By: Dr. Heather A. Shlosser, DNP, APRN, FNP-BC, PMHNP-BC
Director, Psychiatric Mental Health Nurse Practitioner Program
At Frontier Nursing University (FNU), our goal is to make resources readily available for not only our students, but also those who are thinking about getting or furthering their nursing education. We asked Heather Shlosser, Psychiatric-Mental Health Nurse Practitioner (PMHNP) Program Director at FNU, for her thoughts on becoming a PMHNP. Here were her responses:
Q: Why become a PMHNP?
A: Simply put: Your community needs you to answer the call!
According to the Centers for Disease Control, mental illnesses are among the most common health conditions in the United States. One in 5 Americans will experience a mental illness in a given year;1 in 5 children, either currently or at some point during their life, have had a seriously debilitating mental illness; and 1 in 25 Americans lives with a serious mental illness, such as schizophrenia, bipolar disorder, or major depression (Kessler et al., 2007; SAMHSA, 2016; Marikangas et al., 2010).
Did you know that mood disorders, including major depression, dysthymic disorder and bipolar disorder, are the third most common cause of hospitalization in the U.S. for both youth and adults aged 18–44 (“HCUP Facts and Figures,” 2009)? Further, those living with serious mental illness face an increased risk of having chronic medical conditions. Subsequently, adults in the U.S. living with serious mental illness die on average 25 years earlier than others, largely due to treatable medical conditions and lack of access to care (Colton & Manderscheid, 2006; “Morbidity & Mortality,” 2006).
Let’s also take a moment to consider suicide. Devastatingly, suicide is the 10th leading cause of death in the U.S., the 3rd leading cause of death for people aged 10–14 and the 2nd leading cause of death for people aged 15–24 (“Suicide Facts,” 2015; “10 Leading Causes of Death,” 2015). The lack of access to psychiatric services across the nation has been an unfortunate reality for decades and despite the obvious increasing demand for care, and we see the shortage continue to become increasingly pronounced. Although tackling our mental health crisis most certainly will require a range of interrelated solutions, one key starting point is expanding the psychiatric workforce. Psychiatric-Mental Health Nurse Practitioners provide compassionate, comprehensive, holistic, evidenced based, high quality care and are an ideal solution to fill the gap in access to psychiatric and mental healthcare services.
Q: What does a PMHNP do?
A: PMHNPs assess, diagnose, and treat individuals and families with psychiatric disorders or the potential for such disorders using evidenced based practice guidelines, therapeutic skills, pharmacological intervention, and psychotherapy (APNA, 2014).
They provide some primary care services to the psychiatric mental health population, practice as patient advocates, and are champions of stigma reduction. You can find PMHNPs working in settings such as private practices, substance use disorders clinics, in-patient settings, schools, long-term care facilities, community mental health centers, emergency rooms, urgent care/crisis clinics, primary care and specialty medicine practices, and rehabilitation centers.
Q: How long does it take to become a PMHNP?
A: PMHNPs are registered nurses with advanced masters and/or doctoral degrees, which requires several years of post-secondary education. PMHNPs have advanced education and training in assessment, diagnosis, treatment and planning of mental health disorders including psychopharmacology, psychotherapy, practice evaluation, consultation, care coordination and collaborative care approaches.
Q: Who credentials PMHNPs?
A: The American Nurse Credentialing Center (ANCC) is the board certifying body for PMHNPs. The ANCC board exam is a competency-based examination which consists of health promotion and maintenance,differential diagnosis and disease management, and the use and prescription of pharmacological and non-pharmacological interventions across the lifespan (ANCC, 2018). Once successfully passing the ANCC board examination, the credential awarded is PMHNP-BC. Licensure including scope of practice varies by state and is regulated by the respective state Boards of Nursing, Boards of Medicine and/or Pharmacy Boards.
Are you ready to become a PMHNP? Learn more here.
Agency for Healthcare Research and Quality, The Department of Health & Human Services. (2009). HCUP Facts and Figures: Statistics on Hospital-based Care in the United States, 2009. Retrieved from http://www.hcup-us.ahrq.gov/reports/factsandfigures/2009/pdfs/FF_report_2009.pdf
American Nurse Credentialing Center (2018). Retrieved from nursecredentialing.org
American Psychiatric Nurses Association (2018). Retrieved from apna.org
Centers for Disease Control (2015). Suicide Facts at a Glance 2015 [Data]. Retrieved from http://www.cdc.gov/violenceprevention/pdf/suicide-datasheet-a.pdf
Centers for Disease Control (2015). 10 Leading Causes of Death By Age Group, United States, 2015 [Data]. Retrieved from https://www.cdc.gov/injury/images/lc-charts/leading_causes_of_death_age_group_2015_1050w740h.gif
Colton, C.W. & Manderscheid, R.W. (2006). Congruencies in Increased Mortality Rates, Years of Potential Life Lost, and Causes of Death Among Public Mental Health Clients in Eight States. Preventing Chronic Disease: Public Health Research, Practice and Policy, 3(2), 1–14.
Kessler, R.C., Angermeyer, M., Anthony, J.C., DE Graff, R., Demyttenaere, K., Gasquet, I., …For the WHO World Mental Health Survey Consortium, T.B. (2007). Lifetime prevalence and age-of-onset distributions of mental disorders in the World Health Organization’s World Mental Health Survey Initiative. World Psychiatry, 6(3), 168–176.
Merikangas, K. R., He, J., Burstein, M., Swanson, S. A., Avenevoli, S., Cui, L., … Swendsen, J. (2010). Lifetime Prevalence of Mental Disorders in US Adolescents: Results from the National Comorbidity Study-Adolescent Supplement (NCS-A). Journal of the American Academy of Child and Adolescent Psychiatry, 49(10), 980–989. http://doi.org/10.1016/j.jaac.2010.05.017
National Association of State Mental Health Program Directors Council. (2006). Morbidity and Mortality in People with Serious Mental Illness. Alexandria, VA: Parks, J., et al. Retrieved from http://www.nasmhpd.org/docs/publications/MDCdocs/Mortality%20and%20Morbid
Substance Abuse and Mental Health Services Administration (2016). Key substance use and mental health indicators in the united states: Results from the 2015 national survey on drug use and health. Retrieved from https://www.samhsa.gov/data/sites/default/files/NSDUH-FFR1-2015/NSDUH-FFR1-2015/NSDUH-FFR1-2015.pdf