Is it more practical to become a PMHNP or a FNP with specialization/cert in Psych - page 2

by J-Swish 8,712 Views | 19 Comments

The reason I ask is because while Psychiatric-Mental Health is a strong passion of mine, I am also interested in other specialties, such as Internal Medicine, Emergency Medicine, Family, Derm, etc. In other words, an FNP. ... Read More


  1. 0
    wow.. zenman.. But i think this is for the private pay patient... I don't think medicaid or even some health insurance pay that much.... Unfortunately, unlike medical patients, most mental health patients are either uninsured, homeless, or cannot afford the insurance and heavily rely on Medicaid/Medicare/other insurances contracted with the said.. I don't think they can go by this rate all the time.
    Last edit by harmonizer on Sep 3, '12
  2. 0
    Quote from BlueDevil,DNP
    I There are many opportunities for behavioral health, and not nearly enough providers to go around.
    Where is this? There's either no need in my area or employers just simply don't want to pay well. If this is the case, I feel that the pay doesn't not reflect the demand at all at where I live. Due to low autonomy in my state, they can just easily grab the willing FNP providers or PA with no psych background for training. Can't blame on not having enough provider when the pay is below market rate. In the states where NPs are more independent, employers will prefer NP over PA due to less work for the collaborating physician.
    Last edit by harmonizer on Sep 3, '12
  3. 0
    deleted.
  4. 0
    I won't specify where I live, except to say it is an independent practice state. If you are looking for a psych position, try checking with Home - American Psychiatric Nurses Association.

    The 50th percentile for FNPs here is $94,000 annually. Psychiatric NPs are paid significantly better.
  5. 0
    It amazes me how much NP salary can vary. Psych NPs from my old state (ind. practice) made 106k on average, according to the state's salary website. I also know a psych NP who runs her own private practice (cash only) - she makes a lot of money. Of course, that won't be my route, since I plan on working with the underserved, so I plan on taking insurance, medicaid, etc. Still, I'm hopeful to make enough to pay off my loans.
  6. 0
    Quote from harmonizer
    Where is this? There's either no need in my area or employers just simply don't want to pay well. If this is the case, I feel that the pay doesn't not reflect the demand at all at where I live. Due to low autonomy in my state, they can just easily grab the willing FNP providers or PA with no psych background for training. Can't blame on not having enough provider when the pay is below market rate. In the states where NPs are more independent, employers will prefer NP over PA due to less work for the collaborating physician.
    That really sucks. It sounds like since your state doesn't have independent practice and also allows just about anyone to practice psych, you're not in a good position to negotiate.
  7. 0
    With bonuses (which should account for 30-40K), I will make more than $150k this year, my 3rd year in practice. I don't have any school loans, I paid as I went from ADN to DNP, over a 20 year span. I wouldn't change a thing.
  8. 0
    Hmm...so this is what I'm gathering.

    PMHNP - More or less job offers depending on location, in steady demand for such Psych professionals, different rates vary state to state
    FNP - A good overall safety net, more jobs, oversaturated market of FNP's however, able to treat Psych with cert/training

    If I go the PMHNP route, I could potentially become an FNP later down the road, correct?
    And of course, if I become an FNP first, I could do PMHNP later on as well.

    Obviously, I think my heart is set for mental health but my conscious is telling me "No, it's not an economical and financially safe choice." Still, if I were to do FNP > PMHNP or PMHNP > FNP, I would have to pursue a DNP regardless and that's something I am not wishing to go for.

    I have the added flexibility of moving to any place, any time but I am looking at California or Texas only to be close to family. I don't have much stuff, I'm single, no kids, just a youngster. I can pack my stuff in an hour and be on my way. As long as there's a Fresh & Easy nearby, my life is set lol
    Last edit by J-Swish on Sep 4, '12
  9. 0
    Hey J-Swish,

    I'm like you in the sense that I am willing to move wherever, don't have kids, no mortgage, etc. I decided to go with PMHNP because it's my passion, and I also feel that it is a very safe choice financially. I think the demand is only going to go up as healthcare reform comes into play and insurance companies will be forced to cover psych, also keep in mind that 70% of psychiatrists are over 50... the need for providers is going to only increase. However, it is a shame how some states seem to shackle NPs and make things harder from them. I plan on avoiding those states.

    I also am thinking about going back and re-certing as a FNP later on, but I chose psych for the first go around as it is what I love most. Good luck!

    Also, I'm not sure if FNPs can treat psych with just some training. Many states are cracking down on NPs practicing outside their scopes of practice (ie: FNPs working in the ICU).
  10. 0
    A lot of psych issues fall into the realm of family practice and internal med. I'd say 1/3 of my patients, easily, take a SSRI. Perhaps 1/2. So you do get some psych in FP, but you also have to see Zenman's dreaded runny noses, lol. I could do a lot more psych, I just refuse to deal with most of it. If they need haldol, hear voices or have harmed themselves or anyone else, they are out of my league! Unfortunately, it is impossible to get them in with psych, so I send them to one of my colleagues who is more comfortable with major mood disorders, and he sends me everything that needs to be incised, biopsied or cut up in any way. We all have strengths and weaknesses!


Top