PMHNP vs. FNP: Which Nurse Practitioner Career Is Right For You?

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A family nurse practitioner advises a patient.Choosing a helping vocation by becoming a nurse practitioner can be a fulfilling career path for many passionate individuals. Tasked with providing quality care to patients every day, nurses play a vital role in our healthcare system and have the opportunity to change the lives of patients.

For many nurses, becoming a registered nurse is only the beginning; they may go on to pursue an advanced specialty, such as a psychiatric mental health nurse practitioner (PMHNP) or family nurse practitioner (FNP). Specialties that center on mental health and family-focused healthcare services allow nurses to more fully participate in patient care.

Specializing allows nurse practitioners to elevate their careers, compete for leadership roles, and help bridge the gap between doctors and advanced practice nurses. By pursuing an advanced degree, such as an online Master of Science in Nursing (MSN), future nursing leaders can discover the differences between a PMHNP and an FNP and which is right for them, building the knowledge and skills required to take on a nuanced role in healthcare.

What Does a Mental Health Nurse Practitioner Do?

Professionals trained to provide quality mental healthcare are in high demand across the country. Not only are mental illnesses among the most common diseases in the United States, but also more than half of Americans will be diagnosed with a mental illness or disorder in their lifetime, and approximately one in five may experience mental illness in any given year, according to the Centers for Disease Control and Prevention (CDC).

Mental illness isn’t confined to one age group or demographic, making the role of PMHNP a comprehensive care field. Because of what a mental health nurse practitioner does, professionals in the role are at the forefront of a crucial area of medicine; they’re tasked with not only providing quality patient care but also working to fight the stigma against seeking mental health care.

The Role of Mental Health Nurse Practitioners

Unlike any other specialty, the main focus of PMHNPs is conditions of the mind and mental wellness. Recognizing the influence that our mental state has on our physical health, and vice versa, what PMHNPs do is a crucial element of comprehensive and effective healthcare.

As PMHNPs, advanced nurse practitioners evaluate and diagnose patients to provide appropriate care plans, counseling and therapy and to prescribe medications to manage mental health challenges. This may be long-term care, in which nurses are able to build a rapport with patients facing issues such as substance abuse, addiction or trauma, or it may be emergency psychiatric care, in which nurses work to provide efficient and immediate care to individuals in urgent situations.

While the scope of practice between an PMHNP and a FNP may vary, mental healthcare is an integral component of overall patient health, wellness and long-term success, influencing some of the decisions and care options that advanced nurses in both specialties may consider. With advanced education and experience, PMHNPs are able to help their patients face the ebbs and flows of managing mental illness, providing them with the resources they need to pursue a health-conscious lifestyle.

What Do PMHNPs Treat?

PMHNPs provide comprehensive mental healthcare to their patients, treating a wide variety of mental illnesses and disorders and providing counseling throughout a patient’s lifetime. These focuses include the following:

  • Anxiety and depression
  • Substance abuse and addiction
  • Severe mental illness (bipolar disorder, schizophrenia, severe depression)
  • Trauma counseling
  • Behavioral issues
  • Emergency mental healthcare, counseling and treatment

Mental health nurse practitioners work in a wide variety of locations, including hospitals, mental healthcare centers or private practices. Depending on the setting, their duties can vary and influence the type of care or counseling that they’re likely to provide. With a focused education and experience, PMHNPs are able to guide their patients through the challenges of mental illness.

How to Become a Mental Health Nurse Practitioner

Specialization is a valuable opportunity for skilled nurses to pursue the area of nursing practice that they’re most passionate about. While the career paths of PMHNPs vs. FNPs differ, many of the degree steps can be similar, requiring the pursuit of advanced degrees, certifications and board licensure.

For nurses who are passionate about battling mental health crisis across the country, taking the time to learn how to become a mental health nurse practitioner can be inspiring. With an advanced education providing nurses with practical knowledge and skills to pass along to their patients, PMHNPs are able to make mental healthcare more accessible, helping their communities foster support programs and cultivate an atmosphere that encourages individuals to invest in their mental health and wellness.

Steps to Becoming a Mental Health Nurse Practitioner

With the opportunity for skilled PMHNPs to address both the rising rates of mental health disorders and the shortage of primary care professionals, the level of experience and education required to rise to the challenge also rises. Becoming a mental health nurse practitioner begins with qualifying as a registered nurse, which normally requires obtaining a Bachelor of Science in Nursing (BSN) or an associate degree as well as completing a certification.

Future nursing leaders must then pursue an advanced degree program, such as an MSN or a Doctor of Nursing Practice (DNP). Whether becoming a PMHNP or an FNP, it’s during this advanced degree phase that nurses are able to specialize. For PMHNPs, this entails focusing on mental healthcare and treatment, delving into how to assess, diagnose, treat and create a care plan to manage mental health illnesses and disorders.

By completing an advanced degree program, nurse practitioners are able to prepare themselves for the examinations and assessments required to achieve board certification. These certifications can vary by state and specialization, requiring nurses to prove that they’ve met the clinical knowledge and practical skill standards of their field.

Mental Health Nurse Practitioner Qualifications

Different nursing specialties are governed by their own assessment board. The process of becoming a mental health nurse practitioner concludes with seeking board certification and completing the licensure criteria set out by the state boards of nursing and the requirements of each state.

PMHNPs can expect to face the board exam from the American Nurses Credentialing Center (ANCC) before beginning their careers. The exam may cover topics including the following:

  • Psychotherapy care and theories
  • Scientific knowledge and foundation
  • Ethical and legal foundation
  • Analysis, diagnosis, and treatment
  • Advanced practice skill requirements

Obtaining the board certification to become a qualified PMHNP, functions as a professional benchmark, proving that graduates are equipped to provide independent, comprehensive, focused patient care.

PMHNP Salary and Job Outlook

The demand for qualified mental health practitioners is on the rise across the country. While factors such as level of education, work experience, and job location can impact the average PMHNP salary, the American Association of Nurse Practitioners (AANP) reported an approximate median annual salary of $137,000 in 2020, accounting for base salary, productivity bonuses, and incentive payments.

Additionally, for the period 2021 to 2031, the U.S. Bureau of Labor Statistics (BLS) predicted an incredible 46% growth of employment opportunities for nurse practitioners, significantly higher than the national average for all occupations. This increase reflects many factors, including the replacement of workers who are transferring to different occupations or who are retiring, as well as the demand for skilled nurses to address the shortage of both doctors and nurses.

What Does a Family Nurse Practitioner Do?

PMHNP or FNP specialization can be the beginning of a challenging and rewarding career. The United States could see a shortage of nearly 124,000 physicians by 2034, according to the American Association of Medical Colleges (AAMC). In response, nursing leaders and policymakers are pushing for additional training and certifications for nurses, allowing them to provide advanced, comprehensive care to patients and bridge the gap between nurses and physicians.

What family nurse practitioners do makes them particularly well suited to bridge this gap. Tasked with providing comprehensive care to patients of all ages and demographics, qualified FNPs are able to meet many of the needs that are normally covered by primary care physicians.

The Role of Family Nurse Practitioners

FNPs work with patients across their lifetimes, addressing various aspects of care, from preventive healthcare plans to diagnosis and disease management. As a wellness resource for healthy patients; a provider of care for minor injuries; and a source of support for those with chronic illnesses, such as diabetes and hypertension, FNPs must be both resourceful and versatile to meet the demands of their practice.

Evaluating and diagnosing patients, prescribing medications and care plans, ordering diagnostic tests, and performing physical exams — the role of family nurse practitioners is multifaceted. By using resources such as referrals or by collaborating with other nurses, physicians and specialists, they’re able to provide comprehensive healthcare to patients.

Among the many advantages of becoming an FNP is the opportunity to build a healthy rapport and working relationship with patients. These relationships are a key aspect of an FNP’s ability to provide appropriate care strategies and improve patient outcomes.

Family Nurse Practitioner Specialties

The scope of care required of PMHNPs and FNPs spans broad areas of medicine: engaging with patients throughout their lifetime, practicing within various different facilities and requiring a strong foundational knowledge of many aspects of care. This challenging scope inspires many nurses to specialize as an FNP and pursue additional certifications or clinical experience. Additional areas of certification may include the following:

  • Pain management
  • Chronic illnesses (diabetes, hypertension)
  • Obesity management
  • Addiction management and recovery

By coupling an advanced education with further specialization, FNPs are able to take an active role in the treatment of patients, allowing them to improve outcomes and have a hand in decisions throughout patient care.

How to Become a Family Nurse Practitioner

The demands of providing full and comprehensive care to patients of all ages require extensive training, experience and dedication. Learning how to become a family nurse practitioner involves an advanced education in how to properly assess, diagnose, treat and plan care strategies for both acute and chronic disorders as well as long-term wellness-focused or preventive care.

Whether choosing to become a PMHNP or an FNP, a nurse practitioner must dedicate several years of study and supervised clinical practice to qualify as a certified and specialized nurse practitioner.

Steps to Becoming a Family Nurse Practitioner

Requiring many of the same steps as becoming a PMHNP, the process of learning how to become a family nurse practitioner begins with qualifying as a registered nurse, normally completing a BSN before pursuing advanced degree programs and specialties. Typically requiring several years of study, FNPs can look to either an MSN or a DNP to complete their advanced degree studies and FNP concentration.

Family Nurse Practitioner Qualifications

Upon graduating from their advanced degree program, nurses prepare to complete their board-approved certification exams administered by either the ANCC or AANP. As FNPs provide care to patients of all ages, their board certification requires that they’re capable of safely and effectively treating families and individuals, from prenatal to pediatric, adolescent, adult, older adult, and elderly primary care.

For board certification, FNPs must prove that they have adequate working knowledge of areas including the following:

  • Assessment, diagnosis, planning, and evaluation of patient care
  • Pathophysiology
  • Pharmacology
  • Evidence-informed practice

Different states require specific or additional licensure to become fully qualified and practicing FNP. Through advanced education, board certification, and state licensure, FNPs are able to embark on a rewarding career that positively impacts the lives of families and communities.

Family Nurse Practitioner Salary and Job Outlook

Able to work in various healthcare institutions, from hospitals to long-term care facilities, private practices or community clinics, FNPs are uniquely qualified to battle the shortage of nurses and physicians, providing essential care to those who need it most.

According to AANP, the approximate median annual family nurse practitioner salary was $115,000 in 2020, inclusive of base salary, productivity bonuses and incentive payments. While factors such as job location, work experience and level of education impact the average salary, FNPs can rest assured because of the 46% job growth projected by the BLS; myriad opportunities are available to them.

Prepare to Meet Patient Needs and Healthcare Industry Demands

From fighting the stigma of seeking help for mental illness to building a lifelong rapport and providing comprehensive and reassuring care to patients, advanced care nurse practitioners have the opportunity to make a positive impact on the lives of others. Whether they choose the PMHNP or FNP path, becoming a skilled nurse practitioner can be much more than simply a fulfilling career — it can be a calling.

With both PMHNPs and FNPs playing an essential role in filling healthcare industry demands, numerous opportunities are available to nursing graduates. For nurses who are passionate about providing much-needed mental healthcare to patients, pursuing a future as a PMHNP can be rewarding. In comparison, FNPs have the opportunity to provide comprehensive and lifelong care to patients and their families, allowing them to serve both individuals and their communities.

Regardless of specialty, pursuing an advanced degree, such as Duquesne University’s online MSN, is essential to the success of future nursing leaders. With the option to choose between the Psychiatric-Mental Health Nurse Practitioner or Family Nurse Practitioner concentration, prospective nurses can pursue the area of nursing that they’re passionate about, building the knowledge and skills they need for a successful career in the real world.

Discover how this fully online program from Duquesne, with a dedicated support team, small class sizes and a faculty of experienced industry professionals, can open doors for you.

Recommended Readings

The Importance of Leadership Skills in Nursing as the Industry Evolves

Next-Level Nursing: Exploring the Benefits of Nursing Certification

What Are the Nurse Practitioner Specialties Nurses Can Pursue?


American Academy of Nurse Practitioners Certification Board, Family Nurse Practitioner (FNP)

American Association of Colleges of Nurses, DNP Fact Sheet

American Association of Nurse Practitioners, “Are You Considering a Career as a Psychiatric Mental Health Nurse Practitioner?”

American Association of Nurse Practitioners, Are You Considering a Career as a Family Nurse Practitioner?

American Nurses Credentialing Center, Psychiatric-Mental Health Nurse Practitioner (Across the Lifespan) Certification (PMHNP-BC)

American Psychiatric Nurses Association, About Psychiatric-Mental Health Nursing

Association of American Medical Colleges, AAMC Report Reinforces Mounting Physician Shortage

Centers for Disease Control and Prevention, About Mental Health

Incredible Health, “RN vs. NP: A Definitive Overview of Both Roles”

Johnson & Johnson, Psychiatric Nurse Practitioner at a Glance

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National Alliance on Mental Illness, Mental Health by the Numbers

U.S. Bureau of Labor Statistics, Nurse Anesthetists, Nurse Midwives, and Nurse Practitioners