Seeking Career Change Advice: Mental Health Counselor or Psychiatric Nurse Practitioner?

Students Pre-Nursing

Updated:   Published

Seeking Career Change Advice: Mental Health Counselor or Psychiatric Nurse Practitioner?


I find myself at a crossroads in my career and could really use your input. I've been working in corporate HR for nearly a decade, and while it's been a great career, I now want to find true purpose/meaning in my work.

I'm torn between two paths: becoming a mental health counselor/therapist or a Psychiatric Nurse Practitioner. The former seems more feasible in terms of finances and time commitment. I can pursue a master's in counseling without taking out any loans since I can continue working my HR job to cover tuition. The program will take around 2.5-3 years to complete.

On the other hand, the ABSN (Accelerated Bachelor of Science in Nursing) route seems more challenging. The program is quite expensive, ranging from $50k-$60k, and lasts for 12-16 months in Charlotte, where I currently reside. Additionally, I would need to quit my full-time job as I pursue this path, which is difficult as the main breadwinner in my household (no kids, but I do have a mortgage). The ABSN program also requires me to complete five prerequisite courses at my local community college. Lastly, I'll also need to get a MSN which will be 2-2.5 years.

To be honest, I'm feeling a bit lost and unsure about what to do. On one hand, I long for a second career that brings purpose and truly helps people. I also dream of gaining financial independence and not relying solely on a company for stability. Work/life balance and autonomy are also crucial to me.

I would greatly appreciate any insights, advice, or personal experiences you may have that could help me make a well-informed decision. Thank you in advance for your support!

Specializes in Telemetry, Primary Care.

Although I am an FNP and not a psychiatric mental health nurse practitioner (PMHNP for short) and cost of schooling aside, I'd like to mention that PMHNP and a MH counselor/therapist are two vastly different occupations. They both are under the MH umbrella, but the NP is taking care of patients (diagnosing, treating, prescribing, evaluating, etc) whereas the counselor/therapist may be more of just communication rather than hands-on type of work. I may be completely biased, but I would say becoming and being a PMHNP is more work than being a MH counselor/therapist simply because you are doing nearly all the care for the patient. Another way of saying it is that as an NP, your patient's life is literally in your hands. Do you have that mindset to pursue the PMHNP profession? The schooling between the two occupations are also vastly different. 

Of course there are also other things you want to consider. PMHNP can and will pay very well, there is a potential for being able to choose your own schedule/hours, and there are all kinds of facilities you can work at, some with heavier patients, and some with not has heavy. I don't know much about a MH counselor/therapy position, but I'd assume it would mostly follow the M-F, 8 hour/day job.


Andy Munoz

3 Posts

Thank you so much for your thoughtful comment! I really appreciate it. You've asked some great questions that will help me better find the best path for me. Thank you again!


1 Article; 6,683 Posts

What I'm wondering about is the motivation for going into mental health. If you haven't gotten much exposure to people with mental health concerns, I wonder if there are volunteer opportunities in your area where you could do so - before you make major life changes.

I understand the need to find meaning in your work. I would just consider that there are a ton of healthcare jobs that you might find meaningful. U.S. healthcare is a mess in a lot of ways, and it's pretty eye-opening how often patients fall through the cracks in mental health specifically. I still like what I do in inpatient psych, but sometimes it feels like a revolving door and at times I wonder how much I'm really helping anyone. I worked in a different specialty for years and never felt quite this sense of futility. 

Looking at the timeline you lay out for becoming a PMHNP, I think you should make sure to add some time working as an RN. PMHNP programs are doing a disservice to people by admitting a lot of applicants with minimal psych nursing experience. I know a number of nurses who went through the PMHNP education only to discover that they really don't like working full-time with people suffering from mental illness. 

I hope this gives you a few more things to think about, though I'm sure you've considered some of this already. Good luck to you!  

Andy Munoz

3 Posts

Thank you! You shared some great suggestions and self-reflection questions. I really appreciate your advice!

HRoark64, BSN

22 Posts

Specializes in Peds CVICU.


Looks like some solid advice in the previous replies. I have a different approach to pitch if you're interested. 

Look into Vanderbilt's direct entry MSN program. PMHNP is one of the track options in it. It's essentially an accelerated ADN/MSN program. You spend your first year knocking out the RN portion + NCLEX and your second year (maybe +1 semester on top of that) completing grad work. At the end of it you'll have your MSN in hand and you're eligible to sit for state boards. 

I know this isn't in your area but I found a few like it in other large metro markets when I was planning my second career. Not sure how flexible you are with location and finances, but this path definitely accelerates the time portion of the equation. 

By using the site, you agree with our Policies. X