HELP! PMHNP vs. LCSW

myelin · Oct 5, 2012

PMHNP - no question. The market for LCSWs is terrible and the pay is very low. PMHNPs can do very well and have a strong market, especially if you're open to relocating. However, while money and job opportunities matter, the most important factor is what you want to be doing. Do you enjoy nursing? Are you interested in being a healthcare provider, and having to learn patho, pharm, etc.? Do you want to prescribe? I left the field of clinical psychology to become a PMHNP and while I'm only a student in the RN portion of my direct entry MSN, I have no regrets.

mpolen6497 · Oct 5, 2012

I agree with myelin on this one! Having worked closely with social workers for many years, I hold them in the highest regard but would never want to do what they do. They don't get paid for all the things they have to deal with.

SycamoreGuy · Oct 5, 2012

First, thanks for your replies.

I haven't started any actual nursing classes so I am really not sure how much I will enjoy nursing. I know my end goal in nursing would be some form of advanced practice (leaning toward PMHNP). I do enjoy my anatomy and physiology classes, I find the material fascinating. If I went the LCSW route I would probably try to get a job with the VA, they seem to pay a little better than most agencies.

I guess what makes the decision hard for me is that I really like the counseling / psychotherapy aspect that is in common with both. To complicate things more I really don't care much about prescribing, although I see how it could be frustrating to try to help somebody who needs medicine and you cant give it to them.

My wife and I have decided that when we have kids we want her to be able to stay at home until they start school so I guess PMHNP would support that better money wise. I've got another semester of prereqs and a year before the LCSW starts up so I guess I have some time to think about it.

harmonizer · Oct 5, 2012

Depending on what you enjoy doing most. Most jobs for PMHNP are for psych eval/diagnostic with medication management. You won't have much time to do psychotherapeutic intervention. If you prefer therapy and psycho-social part, I would recommend LCSW. I would not care much about demand because it can change in a few years based on different factors.

mpolen6497 · Oct 5, 2012

This is for harmonizer......if you are out there can you reply to my post about needing help deciding about NP route to take. I am trying to connect with someone. I'm new to this site and so far nobody is replying to me.

Thanks!

myelin · Oct 6, 2012

I would seriously, seriously look into the demand for LCSW in your area before making any more decisions. Do you know any LCSWs? Talk to them! How much do they make? How long did it take them to find a job? While markets go up and down, I would argue that the market for LCSWs is extremely poor, and has been that way for years. My very good friend was a MSW getting her LCSW and I couldn't believe how little she was paid, and the extremes she had to go to in order to be hired, since each position received over 50 applications. PMHNP demand definitely varies by region, but I do not think the two fields are comparable at all. Also, your pay will be about half that of a pmhnp, (~45k average, more like 30k to begin).

lweatherby · Oct 6, 2012

I was a licensed social worker for 13 years before going back to school in 09 to get my BSN. I am now in a FNP program. I would never get my masters in social work because the pay is so low. There is absolutly no return on that investment. I don't know what area you are from, but in my part of Texas the PMHNPs are definitely involved in the therapeutic intervetions. In our mental health hospitals, the PMHNP leads the group therapy sessions. You are right in that it is very frustrating working with clients when you are not hte prescriber. There are many times when you will not agree with the medication regimen of a client for one reason or another. The market for LCSWs is pretty much non-existant here and the pay is horrible. My advice......PMHNP.

SycamoreGuy · Oct 6, 2012

According to the school the reason for creating the program is to fulfill the need for LCSWs in rural areas of Indiana. I have no insight into how genuine that statement is but it is a state school so I don't think they are just looking for the money. On the other hand Indiana allows independent practice and only requires collaboration for prescriptive rights so if I did do the PMHNP I could do as much or as little of whatever I wanted to do once I am on my own.

myelin · Oct 6, 2012

Honestly, even if the market for LCSWs in your area is "strong" (which would surprise me, since that market is pretty horrible everywhere else), you're looking at topping out around 50/60k at the absolute most. That's about half of what a PMHNP will make at the top. Also, PMHNPs do therapy and assessment. Sure you'll make more money prescribing, but you are licensed to do therapy as well. as a LCSW, expect to start around 35k. PMHNPs start around 85/90k, sometimes higher if the state is independent.

edit: I just saw that you do live in an independent practice state. I'm going to be even more blunt: PMHNP no question. You can open up your own private practice and do as much therapy as you like, supplementing your income with your prescription pad. You can work in any site that a LCSW can work in, only you can do more, and you will be paid far, far more.

mtsteelhorse · Oct 6, 2012

PMHNP unless you really don't want to make a good living. I LOVE LCSW but they are a dying breed in many areas...the pay is absolutely deplorable. With PMHNP you can add on to your therapy skills through other avenues. With LCSW you'll honestly never make a decent living. In my area $30K would be about average. I'm going for PMHNP. I want to help others and have earn a good living. You can do both!

SycamoreGuy · Oct 7, 2012

Thanks for all your responses! I think I am going to go the PMHNP route unless for some unforeseen reason I can't get into my program I guess I can use LCSW as a backup plan.