Mental health nurse speaking to a patient

Not all patients’ ailments are physical. They need ongoing support and care for psychiatric conditions, like someone healing from a broken bone or chronic illness. In these instances, they rely on the expert skills of a mental health nurse to lead better lives.

Mental health nurses are registered nurses (RNs) with specialized training and education in treating patients with mental health disorders.

According to the National Alliance on Mental Illness, 1 in 5 US adults experience one or more mental illnesses each year, and 1 in 20 adults experience what is known as a “serious” mental illness. 

All mental illnesses are serious, so what does this mean?

Serious mental illnesses, in this case, significantly impact someone’s ability to perform everyday activities. They may influence their ability to communicate or understand reality.

Disorders that fall under the realm of serious mental illness include those that affect perception, emotional regulation, and decision-making. They can consist of schizophrenia, borderline personality disorder, and type 1 bipolar disorder. 

A mental health nurse provides care to patients in psychiatric hospitals, rehabilitation centers, and private homes. They offer both acute treatment and ongoing care that supports long-term wellness.

What is the difference between a mental health nurse and a psychiatric nurse (PN)?

Mental health nurses are psychiatric nurses. They offer specialized care for the ongoing management of psychological disorders. They help patients recover and help people with permanent disorders manage their symptoms and lead a higher quality of life.

Psychiatric mental health nurses (PMH-BCs) are mental health nurses and psych nurses.

All mental health nurses are registered nurses who chose to specialize in treating patients with mental health disorders. 

What qualifications does a mental health nurse need?

Before becoming a mental health nurse, you’ll have to work as a registered nurse (RN) in your state. Psychiatric mental health nurses are certified. 

To earn a PMH-BC, you need to be a full-time nurse for at least two years, complete 30 hours of continuing education courses, and complete 2,000 hours of clinical psychiatric care within the last three years.

To start gaining clinical experience, you may look for opportunities as a mental health nurse in internships. You can also apply for mental health nurse jobs as a new grad, but employers typically only hire nurses with at least one year’s experience in nursing full-time.

What work does a mental health nurse do day to day?

Some mental health nurses provide in-home care, while others work in hospitals, rehabilitation centers, and outpatient care facilities. Being a psychiatric nurse combines traditional nursing elements with the added mental health care component. 

Typical responsibilities for a mental health nurse include:

  • Examining patients and performing mental health evaluations

  • Consulting with psychologists, psychiatrists, and physicians about the best course of action for a patient's care

  • Updating patient fields with assessments of their emotional states and psychiatric symptoms

  • Monitoring high-risk patients and intervening when necessary

  • Offer emotional support by employing skills such as motivational interviewing and active listening

  • Reviewing patients’ care plans and updating medical charts

  • Administering psychiatric medications

  • Encouraging patients to participate in therapy and ancillary treatments

  • Answering patients’ questions about the care and possibly educating family members on their loved one’s condition

One of the most important things a mental health nurse does is help patients feel less alone. Living with a psychiatric condition is often isolating and, at times, terrifying. The emotional support nurses provide can inspire hope, decrease stigma, and motivate patients to care for themselves. 

Where do mental health nurses work?

Mental health nurses can work in various settings, including hospital psychiatric wards, outpatient treatment centers, mental health rehabilitation centers, and in-home care. The type of work they do varies based on their location.

Generally, nurses in-home care or treatment facilities build longer relationships with their patients. Psychiatric nurses in hospital settings primarily focus on stabilization. They help patients reach benchmarks in their treatment until they can be safely discharged and continue therapy independently.

What is it like to be a mental health nurse?

Mental health nurses are supporters, advocates, and caregivers. They are there to encourage their patients, acknowledge their struggles, and remind them that there is always a way to get help somehow.

For many patients, living with mental illness can be a disorienting experience. Those with extreme psychiatric conditions are often afraid, confused, and suspicious of people around them. They may reject treatment and care because they fear medical professionals want to hurt them.

Living in any mind affected by mental illness is an enormous challenge; mental health nurses are there to make that burden easier.

While you can be a source of support for many patients, there are also struggles. Patients may become aggressive, lash out, and even threaten you. Sometimes, no nursing care is enough to help someone because they simply refuse to help themselves.

There is a delicate balance between caregiving and care-inspiring. As a mental health nurse, you want your patients to care about themselves as much as you do and actively participate in treatments that can help them get better.

How much do mental health nurses make?

According to ZipRecruiter, the average mental health nurse salary in the United States is $77,683. Salaries for psychiatric nurses range between $47,002 to over $190,000. Your earnings will vary based on the state you live in, your workplace, and your credentials and nursing experience. 

ZipRecruiter also reports that certified psychiatric nurses with PMH-BCs have much higher annual salaries, with an average of $116,199.

Are there different specialties of mental health nurses?

There are subspecialties of mental health nursing that can help you further prepare to treat patients with particular conditions or in specific populations. You can choose to focus on different topics within psychiatric care, such as:

  • Addiction medicine

  • Child development

  • Geriatric psychiatry 

  • Military mental health

  • Pediatric psychiatry 

  • Psychosomatic medicine (consultation-liaison psychiatry)

Each of these specialties gives you further training in the proper skills necessary to work with patients in these groups. For example, a mental health nurse specializing in military mental health must be highly trained in depression, grief, trauma, and post-traumatic stress disorder (PTSD).

Nurses that choose to specialize in pediatric psychiatry will have to understand the underlying influences and effects of mental health conditions on child development. In geriatric psychiatry, nurses focus on helping patients among the aging population cope with chronic illnesses, injuries, grief, existential crises, and life changes. 

If you specialize in addiction medicine, you would learn about the psychosocial and physiological underpinnings of substance use disorders, behavioral addictions, and compulsive behaviors.

Psychosomatic medicine is a lesser-known type of mental health nursing. It focuses on the intersection of physical and mental health, helping patients cope with many physical effects of psychiatric illnesses. This includes substance withdrawal and self-harm.

In any specialization, you need a foundation in general mental health nursing to build upon. Acquiring your PMH-BC is the first step toward becoming an expert in any subspecialty of mental health nursing.

Advantages and disadvantages of becoming a mental health nurse

If you decide to become a mental health nurse, you can make a major difference in people’s lives. Many patients of mental health nurses often suffer in silence. Because their conditions are often shrouded in stigma, they may not vocalize what they’re going through or feel as though anyone understands their pain.

Making a difference in people’s lives is at the heart of any type of nursing. But like all specialties, there are unique challenges and drawbacks to mental health nursing to know. 

Give yourself a complete understanding of the field before pursuing certification. Applying for internships or apprenticeships in mental health care settings can help you decide if this is the right career path for your future.

Advantages of choosing a career as a mental health nurse

1) Help patients suffering from psychiatric illnesses

A unique understanding and approach is required to truly help people with mental illness. A nurse must be able to tend to immediate needs and potential risks based on a patient’s condition.

Many mental health patients can feel invisible and invalidated by the healthcare system. As a passionate nurse, you could be the one who makes them feel less alone and truly deserving of care and a brighter future.

Patients with severe mental health disorders may require ongoing support for the rest of their lives. Being their nurse helps you promote a higher quality of life they may not be able to achieve on their own.

2) Continually learn about mental health

Continued education is both a requirement and a benefit for mental health nurses. They get to discover new research and emerging trends in treatment to assist their patients better. As our understanding of mental health continues to evolve, newer, more effective care models will also emerge.

3) Multiple career opportunities

Psychiatric nurses are in-demand across the country and can choose where they’d like to work. You can work with the more intense, varied patients in a fast-paced hospital setting or choose more one-on-one care in treatment centers or mental health homecare. 

Disadvantages of choosing a career as a mental health nurse

1) Lack of appreciation 

Nurses don’t work to receive praise, but seeing their patients improve and express gratitude is a welcome feeling. Unfortunately, not all mental health patients are open to the idea of treatment. They may see you against their will and can be completely unwilling to respond to your efforts.

You’ll often treat people going through the lowest points in their lives. You may never know what happens to them after they leave; some will be too eager to get away from the facility you’re treating them in.

2) Risk of violence

Some patients with mental illness can become physically aggressive. While there is security in most settings, there is always a risk that a nurse assumes by treating patients with psychiatric illnesses. You must be prepared to handle any physical confrontations and be well-versed in de-escalation strategies to help prevent them.

3) Emotional stress/compassion fatigue

Burnout can happen to any nurse, and emotional stress is especially common when working closely with psychiatric patients. You want to support their recovery in every way, and it can be difficult seeing them experience setbacks.

You’ll also be exposed to many people in immense psychological pain; they can struggle with self-harm, attempts to end their own life, and feelings of worthlessness that you desperately wish you could heal for them.

While compassion is essential to this career, you have a higher risk of being drained emotionally and even developing your own mental health struggles due to your work. 

How to become a mental health nurse

Start your career in mental health nursing by earning a degree in nursing. You can become an RN with an associate’s or bachelor’s degree. You may also choose to take mental health care, psychology, and psychiatry electives.

After you pass the NCLEX exam, you can become a licensed registered nurse. Then, you can begin gaining clinical experience. There are many job opportunities to help new nurse grads get the experience they need to become specialists in the future.

You will need at least two years of experience in clinical care, plus 2,000 hours in mental health care, to qualify for your psychiatric mental health nurse certification.

Recommended Reading - How to become a mental health nurse in the USA

Frequently asked questions about mental health nurses

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

It takes approximately 4 to 7 years to become a nurse with a PMH-BC. You will be able to start treating patients as a registered nurse within 2 to 4 years, depending on the degree type you pursue.

Is psych nursing hard?

All types of nursing are difficult, and psych nursing is no exception. This type of work can be particularly difficult emotionally because so many patients either deny their need for care or refuse treatment. 

What personal qualities do you need to be a mental health nurse?

All mental health nurses must be compassionate, empathetic, organized, and assertive when necessary. Although you must be a source of emotional comfort for your patients, you must also be comfortable enforcing boundaries.

What are the biggest risks of mental health nursing?

Physical violence from patients is a greater risk for mental health nurses. People who are angry, afraid, or delusional can become aggressive. There is also the risk of medical error and failing to notice warning signs in a patient at risk of self-harm. 

Mistakes with treatment or medication can also have serious consequences on the patient. You must be 100% attuned to every aspect of your patient's care at all times.