Psychiatric-Mental Health Nurse Practitioner (PMHNP) vs. Psychiatrist — What’s the Difference in 2026

As mental health gains national and global attention, the need for professionals qualified to diagnose and treat mental illnesses continues to rise. Psychiatric mental health nurse practitioners and psychiatrists play a crucial role in meeting this demand. While both of these types of professionals specialize in mental health, their educational requirements, job duties, and scopes of practice differ. Keep reading to learn more about each career path and discover how you can earn a degree that supports continued career advancement in healthcare. 

What Is a Psychiatric Mental Health Nurse Practitioner?

Psychiatric mental health nurse practitioners (PMHNPs) are advanced practice registered nurses (APRNs) who help patients with mental health conditions and provide support during psychological or emotional challenges. While PMHNPs are nurses rather than physicians, their advanced credentials and scope of practice go far beyond that of a registered nurse (RN). PMHNPs have the flexibility to work in a variety of settings, including outpatient clinics, community mental health centers, hospitals, correctional facilities, addiction treatment centers, and through telehealth services. 

Training and Credentials

The path to becoming a PMHNP typically begins with earning a bachelor's degree in nursing, which provides foundational knowledge and skills in general nursing practice. Graduates must then pass the NCLEX-RN exam to gain their RN license.  

After becoming an RN, a nurse must complete graduate-level education to qualify for advanced practice in psychiatric and mental health care. At a minimum, this includes a master’s degree in nursing (MSN) with specialized psychiatric coursework and clinical training. MSN graduates must then pass the PMHNP-BC certification exam through the American Nurses Credentialing Center and obtain a state nurse practitioner license. Typically, this pathway takes six to eight years, though accelerated and competency-based programs can reduce the time required.

Some nurses choose to further their education by pursuing a Doctor of Nursing Practice (DNP). A DNP offers advanced preparation in clinical practice, leadership, and evidence-based care. DNP-prepared PMHNPs are qualified to manage complex psychiatric cases, lead quality improvement initiatives, and support changes in care delivery at the organizational level.

Duties and Scope of Practice

Psychiatric mental health nurse practitioners (PMHNPs) perform a range of duties that contribute to their patients' overall well-being. Their responsibilities include: 

• Conducting psychiatric evaluations. PMHNPs use a variety of assessment tools and techniques to gather detailed information about a patient’s mental health history, current symptoms, and overall functioning. This allows for a thorough understanding of the patient's mental state, which is essential for accurate diagnosis and treatment.
• Diagnosing mental health conditions. PMHNPs use established diagnostic criteria to diagnose mental health conditions such as depression, anxiety disorders, PTSD, and bipolar disorder.  
• Creating and managing treatment plans. They create individualized plans tailored to each patient's specific needs. 
• Prescribing and managing medications. Nurse practitioners (NPs) have prescribing privileges in all 50 U.S. states. In full practice states, they can prescribe independently, while in reduced- or restricted-practice states, they must collaborate with a physician. The types of medications NPs may prescribe, and the level of independence allowed, vary by state law. 
• Providing counseling and education. PMHNPs offer counseling services to individuals, families, and groups. They help patients develop coping strategies and work through personal challenges. They also educate patients about symptoms, treatment options, and practical tools for managing stress.
• Collaborating with other mental health professionals. PMHNPs work with psychologists, social workers, psychiatrists, and other providers to ensure a comprehensive approach to patient care. This collaborative effort is essential for developing holistic treatment strategies that encompass all aspects of an individual’s health. 

Psychiatric NPs help expand access to mental health services, especially in underserved and rural communities with limited access to psychiatric care. By practicing in a wide range of settings, including community clinics and telehealth, they help patients who might not otherwise be able to access mental health services. 

These professionals bring a holistic, patient-centered approach to mental health care. Their nursing background helps them consider the emotional, social, and physical factors that influence mental well-being. This perspective supports continuity of care, meaningful patient education, and long-term management, rather than focusing solely on symptom treatment.   

Job Outlook 

According to the U.S. Bureau of Labor Statistics (BLS), the employment of nurse practitioners is projected to grow by 35% from 2024 to 2034. This growth rate is significantly faster than the projected growth for all occupations. Approximately 32,700 openings for nurse practitioners, nurse anesthetists, and nurse midwives are expected each year during this period.  

Salary 

The BLS reports that nurse practitioners earn a median annual salary of $129,210. Pay varies depending on several factors, including the NP’s education and experience as well as the setting, employer, and geographic location.  

What Is a Psychiatrist?

A psychiatrist is a medical doctor (MD or DO) who specializes in the diagnosis, treatment, and management of mental health disorders. Patients often seek help from a psychiatrist when ongoing mental health issues negatively impact their daily life. As fully trained physicians, psychiatrists are uniquely qualified to assess the interaction between mental and physical health, including how medical conditions and biological factors affect overall well-being. Because they’re doctors, psychiatrists have full prescriptive authority and broad practice autonomy across all U.S. states. 

Training and Credentials

Psychiatrists start their education with a bachelor's degree, often in a pre-medical field. They then attend medical school to earn either a Doctor of Medicine (MD) or a Doctor of Osteopathic Medicine (DO) degree. After medical school, they complete a four-year residency in psychiatry. Some choose to pursue additional fellowship training in specific specialties, such as child and adolescent psychiatry, geriatric psychiatry, or addiction and substance abuse.  

Once they finish their residency, psychiatrists must obtain a medical license in their state, which typically involves passing exams such as the United States Medical Licensing Examination (USMLE) or the Comprehensive Osteopathic Medical Licensing Examination (COMLEX). Many psychiatrists also seek board certification from the American Board of Psychiatry and Neurology (ABPN). 

Overall, the complete training pathway to become a psychiatrist usually takes about 12 years, including undergraduate education, medical school, and residency training. 

Duties and Scope of Practice

Psychiatrists diagnose and treat mental health disorders. They work in many healthcare settings, including hospitals, private practices, inpatient facilities, outpatient clinics, community centers, and telehealth platforms. In addition to healthcare settings, psychiatrists may also work in courts, correctional facilities, and academic institutions.  

While their day-to-day responsibilities can vary by specialty, psychiatrists typically perform the following duties: 

• Evaluating psychiatric symptoms and overall health. Psychiatrists conduct thorough assessments that consider not only psychological symptoms, but also the patient’s medical history, physical conditions, and any other contributing factors that may influence the patient’s diagnosis.  
• Ordering and interpreting diagnostic tests. When needed, psychiatrists may order laboratory tests to better understand how physical conditions affect psychiatric symptoms. 
• Diagnosing psychiatric conditions. Using clinical evaluation and standard diagnostic criteria, they identify specific disorders and distinguish psychiatric symptoms from medical or neurological factors.  
• Developing treatment plans. Psychiatrists create care plans that may combine psychotherapy, pharmacology, and advanced medical interventions such as electroconvulsive therapy (ECT) and transcranial magnetic stimulation (TMS). 
• Prescribing and managing medication. As physicians, psychiatrists are authorized to prescribe medications, monitor patient response, and adjust treatment to address side effects or changing needs.  
• Collaborating with multidisciplinary teams. Psychiatrists partner with therapists, psychologists, social workers, and other medical professionals to ensure continuity of care. 

How Do PMHNPs and Psychiatrists Compare?

Education and Training 

• PMHNPs typically complete six to eight years of education. They need a master’s degree in nursing with a focus on psychiatric and mental health care as well as a nurse practitioner license. 
• Psychiatrists typically complete twelve years of education that includes medical school and a multi-year psychiatric residency.  

Certification and Licensure

• PMHNPs must hold an active RN license, nurse practitioner license, and PMHNP-BC certification.  
• Psychiatrists need a medical license. Many employers require board certification through the American Board of Psychiatry and Neurology. 

Scope of Practice 

• PMHNPs' scope of practice varies by state, but their duties may include patient assessment, diagnosis, therapy, and medication management. Some states require physician oversight.  
• Psychiatrists have full prescribing authority and can treat complex cases and perform advanced interventions. 

Settings

• PMHNPs may practice in hospitals, clinics, substance abuse treatment centers, and correctional facilities.  
• Psychiatrists may practice in hospitals, private practices, inpatient psychiatric facilities, clinics, and other settings. 

Focus/Approach 

• PMHNPs take a holistic, patient-centered approach that integrates counseling, education, and lifestyle interventions.  
• Psychiatrists follow a medical and biological model with a focus on managing complex psychiatric and comorbid medical conditions. 

Salary

• PMHNPs typically earn $120,000 to $130,000 a year.  
• Psychiatrists typically earn $220,000 to $270,000 a year.

Job Market Outlook

• PMHNPs fall under the broader nurse practitioner category. The BLS projects that the employment of NPs will grow by 35% from 2024 to 2034.  
• Psychiatrists are included in the physician and surgeon workforce, which the BLS reports will experience 3% growth from 2024 to 2034. 

Which Path Is Right for You?

If you are deciding between becoming a psychiatric nurse practitioner or a psychiatrist, it helps to consider how each role aligns with your career goals. The psychiatric nurse practitioner pathway allows you to enter the mental health field more quickly, practice with a holistic and patient-centered approach, and work in flexible settings such as community clinics or telehealth. Psychiatry requires a longer and more intensive medical education but offers full practice autonomy and the opportunity to manage complex or medically involved psychiatric conditions, often in hospital, specialized, or private practice settings. 

The choice comes down to what matters most to you. How quickly do you want to begin practicing? Do you want to provide holistic, patient-centered care or focus more on complex medical and psychiatric conditions? Where do you see yourself working? Are you comfortable committing to a longer and more intensive education? Ultimately, choosing between these paths depends on your personal goals, values, and the kind of role you want to play in caring for people with mental health needs. Regardless of which path you choose, pursuing an accredited degree program ensures you gain the knowledge, credentials, and practical experience needed to succeed in mental health care.

Advance Your Healthcare Career with a Degree from WGU

At WGU, you can earn an accredited healthcare degree that prepares you with the specific skills needed to succeed in the industry. If you are just starting out, our Bachelor of Science in Nursing (Prelicensure) program offers a strong foundation in nursing fundamentals and prepares you for RN licensure. For current registered nurses (RNs) looking to earn a Bachelor of Science in Nursing (BSN), we provide a streamlined RN-to-BSN program that builds on your existing knowledge. If your goal is to become a nurse practitioner, we offer two Master of Science in Nursing programs: the Psychiatric Mental Health Nurse Practitioner (BSN to MSN) and the Family Nurse Practitioner (BSN to MSN).