to patients in various healthcare settings. Psychologists primarily work to identify patterns and help patients develop better coping mechanisms. Substance abuse, behavioral disorder, and mental health counselors work with clients who are managing addiction, eating disorders, or other mental health issues. They treat clients through counseling methods that target problem behaviors and strengthen emotional wellbeing. While some substance abuse and behavioral disorder counselors hold a bachelor's degree, most have at least a master's degree. Therapists care for patients in private practices, mental health centers, and medical offices. They offer counseling services for couples, families, and individuals struggling with personal issues. Through therapy, they help patients manage behavioral or relationship problems. Most therapists hold a master's degree, though some roles may only require a bachelor's degree.

What to Look for in a Program

Prospective mental health nurses should carefully research programs to find the right fit for their interests and career goals. Always choose an accredited nursing program to make sure the degree meets licensure requirements. The Commission on Collegiate Nursing Education and the Accreditation Commission for Education in Nursing both grant accreditation for nursing programs.

In addition, consider both in-person and online nursing programs. Some degree-seekers prefer the flexibility of an online college, particularly when balancing school with work.

Mental Health Nurse Professional Organizations

Frequently Asked Questions

true How Long Does It Take to Become a Mental Health Nurse?

Mental health nurses can enter the field with an associate degree in nursing, which takes two years to earn. However, many roles require a bachelor's degree, and advanced practice mental health nurses often need a master's degree.

true What Is the Difference Between Mental Health Nursing and General Nursing?

Mental health nurses focus on mental health issues, including psychiatric and behavioral disorders. Psychiatric-mental health nursing is a specialization within general nursing.

true What Can You Specialize in as a Mental Health Nurse?

Mental health nurses specialize in treatment areas, like addiction or eating disorders, or they work with specific patient populations, such as children or military service members with mental healthcare needs.

true Can You Become a Mental Health Nurse Without Going to University?

Mental health nurses need an RN license, which requires a nursing degree or diploma. Some hospitals offer RN diploma programs, but most nurses attend a nursing program through a college or university.

Genevieve Carlton holds a Ph.D. in history from Northwestern University. After earning her doctorate in early modern European history, Carlton worked as an assistant professor of history at the University of Louisville, where she developed new courses on the history of science, Renaissance Italy, and the witch trials. Carlton has published five peer-reviewed articles in top presses and a monograph with the University of Chicago Press. She also earned tenure with a unanimous vote before relocating to Seattle. Learn more about Carlton's work at genevievecarlton.com.

As an assistant professor of nursing and entrepreneur with nearly twenty years of varied nursing experience, Brandy Gleason offers a unique perspective. She currently teaches within a prelicensure nursing program and coaches master's students through their culminating projects. Brandy has additional expertise as a bedside nurse and a nurse leader, having held past roles at the supervisory, managerial, and senior leadership levels. Her passion and area of research centers around coaching nurses and nursing students to build resilience and avoid burnout. Brandy is also an avid change agent when it comes to creating environments and systems that contribute to the wellbeing of students and healthcare professionals.

Header Image Credit: PeopleImages | Getty Images

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