Seeking care for your mental health condition is an important part of your long-term well-being. The type of mental health care you pursue depends on a number of factors, like what kind of treatment modality you prefer. What will your insurance cover? Does the provider accept cash payments instead of insurance?
One other factor is who you work with. It should be someone who delivers the type of care you’re interested in and is someone you feel comfortable working with long-term. But another thing to consider is the type of provider. For many people, the choice comes down to working with a psychiatrist or a psychiatric nurse practitioner.
Many people think that psychiatrists focus only on the brain, and psychiatric nurse practitioners treat the body, but that’s not necessarily the case. Both disciplines routinely manage the whole person because the head and body work together.
So, what is the difference between a psychiatric nurse practitioner and a psychiatrist? And which one should you choose for your mental health treatment?
What Is a Psychiatric Nurse Practitioner?
A psychiatric nurse practitioner (PNP) is a specialized type of nurse. Also known as a psychiatric mental health nurse practitioner (PMHNP), they are a type of advanced practice registered nurse. As a PMHNP, they have graduate-level training (a Master’s degree or Doctoral degree, at least six years of education) and completed 1,000 hours of a practicum (work in a clinical setting) in mental health care. They have completed a national board exam in psychiatric nursing. PMHNPs are licensed by the state and treat mental health conditions with a combination of medication management and psychotherapy.
What is a Psychiatrist?
A psychiatrist is a medical doctor (MD) or Doctor of Osteopathic Medicine (DO), meaning they’ve completed medical school, completed at least four years of residency in mental health, and have passed a national board exam in psychiatry. Psychiatrists are licensed by the state and can diagnose and treat mental health conditions with a combination of medication management and psychotherapy.
Similarities Between Psychiatric Nurse Practitioners vs. Psychiatrists
Psychiatric nurse practitioners and psychiatrists are similar in that their primary focus is working with patients with mental health conditions. Both specialities can:
- Evaluate a patient’s mental health condition
- Deliver psychotherapy services
- Provide medication management services
- Monitor the side effects of any medications the patient is on
- Coordinate care among multiple mental health care and medical doctors when necessary
However, this is where some of the similarities end.
Full Practice Authority: What It Is and How It Makes a Difference
Some states grant psychiatric mental health nurses full practice authority, meaning they can practice and provide services without a medical doctor’s oversight. In states where PNPs have full practice authority (including Washington State), they can:
- Prescribe medications — including controlled substances
- Provide an initial diagnosis and treatment plan
- Change medications and dosages
- Order and interpret relevant labs
- Provide long-term care and support to prevent relapse and improve long-term well-being
In essence, a psychiatric mental health nurse with full practice authority can practice independently in the same way as a psychiatrist.
Differences Between Psychiatric Nurse Practitioners vs. Psychiatrists
The broad duties of psychiatric nurse practitioners and psychiatrists are the same, even in states where PNPs don’t have full practice authority. The main difference often comes down to a practitioner’s approach to patient care, where they practice, and how they collaborate with other mental health providers.
However, the nuances between a psychiatric mental health nurse practitioner and psychiatrist are real and important.
Psychiatrists may perform some medical procedures in a hospital. They’re also more likely to be the attending physician in a hospital or inpatient mental health facility and lead or manage inpatient mental health treatment plans.
While a psychiatric mental health nurse may work in a hospital or inpatient mental health setting, they don’t perform any medical procedures. Psychiatric nurse practitioners also don’t have admitting privileges, even when a patient is having a mental health crisis.
What About Psychologists?
Like psychiatrists and PNPs, a psychologist provides mental health services. They can:
- Administer psychological evaluations and assessments
- Diagnose mental health disorders
- Provide psychotherapy services
- Practice independently
The primary difference is that a psychologist has a Ph.D., meaning that they did not go to medical school and are not a medical professional. Therefore, most states do not allow psychologists to prescribe, adjust, or discontinue any psychiatric medications, even when they have full practice authority. It also means psychologists can’t provide medication management services or help you deal with the side effects of any of your medications.
When to See a Psychiatric Nurse Practitioner vs. a Psychiatrist
Both psychiatric nurse practitioners and psychiatrists are trained medical professionals who focus on helping people with mental health conditions. Though their education and training are different, both can provide similar or even the same services, particularly in states where a PNP has full practice authority. So, how do you choose between a psychiatric nurse practitioner and a psychiatrist?
Ultimately, the choice comes down to accessibility, affordability, and personal preference. You should see someone you trust, and who has a treatment approach you’re comfortable with. Here’s what to consider.
When to Choose a Psychiatric Nurse Practitioner
Psychiatric nurse practitioners can help manage some complex mental health conditions, though some patients may be better managed by a psychiatrist. A PNP can treat someone who’s tried several psychiatric medications without success or has treatment-resistant mental health issues. Often, PNPs can schedule your first appointment quickly. They’re also more likely to accept insurance and may charge less than a psychiatrist if you prefer to pay cash.
Unlike a psychiatrist, who may approach care and treatment through a disease model, a PNP takes a more holistic approach to your care, treating a patient’s emotional and social needs to improve health outcomes. Many PNPs tend to collaborate with other mental health and medical providers you may be working with, allowing them to take an integrative, holistic approach to care, developing a treatment plan that fits your lifestyle and preferences and changes based on your response to treatment, instead of being authoritative.
When to Choose a Psychiatrist
Psychiatrists often have longer wait times before you can see them for an initial appointment. However, if you have:
- Complex mental health concerns
- Co-occurring disorders (like high blood pressure or diabetes)
- Treatment-resistant mental health issues
- Need inpatient services
- Tried several psychiatric medications that haven’t helped
a psychiatrist may be the better fit for you.
Find Your Fit
When it comes to choosing between a psychiatric nurse practitioner and a psychiatrist, there are no wrong answers. Ultimately, the best fit for you is someone who delivers the kind of care you’re looking for and you feel good about working with.
Owens Mental Health’s psychiatric nurse practitioner has full prescriptive authority in Washington State and provides psychiatric care and medication management services to anyone struggling with their mental health. Schedule a free consultation and take the first steps toward living a happier, healthier life.
