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Psychiatric NP vs. Psychiatrist: Similarities and Differences 

Psychiatric/mental health nurse practitioner (PMHNP) and psychiatrist are two closely aligned career paths that share many similarities. There are some key differences worth considering, too, though. Both are health professionals that assess and diagnose mental health conditions. They both must possess in-depth knowledge of medications used to treat these conditions, as well. However, the paths to these different professions are very different. What should nurses know about each career path?

What Is a Psychiatric Nurse Practitioner?

A psychiatric (mental health) nurse practitioner (PMHNP) is an advanced practice registered nurse (APRN) that specializes in the diagnosis and treatment of mental health disorders, including prescribing medication. Like all nurse practitioners, this career requires a four-year degree in nursing and advanced graduate studies. The additional education provides them with a Master of Science in Nursing (MSN) degree. They may also go on to earn a Doctor of Nursing Practice degree.

PMHNPs work in a variety of healthcare settings, including but not limited to:

  • Outpatient clinics
  • Hospitals
  • Substance abuse treatment programs
  • Emergency rooms
  • Homeless shelters
  • Correction facilities

In today’s changing healthcare culture, the PMHNP often fills the gaps in underserved populations needing mental health care. The Association of Nurse Practitioners reports that psychiatric/mental health is among the top five certifications sought by nurse practitioners.

What Is a Psychiatrist?

A psychiatrist is a medical doctor (MD or DO) that specializes in psychiatry. Their role involves the prevention, diagnosis, and treatment of mental health disorders, similar to a PMHNP. Unlike a nurse practitioner, though, a psychiatrist must obtain a four-year degree, attend and graduate from medical school, and complete a residency program.

PMHNP vs. Psychiatrist: Key Similarities

Both healthcare careers have similar day-to-day duties. They see patients with various emotional and mental health concerns for treatment. They both make diagnoses and prepare care plans for their patients.

As a nurse practitioner or a medical doctor, you can also do physical exams and order medical laboratory tests. Both use the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as a basis for the diagnosis, testing, and treatments.

They also both use the same treatments to help manage psychiatric symptoms, including talk psychotherapy and medication. They may treat individuals, families, or groups of people. From a patient’s perspective, there are a few differences.

PMHNPs vs. Psychiatrists: Main Differences

Although the job functions of the PMHNP and the psychiatrist are similar, there are key differences worth noting.

Scope of Practice

In many states, a psychiatric nurse practitioner works under the supervision of a psychiatrist. A psychiatrist may review and sign documents and orders from PMHNPs. All states give PMHNPs prescription privileges, though certain states still require them to work under a medical doctor.


Another significant difference is the educational path. First, a psychiatrist must attend medical school, which can take up to four years to complete, then obtain a Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO). After graduating from medical school, they must get a license and then establish residency. The education process takes approximately eight years between college and medical school. They also must go through an additional three to seven years of clinical training in a residency program.

A PMHNP does not need to attend medical school to obtain their licensure. However, they must earn a Master of Science in Nursing degree, which typically takes a minimum of two years if they already hold a Bachelor of Science in Nursing. That means the path to practicing for a PMHNP is about six years, during which time they will also do clinical training.

What Are the Job Duties for Each Role?

The job duties for a psychiatric nurse practitioner and a psychiatrist are also very similar. They both work closely with patients to develop treatment strategies designed to treat mental health issues.

Common job duties for both include:

  • Obtain medical histories from patients
  • Conduct psychological evaluations
  • Determine the risk factors that may have an influence on a patient’s mental health
  • Make treatment plans based on the requirements of the patient and the intended goals
  • Prescribe medications and evaluate their efficacy
  • Provide patient and caregiver education

There are additional duties that a psychiatrist may or may not perform, such as:

  • Examine or co-sign documents and orders completed by mental health nurse practitioners
  • Serve as an administrator at a psychiatric care facility or hospital ward
  • Conduct research on mental health disorders and treatments

Although some of these tasks are not exclusive to psychiatrists, in general they tend to see more administrative work and research opportunities.

What is the Level of Education Required for Each Role?

A psychiatrist must have a medical degree, local state certification, and completion of an internship to practice. PMHNPs, on the other hand, generally hold a Bachelor of Science in Nursing (BSN) and must pursue a Master of Science in Nursing (MSN) or a Doctor of Nursing Practice (DNP).

A program to earn an MSN allows the student to take advanced-practice classes geared toward psychiatric mental health studies. These courses could include topics like:

  • Individual psychotherapy
  • Family therapy
  • Psychopharmacology
  • Psychiatric mental health nursing
  • Advanced assessment practices for psychiatric conditions

The right MSN program will focus on mental health along with advanced nursing.

How Much Does Each Position Earn?

The Bureau of Labor Statistics states that the mean annual wage for a PMHNP is $114,510. A psychiatrist is likely to make around $217,100 annually; however, their education expense is also much higher. They must attend school for at least eight years in most cases. Earnings will vary depending on many factors, including location, years of experience, and skill level.

Choosing the right career path is critical, and there are many things to consider, especially when considering a nursing specialty. For example, becoming a psychiatric nurse practitioner allows you to work in the mental health industry and help patients with mental health conditions, much like a psychiatrist. The American Sentinel College of Nursing & Health Science at Post University can help get you there. We offer a psychiatric nurse practitioner program online that allows you to complete your MSN PMHNP specialization while you continue to work as a nurse.


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Please note jobs, career outcomes, and/or salaries highlighted in this blog do not reflect jobs, career outcomes, and/or salaries expected from any Post program. To learn more about Post’s program and their outcomes, please fill out a form to speak with an admissions representative.