Considering PMHNP program, looking for input from PMHNPs or current students.

I would do some searches on all.nurses for the current working environment of PMHNPs. In NY at this time you need a collaborating psychiatrist and sometimes you have to pay them. The PMHNP role is mostly med management. You can do some therapy and the role qualifies you to be a therapist. In private practice you can do what you want but there is higher reimbursement for med management. You would make more money as a PMHNP--at least that is the case now.

Thanks. I appreciate you taking the time to comment. Fortunately, the group practice that I currently work with does have two psychiatrists and it's likely that one would be more than willing to collaborate with me so that requirement isn't a huge barrier. I know that a lot of programs don't provide much in the way of psychotherapy training even though the role qualifies you to practice so already having that experience feels like a little advantage for remaining in private practice. That being said, I really do need to look more into the regs and SOP in NY. As for the money, everyone in the field makes more than social workers. I mean technically, I think I made more as an LDRP nurse than I ever did in an agency clinic as a therapist. Private practice is a little different, but I'm not expecting to make the big bucks. I'm really looking to expand my SOP a little and ultimately, have an easier path to credentialing with insurance. I know lots of clinicians want to move towards private pay once they're in private practice, but the population I work with often needs to use insurance and have very few options to do so with clinicians who specialize in perinatal mental health-- at least in the area that i'm located.

You'll have a larger panel and more reimbursement as a PMHNP particularly if you limit yourself to psych evals and med mgmt. You could do therapy, sure, but I would encourage you to not schedule therapy more than one day per week.

I think you'll perceive some role conflict having spent so much time and effort training to be a LMSW, etc.

I think you're setting yourself up for a great concierge practice in the future especuly with higher functioning professionals by making office and house calls. A lot of them are just dysfunctional in some way and need supportive therapy, but whipping out a med is what most people want so you could provide that as well.

I live in NYS and am graduating in 4 weeks with my PMHNP. If you have specific questions I would be happy to answer any I can.

I would really appreciate the opportunity to pick your brain a little, if you're still open to chatting. I had tabled the idea for awhile, but recently decided that it's an option I really need to consider now.

PM me when you want

Sorry to hijack OP but for the love of Pete does anyone find this fact as alarming as I do?

the nursing boards have made our profession into a job basically. (Not downing social work) but RXing should be a more difficult endeavor to acquire

Sorry to hijack OP but for the love of Pete does anyone find this fact as alarming as I do?

This probably goes without saying, but I do. Being a social worker in NYS is extremely difficult, and completing supervision is becoming increasingly difficult for many because many employers treat it as an after-thought. 3-6 years of post-LMSW supervision to be eligible for LCSW, then another 3yrs to be eligible for an R number (which many insurance companies still require in NYS for credentialing). I am grateful to already have a BSN and have the NP option available to me.

PM me when you want

It seems that I haven't been a member long enough to PM. Thanks for offering though!

ETA: This was the reply I tried to send you...

Mostly wondering how you feel about the general climate for PMHNPs in NY? Anything you wish you had considered about scope of practice or role? Or things you would recommend others consider before choosing this specialty?

I only have two options for programs- one being distance and affordable (Stonybrook), and the other much more appealing and $$$ (University of Rochester). My main hesitation is the cost at this point. Ultimately, I think a PMHNP is the most sustainable way for me to continue my work. I had tabled the idea a few months back, but I'm now reconsidering it.

Thanks again and congrats on completing your program!

What a shame it is so difficult. Anyone with any sense realizes a skilled therapist is the key to patient's recovery and growth. The medication I prescribe in most cases except perhaps the most severe psychosis does little more than take the edge off and get a patient's attention so they are able to do the much needed therapy work. Love, love, love my therapists and the truth is they should make more than I do because their role although not as dangerous is actually more important to our patients in the big picture, imo.

It's also a shame that it doesn't have to be this way, and it wasn't always. This tiered pathway to full clinical licensure didn't always exist, and the push to legitimize social work as a profession has made it that much more difficult to actually help people. I'm not in favor of direct entry to private practice, but I think a lot of good clinicians are putting in their time in hospitals/clinics working as "therapists" and still not getting the supervision hours (not that they aren't receiving some supervision, but that it just isn't meeting requirements to be counted for licensure i.e. being supervised by someone with non-SW licensure or similar scenarios).

In all honest, I don't really want prescribing privileges... just to keep the scope I've been working in and be able to be insurance reimbursable in this lifetime (Medicaid is one of the hardest to panel with in NY). I know the $$$ is in private pay and people will pay, but I'm more concerned with those who can't. Perinatal MH is my passion and I think a PMHNP is the best way for me to be of service to mothers/families in my community (hopefully, more providers/clinicians will want to join me in expanding services locally too).

Thanks for your comment Jules A, really reminds me why I love my work.