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How to Become a Psychiatric Nurse Practitioner: 6 Step Guide

M.S. in Nursing Nursing Programs

Being a psychiatric mental health nurse practitioner (PMHNP) is a rewarding and highly specialized career that uses medicinal and therapeutic interventions in treatment plans to help patients.

The career is also in high demand. Nearly one in five people (47.1 million) in the U.S. is living with a mental health condition according to the State of Mental Health in America report. But often, access to treatment is limited for the communities most in need of mental health services. Indeed, 154 million people live in an area designated as a health professional shortage area (HPSA) for mental health. And the Health Resources and Services Administration (HSRA) projects that there will be a shortage of more than 250,000 mental health professionals by 2025.

Psychiatric nurse practitioners can help fill that gap, providing access to much-needed mental health services. And they can do that while earning the highest median base salary ($125,000) of all nurse practitioners, according to the American Association of Nurse Practitioners (AANP).

This step-by-step guide will lead you through how to pursue a career in this in-demand field.

Get a FREE guide to help you advance your career, featuring helpful advice and thoughtful insights from nursing experts.

The Six Steps to Become a Psychiatric Nurse Practitioner

Psychiatric nurse practitioners assess patients, study their medical histories and perform comprehensive mental-health testing. They also make diagnoses and create treatment plans. To do all this, they must be registered nurses with graduate nursing degrees — either a master’s or a doctorate — and have the necessary licensures.

Here are the steps you’ll need to take to become a psychiatric-mental health nurse practitioner (PMHNP).

Step 1: Go to Nursing School and Earn a BSN or ADN

To become a psychiatric nurse practitioner, you will first need to attend an accredited nursing school and get either a four-year bachelor of science in nursing (BSN) degree, an associate degree in nursing (ADN), or a nursing diploma.

In 2021, nearly 41% of hospitals and other healthcare workplaces were requiring bachelor’s degrees and 77% of employers strongly preferred BSN graduates, according to the American Association of Colleges of Nursing (AACN). This is a result of evidence that having a bachelor’s-degree trained nurse at the bedside improves patient outcomes.

But an ADN, which you can earn in 18 months to two years, can enable you to work (and earn money) while also pursuing a higher-level nursing degree. For example, an RN to BSN program is designed specifically for registered nurses with an associate degree (ADN) or nursing diploma. And RN to MSN programs allow registered nurses who don’t have BSNs to go straight to a master of science in nursing (MSN) or to complete their MSN and BSN simultaneously.

Learn more about the differences between BSN and ADN degrees.

Step 2: Receive Your RN Licensure by Passing the NCLEX-RN Exam

Once you’ve graduated from nursing school, you must pass the NCLEX-RN exam to become a registered nurse. The National Council of State Boards of Nursing (NCSBN) developed this National Council Licensure Examination (NCLEX) test to determine if you are qualified to begin practice as an entry-level nurse.

The NCLEX questions test you on nursing concepts and require you to decide what to do next in scenarios. They also cover client education, caring, communication with others, knowledge of the nursing process and work documentation.

Registering for the NCLEX-RN

Before you can take the NCLEX, you will need to:

Apply for your registered professional nursing license with the nursing regulatory body (NRB) in the state you want your license in.
Meet all the NRB’s eligibility requirements for taking the test.
Register for the NCLEX-RN exam with Pearson VUE, the official testing company that administers it at one of their testing locations.
Receive your registration acknowledgment by email after the state board of nursing confirms you are eligible to take the exam. The NRB will also mark you eligible in the Pearson VUE system.
Receive your authorization to test (ATT) email from Pearson VUE.
Schedule the date and time of your exam with Pearson VUE and pay the $200 basic registration fee.

About the NCLEX-RN Exam

The NCLEX-RN is a computerized adaptive test of 75 to 265 questions that covers your knowledge, recall and comprehension of the material and your ability to use the material in nursing practice. The questions/answers can be set up as four-option multiple choice, multiple responses, fill-in-the-blank, “hot spot” or ordered responses. They may include charts, tables, graphics, sound and video. You will have five hours to complete the exam.

5 Tips for Preparing for and Passing the Exam

In 2021, 68.9% of all candidates taking the NCLEX-RN for U.S. licensure passed the exam, according to the National Council of State Boards of Nursing (NCSBN). The most effective way to pass the NCLEX is to review the information you learned in nursing school and take the time to study it thoroughly. Plus:

Familiarize yourself with the test format. The NCLEX Candidate Bulletin is your guide to everything about the exam, from how to register to how results are processed. The NCLEX-RN Test Plan includes in-depth information about the exam’s content, how the exam is administered and exercises to help you prepare.
Understand how the NCLEX-RN is graded. Because the exam uses a computerized adaptive testing (CAT) format, no two exams are the same. Instead, as you answer each question, the computer identifies the content area for your next question and finds a question that you will have about a 50% chance of answering correctly based on the estimate of ability it generated for you from your earlier answers. When the computer determines you’ve demonstrated competency with marginal doubt, you will pass. Or you’ll fail when the computer is 95% confident you will not be able to rise above the pass line. The test will end when it makes a pass/fail determination at any point between questions 75 and 265 or it will end at six hours, the maximum time allowed. (In 2021, the average test length was 99 questions, and the average testing time was two hours.) BONUS TIP: While taking the exam, read the directions carefully. Don’t assume you know what they say.
Create a study plan — and then stick to it. Decide which days you’ll study and for how long. Plan out your goals for each study session (for example, to master content on a specific subject or answer a particular number of test questions). BONUS TIP: Don’t try to learn everything at once. Instead, study small sections of content, take a break, and then study more.
Use study aids. As you study, create a review sheet for each textbook chapter so you can look back at it. Create flashcards with the words and terms that challenge you the most, then review them in random order until you’re confident you know them. Practice exams can help you prepare for the real thing. BONUS TIP: As you use your study aids, track your progress, so you know which areas you need to review more.
While taking the test, give each question your best shot. You will be given one question at a time. You may think about each question for as long as you like, but you must answer each one before you can go to the next. Read the question carefully and then give it your best try, selecting the answer you think is the best choice even when you aren’t sure. Answer questions at a reasonable, consistent pace. Also, trust yourself: If you are unsure of an answer, trust your first instinct. BONUS TIP: Because NCLEX questions are written so more than one answer might sound good to you, it’s essential to consider each answer option before selecting one. Eliminate answers you know are incorrect. Then consider the others and ask yourself, “If I could only do this one thing for my patient, what would the outcome be for them?”
Don’t answer questions based on “real world” experiences. Remember that there can be a difference between textbooks and real-life healthcare. The questions on the NCLEX-RN are based on proven research-based and evidence-based practice, so as you read each question, think about what the author of a nursing textbook would do. Don’t consider what you do at work or what you’ve seen others doing. Instead, assume the question is about a “perfect world” scenario in which you have enough time and resources to perform the nursing task at hand – there are no real-life constraints.

Step 3: Gain Requisite Experience as an RN

If you are interested in becoming a PMHNP, research the degree programs you are considering and determine their entrance requirements. Some nurse practitioner programs require at least two years of relevant work experience, believing that it will help you learn a lot about nursing and working with other healthcare professionals. But because nurse practitioners are in such high demand, other NP degree programs will take RNs straight from their bachelor’s or associate degrees. These programs will prepare the RNs to be nurse practitioners capable of providing excellent care with outcomes as good as healthcare providers with previous experience.

Step 4: Earn a Nursing Graduate Degree: Master of Science in Nursing (MSN) or a Doctor of Nursing Practice (DNP)

To become a PMHNP, you must complete either a Master of Science in Nursing (MSN) or a Doctor of Nursing practice (DNP). You’ll want to understand their differences before deciding which graduate program is right for you.

The Master of Science in Nursing (MSN) is the minimum educational requirement for PMHNPs and usually takes two years to complete from a BSN. Generally, it is geared toward nurses who want to specialize clinically.
A DNP is a Doctor of Nursing Practice and is the highest level of education in nursing. It can take up to six years to complete. Like the MSN, it will prepare you for certification as a PMHNP. But it will also equip you with advanced clinical skills and systems thinking, as well as organization and system leadership. If you want to go into teaching or administration, consider a doctoral program.

Note that there is talk of changing the requirements for advanced practice registered nurses from an MSN to a DNP. So if you aren’t planning on enrolling in your graduate education for a few years, recheck the requirements to be sure you enroll in the program that will get you to where you want to go.

Step 5: Get Your Psychiatric Mental Health Certification and Nurse Practitioner License

Congratulations! Now that you have graduated with your MSN or DNP and have 500 supervised clinical hours – and have the nursing license you got in step two – you can apply for psychiatric-mental health nurse practitioner certification (PMHNP-BC). The American Nurses Credentialing Center (ANCC) administers the PMHNP-BC exam, which assesses your clinical knowledge and skills.

You can apply online for the PMNHP-BC test and pay the initial certification fee, which is $395 but is discounted for members of specific nurse associations. For example, members of the American Nurses Association will pay only $295.

The exam gives you three and a half hours to answer 175 multiple-choice questions that cover scientific foundations, advanced practice skills, diagnosis and treatment, psychotherapy and related theories, and ethical and legal principles.

In addition to the certification, you’ll need to apply for your nurse practitioner license once you’ve met the requirements for licensure set by the Board of Nursing in your state.

Step 6: Find a Job as a PMHNP

Psychiatric nurse practitioners can work in a variety of workplaces, including psychiatric hospitals, private clinics or practices, assisted-living homes, community mental health centers, drug and alcohol treatment centers and schools.

Psychiatric nurse practitioners with doctorates can also work as psychotherapists, psychiatric primary-care providers and nurse educators at universities. In some states, they can have a private practice.

While job boards such as ZipRecruiter, Indeed and Glassdoor include nurse practitioner positions, first leverage job centers offered by your school and nursing associations, including the American Association of Nurse Practitioners (AANP) and the American Nurses Association (ANA). Nurse.com says it will use artificial intelligence to match you with roles that fit your experience level, licenses, certifications, specialties and what you’re looking for. Other nursing job sites include NursingJobCafe.com, NurseRecruiter.com, and Health eCareers.

You can also check the job postings listed on the websites of the hospitals or agencies you’re interested in working for.

How to Become a Psychiatric Nurse Practitioner: Three FAQs Answered

Here are three key questions someone might ask if they are interested in becoming a PMHNP so they can help improve the mental health and psychiatric well-being of patients and communities.

How Long Does It Take to Become a Psychiatric Nurse Practitioner? How long it will take you to earn an MSN- or DNP-level psychiatric-mental health nurse practitioner degree and licensure can depend on many things, including your starting point, whether you take classes full time, how long you study for the certification exams and even how long it takes your state to approve your license.

You should expect to be in school for six to eight years from start to finish. For example, a BSN program will take about four years. A BSN to MSN will take about another two years, and a BSN to a DNP will take three to four years.

Can I Become a Psychiatric Nurse Practitioner without a Nursing Degree? While an undergraduate degree in nursing is not required, you must have a Master of Science in Nursing (MSN) or a Doctor of Nursing Practice (DNP) as well as a registered nurse (RN) licensure to become a nurse practitioner.
Can I Become a Psychiatric Nurse Practitioner with a Psychology Degree? A background in psychology could be helpful as a PMHNP, but a psychology degree alone is not enough. You must have an advanced nursing degree and be a registered nurse.

Find the Right Nursing Program for You

If you care deeply about the emotional and mental health of your patients as well as their physical well-being and you are drawn to addressing problems like depression, anxiety, insomnia, dementia and substance abuse, consider becoming a PMHNP. If you do, you’ll be in demand, as patients need the skills of these specialized advanced practice nurses.

Wherever you are in your preparation for a career as a psychiatric nurse practitioner, Franklin University offers programs to get you to your desired degree, including a BS in Nursing (RN-BSN) and MS in Nursing – Psychiatric Mental Health Nurse Practitioner (MSN-PMHNP), and Doctor of Nursing Practice – Psychiatric Mental Health Nurse Practitioner (DNP-PMHNP). Franklin also has a Psychiatric Mental Health Nurse Practitioner Certificate for RNs with an MSN, a Ph.D. in Nursing, or a DNP.

And because Franklin streamlines your education with flexible online coursework and embeds practicum hours that let you practice while you learn, you can complete your MSN-PMHNP degree in 28 months – or even faster, depending on your previous education. Faculty are in-field practitioners who provide individualized attention to all students and support working nurses, while simulation software gives you a dynamic online learning experience that will sharpen your skills before and during your clinical experience.