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Psychiatric mental health (PMH) nurses are in demand, and you have your choice of where you want to work.

The popular choice: Hospitals

Most PMH nurses, like other nurses, are employed by inpatient hospitals—either psychiatric facilities or general hospitals with a psychiatric unit. As a staff nurse, you use the nursing process model: assess patients, develop a nursing care plan, implement the plan, and then evaluate it. Most psychiatric staff nurses stick to one unit or specialty such as substance abuse, eating disorders, pediatrics, or geriatrics.

The duties involved in the nursing process include medication administration and monitoring, physical assessment and care (including treatment of other medical conditions), and administrative tasks. You may assist with electroconvulsive therapy, which is still used for a small fraction of patients who have failed all other treatments.

You will likely facilitate therapeutic groups and lead patient support meetings. You’ll participate in family conferences and interdisciplinary meetings. Most importantly, you will work closely with individual patients, establishing and maintaining a therapeutic relationship, which is at the heart of all PMH nursing.

Inpatient psychiatric nursing isn’t like it used to be 20 years ago. With tighter insurance restrictions and trends toward outpatient and community care, most patients in hospitals are suicidal, homicidal, or completely unresponsive to prior treatments. Many have very short stays and must be transitioned back into the community quickly, so discharge planning is a big part of your job.

Other settings for PMH staff nurses

Some PMH nurses work in community-based outpatient settings, home health, or state or federal agencies. Your duties remain essentially the same as with inpatient settings. You may collaborate more with other healthcare professionals (such as social workers or occupational therapists) who are involved in your patient’s care. Along with individual patients, you may work with entire groups (as in assisted living or transitional group homes) or even communities, where you assess and care for the overall needs of people living in a particular area.

Many roles for advanced practice nurses

Advanced practice PMH nurses are known as APRNs (advanced practice registered nurses), APPNs (advanced practice psychiatric nurses), PMHNP-BC (psychiatric mental health nurse practitioner, board certified), or PMHCNS-BC (psychiatric mental health clinical nurse specialist, board certified). Psychiatric nurse practitioners work in a physician’s offices (most often in primary care offices, as a mental health resource for patients or in a psychiatric practice as part of a team), community settings (such as substance abuse clinics), or in almost any health-related setting as researchers, administrators, educators, or consultants. They assess patients, diagnose and treat mental health disorders, provide psychotherapy, and prescribe medications. Sometimes they work as prevention specialists, helping at-risk people or groups to forestall mental health problems. They can work as general practitioners or in a subspecialty.

Psychiatric clinical nurse specialists work most often as educators, researchers, and expert consultants, but they can also provide psychotherapy. Both APRNs and clinical nurse specialists are masters-prepared and are increasingly obtaining doctors of nursing practice degrees as a response to the growing trend.

APRNs are in particular demand. In light of the Affordable Care Act and the Institute of Medicine’s call for better-educated nurses who can practice their specialties without restrictive parameters (such as having to practice in collaboration with physicians), APRNs will become even more needed especially in rural areas where mental health services are scarce.