Where Do Psychiatric Nurses Work?

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A psychiatric nurse meets with a patient.

The need for mental health services in the U.S. is increasing, and mental health professionals to address that need are in short supply. A 2019 study by the American Association of Psychiatric Nurses reported that only 20% of children and adolescents, and 44% of adults, are able to receive the care they need to address their mental health and substance abuse issues. With statistics such as these, the role that psychiatric nurses play in helping people improve their mental health has never been more critical.

Psychiatric mental health nurse practitioners (PMHNPs or psychiatric nurse practitioners) and other types of psychiatric nurses work in a variety of settings. From traditional clinical environments to less traditional settings such as schools and telehealth, the places where psychiatric nurses can work are expanding.

Nurses who want to specialize their practice in mental health as nurse practitioners can pursue an online BSN to Doctor of Nursing Practice degree and can benefit from exploring the range of potential work environments.

Psychiatric Nurses Work in Clinical Settings

Some of the most common clinical settings where psychiatric nurses work include hospitals, outpatient clinics, and private practices.

Psychiatric Hospitals

Patients who are admitted to a psychiatric hospital have been declared unable to care for themselves safely because of a psychiatric illness; they also may be suicidal. Some psychiatric hospitals have specialized units where psychiatric nurse practitioners help treat patients with specific illnesses such as substance abuse or eating disorders.

Psychiatric nurse practitioners in psychiatric hospitals develop treatment and care plans (in conjunction with other members of a medical team), administer medication, and provide individual or group behavioral therapy. They also may be involved in providing electroconvulsive therapy and other types of care.

Outpatient Settings

Examples of mental health outpatient settings include outpatient clinics established within hospitals and community mental health centers. Psychiatric nurse practitioners working in these settings may perform diagnostic evaluation, offer outpatient group and individual therapy, or provide emergency treatment.

Other responsibilities in these settings can include reviewing the efficacy of medication (including whether patients are experiencing side effects) or administering long-acting injectable medications.

Private Practice

Psychiatric nurse practitioners who live in what the American Association of Nurse Practitioners calls “full practice” states can provide care without physician oversight. When operating in private practice, they can evaluate, diagnose, and treat their patients, including prescribing medication, under the authority of their state boards of nursing.

Psychiatric nurse practitioners who open their own private practices help address the shortage of mental health professionals. This can be particularly beneficial in rural areas, where the scarcity of providers is especially acute.

Psychiatric Nurses Can Work in Nonclinical Settings

Psychiatric nurse practitioners also work in a variety of settings that are not predominantly clinical.

School Districts

School districts are recognizing the benefits of hiring psychiatric nurse practitioners to help with students’ mental health challenges. When working in schools, psychiatric nurse practitioners help address a growing need for students to receive treatment for issues such as anxiety and depression by providing services such as therapy or prescribing medication.

Some school districts hire psychiatric nurse practitioners as part of a crisis intervention team to deal with issues such as suicidal behavior or substance abuse. These teams receive referrals from schools and coordinate with community mental health providers to help students obtain needed mental health services.

Correctional Facilities

Jails and prisons are the largest providers of mental health services in the U.S., with more mentally ill persons incarcerated than in hospitals. Yet they face challenges in providing mental health treatment to inmates who need it. For example, jails and prisons sometimes don’t have sufficient staff with the expertise to provide mental health treatment and prescribe medication to offenders. Inadequate funding also has left some jails and prisons unable to provide the treatment and medication that offenders require. This, in turn, has contributed to a long pattern of offenders’ relapsing into criminal behavior.

Psychiatric nurse practitioners who work in correctional facilities have responsibilities such as medication management or providing therapy. One unique aspect of psychiatric nursing in correctional settings is that it can transcend the correctional system itself. For example, nurses in correctional settings are actively involved in making referrals to external community providers of mental health services so individuals can continue mental health treatment after their incarceration ends. Nurses who work in corrections also can be involved in educating individuals such as judges and caseworkers about offenders’ mental health.

Nursing Schools

Nursing schools struggle to hire and retain faculty, particularly those with mental health expertise. As a result, significant opportunity exists for psychiatric nurse practitioners to transition into teaching roles as nursing school faculty members.

Depending on the institution, becoming a member of the faculty may require additional education credentials. A survey from the American Association of Colleges of Nursing revealed the most common qualifications required by nursing schools for vacant faculty positions in the 2018-2019 academic year.

  • 56.1% required a doctoral degree in nursing or a related field.
  • 34.6% required at least a master’s degree in nursing, and preferred a doctorate.
  • 8.7% required a master’s degree in nursing.

Psychiatric Nurses Work in Telehealth

Spurred in large measure by the COVD-19 pandemic, plus the additional ongoing demand for mental health services in rural areas, the growing use of telehealth has significantly expanded the settings where psychiatric nurses can work.

Psychiatric nurse practitioners can use technology to work remotely from almost any setting, treating issues such as stress or anxiety via telehealth. While the effectiveness of telehealth is still being researched, according to a November 2020 article published in the Journal of the American Psychiatric Nurses Association, initial studies have found it has resulted in patients being satisfied with the services provided and able to adhere to their treatment plans.

Finding a Role to Play in Improving Mental Health

With a wide variety of options of where psychiatric nurses can work, the profession can appeal to a range of individuals who want roles in mental health care. Students who are interested in advancing their nursing careers would do well to explore the Regis College online BSN to Doctor of Nursing Practice program and its PMHNP concentration.

Learn how the program can help you achieve your professional goals. Discover a rewarding role in improving mental health today.

Recommended Readings

Benefits of Earning a DNP Degree
How Nurses Can Help Heal Childhood Trauma in Adults
What Is Vicarious Trauma? A Look at an Important Yet Overlooked Concept

Sources:

Academic Psychiatry, “Supporting the Education of Nurse Practitioners and Physician Assistants in Meeting Shortages in Mental Health Care”
American Association of Colleges of Nursing, “Special Survey on Vacant Faculty Positions for Academic Year 2018-2019”
American Association of Nurse Practitioners, “AANP Member Spotlight: Delivering Quality Health Care in Correctional Settings”
American Association of Nurse Practitioners, “Are You Considering a Career as Psychiatric Mental Health Nurse Practitioner?”
American Association of Nurse Practitioners, State Practice Environment
American Psychiatric Nurses Association, Expanding Mental Health Care Services in America: The Pivotal Role of Psychiatric-Mental Health Nurses
American Psychiatric Nurses Association, Psychiatric-Mental Health Nurses
American Psychological Association, Community Mental Health Center
The Atlanta Journal-Constitution, “Pandemic Drives Increased Demand for Nurses in Behavioral Health”
Bangor Daily News, “Mental Health Providers Face Roadblocks as Demand in Rural Aroostook Increases”
Cape Cod Times, “Grant to Help Nauset Schools Address Student Mental Health”
The Daily Gazette, “School District Team Credited with Reducing Mental Health Hospitalizations”
Health Affairs, “Prioritizing the Elimination of Prior Authorizations for Inpatient Psychiatric Care”
Journal of the American Psychiatric Nurses Association, “Adaptation or Revolution: Telemental Health and Advanced Practice Psychiatric Nursing During COVID-19”
Journal of the American Psychiatric Nurses Association, “Will We Be Ready? Preparing Psychiatric-Mental Health Nurses for Future Practice”
National Alliance on Mental Illness, Mental Health by the Numbers
North Texas Help, Types of Mental Health Treatment Settings and Levels of Care
NPR, “Most Inmates with Mental Illness Still Wait for Decent Care”
The Nurse Practitioner, “Telepsychiatry During the COVID-19 Pandemic”
Psychiatry & Behavioral Health Learning Network, “How COVID-19 Is Changing the Nurse Practitioner Role”