Family NP, Ped, NP, Psych NP

PNPs and FNPs often receive some discussion in their programs about mental health issues and treatment however it is generally considered outside their scope of practice to treat mental illness independently. It is important for primary care NPs to be able to recognize signs of mental illness in order to make appropriate referals and to have some familiarity with treatment of mental disorders (both psychotherapy and pharmacotherapy) since they will inevitable have clients either in therapy or on meds. If your goal is to be a mental health provider, however, you should really be trained as a mental health provider. In nursing that would mean either a PMHCNS or PMHNP. As to the differences between the two, it really all depends on your state's definition of the roles, the practice you eventually work in, and the program you were trained in. For example, in some states CNSs cannot prescribe medications but they can in others whereas NPs usually can prescribe but cannot provide psychotherapy. Some practices will hire an NP to basically only do med checks while others will utilize the whole scope of practice. Some training programs differ in they preparation one receives based on the role (CNS or NP). You mentioned apprehension about prescribing psych meds but also realize that it might be helpful and necessary. It your fear comes more from a lack of experience, obviously that's something that can be alleviated with training and experience. It would not hurt to be trained on prescribing medication but not necessarily make that part of your practice. My advice: look into the state(s) you think you'd like to practice in and how they define and regulate NPs and CNSs. Then talk to some mental health providers or look at job descriptions to get a sense of how the practice environment is for each role (sometimes they are interchangeable and sometimes they are night and day). Finally, with a better sense of what your options would look like upon graduation, start evaluating programs on how they fit with your ideal practice allowing some wiggle room for future changes. Good luck!

I'm pretty sure it's within the scope of practice of primary care nurse practitioners to treat uncomplicated mental illness (like non-refractory depression and anxiety).