How to become a mental health nurse in the USA

By ShiftMed Team//Nursing Profession
Mental health nurse talking to a patient

What do you imagine when you think of a nurse?

Most people picture someone who wears scrubs and works in a hospital or doctor’s office, tending to patients at their bedside, administering medication, or helping the doctor perform exams. 

People think of nurses as caring for their patient's physical well-being, but mental health is just as important. So that’s where mental health nurses come in. 

Mental health nurses care for people with psychiatric conditions, which may or may not coincide with physical ailments. A psychiatric mental health nurse (PMH nurse) advocates for some of the most highly stigmatized, misunderstood patients in healthcare. They’re not only health specialists that help people improve their lives; they offer support, education, and guidance to family members and caregivers as well. 

Mental illness can debilitate someone for some time or cause lifelong effects. Whether someone is temporarily experiencing a crisis or they have a chronic psychiatric disorder, mental health nurses are there for them. 

Most importantly, mental health nurses remind patients that having a psychiatric diagnosis doesn’t mean they can’t go on to live meaningful lives. 

If you are passionate about combating stigma and helping people who need compassionate, specialized care for mental health disorders, here is how to become a certified psychiatric nurse.

Read More: What is a mental health nurse?

What are the steps to becoming a mental health nurse (MHN)?

In the United States, 1 in 5 adults has a psychiatric disorder. Although anxiety and depression seem like “everyday” mental health problems, their impact on a person’s life can be crippling and devastating to them and their loved ones. 

Out of the American population, 1 in 20 adults experiences a serious mental illness each year. You may think, “Aren’t all mental illnesses serious?” Yes, they are. But in the psychiatric world, a serious mental illness impacts a person’s functioning so much that they can’t perform daily activities. These are some of the patients who need mental health nurses the most. 

If you’re interested in pursuing psychiatric nursing, here is a mental health nurse career path to guide you. 

1. Earn an ADN or BSN degree

You can earn an associate’s or bachelor’s of nursing degree to start your career. Bachelor’s degrees are becoming more favorable among employers and students alike because they give you a broader education and more time in clinicals. 

Moreover, you could look for opportunities to work directly in mental health care during your BSN program. This could improve your chances of finding work in mental health nursing as soon as you graduate.

If you decide to get an associate’s degree instead, or you’ve already completed yours, don’t worry. There are plenty of RN to BSN degree programs online and in person that you can take to get your bachelor’s. 

Make sure you choose a nursing program accredited by the Commission on Collegiate Nursing Education (CCNE) or Accreditation Commission for Education in Nursing (ACEN). 

2. Get experience with mental health patients

With mental health as your nursing specialty, you’ll have to get clinical experience working directly with people with psychiatric conditions. For example, you may work with people in a hospital psychiatric ward or look for opportunities as a mental health nurse in long-term psychiatric facilities or substance abuse and mental health treatment centers. 

Mental health nurses can also work in retirement homes, schools, community-based mental health practices, family care clinics, and private practices. It all depends on where you live and what type of patient population you want to work with.

What matters is that you have at least 2,000 hours of experience providing mental health nursing before applying to take the certification exam. 

3. Study for and pass the PMH-BC certification

To qualify for the PMH-BC certification exam, you must hold a valid RN license in the US or Canada and have at least 2,000 hours of clinical practice in mental health within the last three years. You must also complete 30 hours of continuing education courses in psychiatric and mental health nursing within the previous three years.

You can take the PMH-BC exam through the American Nurses Credentialing Center (ANCC). You’ll have three and a half hours to answer 175 questions, and you can take a proctored exam online or at an approved testing center.

Once you pass, you’ll officially be a board-certified psychiatric mental health nurse, and you can begin treating more patients and finding even more job opportunities. 

You’ll have to renew your PMH certification every five years. Remember that you must renew your RN credentials separately through your state’s nursing board.

4. Apply for psychiatric mental health nurse jobs

Now that you are certified, you can apply for jobs requiring mental health nurses with certification and experience. Your background in mental health nursing will qualify you to work with a wide range of patients, including children, teens, adults, and seniors.

You can also choose to specialize in certain types of mental health nursing, like child development disorders or adults with substance abuse problems. 

You may also decide to join the American Psychiatric Nurses Association (APNA) to connect with a community of mental health nurses that spans the country. The APNA is also a great resource that can help PMH nurses perform continuing education, research, and network. 

Can you become a mental health nurse online?

You can earn part of your nursing degree online and take the mandatory continuing education courses for the PMH-BC exam. However, if you decide to attend nursing school online, remember that you’ll still need to perform clinical rotations in person.

You can’t do nursing clinicals online because nothing replaces the meaningful and highly educational experience of working one-on-one with actual patients. By the time they graduate, nursing students have spent years in various healthcare settings, building the confidence and clinical skills they need to succeed as independent, entry-level RNs.

What is the difference between a general nurse and a mental health nurse?

A general or registered nurse can treat patients of all ages across various settings. They may work exclusively in hospitals, private practices, clinics, home care, retirement homes, or schools. They have a diverse skill set that allows them to pursue many different career paths, including a specialty in mental health.

Mental health nurses have dedicated their careers to helping people with psychological disorders and psychiatric illnesses. They work exclusively with members of this population and are trained to provide mental health nursing that’s empathetic, empowering, and affirming. 

Mental health nurses also have unique tasks related to their job, such as:

  • Closely monitoring patients’ mental and behavioral symptoms, and record changes

  • Assessing and reporting any dysfunction in a patient, ensuring their doctor, social worker, or psychologist is notified 

  • Administering psychotropic medications, like antidepressants, mood stabilizers, and antipsychotic drugs

  • Escorting patients to and from therapy sessions in a healthcare facility or rehab center

  • Providing psychoeducation to patients and their families

  • Identifying warning signs of mental health crises and provide appropriate, immediate emergency responses

  • Comforting, directing, and supporting patients according to the best psychotherapeutic practices and mental healthcare protocols 

  • Coordinating with members of a patient’s healthcare team to ensure that their care plans are being properly carried out

  • Serving as a case manager for their patients, connecting with services they need, and acting as a liaison between different healthcare professionals

  • Helping patients with daily living activities

  • Helping patients develop coping skills and techniques to manage the side effects of medication, as well as symptoms of their conditions

What positions can you progress to from being a mental health nurse?

If you are a psychiatric nurse and want to treat patients more in-depth, you could become a psychiatric mental health nurse practitioner (PMHNP). These advanced practice registered nurses (APRNs) hold graduate degrees in psychiatric mental health nursing and are licensed to assess, diagnose, and treat various mental health conditions.

In addition to providing direct psychotherapy for individuals, groups, and families, PMHNPs can prescribe medications to their patients and oversee their care plans.

To become a psychiatric mental health nurse practitioner, you must earn a master’s or doctorate from an accredited nursing school. Many RNs will earn their MSN nurse practitioner degrees, then pursue a post-masters certificate to further specialize in their preferred population.

You can then take the Psychiatric-Mental Health Nurse Practitioner-Board Certified (PMHNP-BC) certification exam. The credential, also offered by the ANCC, is valid for five years.

The PMNHP-BC certifies you to treat patients of all ages. 

Do your mental health nurse qualifications expire?

Yes, PMH-BC certification is valid for five years. You must renew it every five years to remain a fully certified mental health nurse. If your PMH credentials expire, you can still work as an RN (with a current license). However, you cannot use the PMH-BC title if your certification is no longer valid.

To renew your PMH-BC, you must meet the professional development requirements outlined by the ANCC. You can read all about renewal requirements on the official site. 

How much do mental health nurses make?

Psychiatric nurses earn an average salary of $141,884 per year, according to Indeed. Salary reportings from Comparably reveal an average annual salary of $80,314, with a base salary of $79,041 and a typical annual bonus of $1,273 per year.

Discover more about how much you can earn as a nurse in our salary guide.

How long does it take to become a mental health nurse?

It takes 4 to 5 years to become a fully certified mental health nurse with a PMH-BC. Depending on your degree level, it will take 2 to 4 years to graduate from nursing school. Afterward, you must complete 30 hours of continuing education courses and 2,000 hours of psychiatric nursing to qualify for the exam.

Some nurses may have to develop clinical experience before finding nursing jobs in mental health facilities. 

Read more: How long does it take to become a nurse?

FAQs about becoming a mental health nurse

Is psych nursing hard?

Psychiatric nursing has its share of challenges, like any other nursing specialty. There can be additional challenges for nurses treating patients with severe psychiatric illnesses or mental health disorders. Some patients may self-harm, others may be completely resistant to treatment, and some may become volatile. 

Any psych nurse needs to understand the risks they face when treating their patients; having communicative strategies in check, and taking appropriate precautions, can ensure they can help as much as possible without jeopardizing their safety. 

Another challenge of psych nursing can be emotional burnout or compassion fatigue. Helping people struggling so much is emotionally taxing, and it can even negatively shape a nurse’s mental health.

They need appropriate tools and a support system to avoid having their own psychological complications from their job.

What does a mental health nurse do daily?

The daily tasks of mental health nurses depend on where they work. Overall, their job is to support patients’ care, monitor their behavior, and help them develop skills that support their health and recovery. 

Mental health nurses must also collaborate with social workers, therapists, doctors, and other care team members to ensure patient care is correctly aligned with their current needs and abilities. 

Do mental health nurses get paid more?

With a specialty and certification, you can qualify for a higher salary than you’d receive as an RN. If you decide to go for your PMH-BC, you can look for psychiatric nurse jobs that pay well in your area. The more experience and education a nurse has, the higher they stand to earn.