Psychiatric Nurse Practitioner or Psychiatrist: What Is the Difference?

What is a psychiatric-mental health nurse practitioner?

A psychiatric-mental health nurse practitioner, or PMHNP, is a registered nurse who went on to complete a graduate program in psychiatric-mental health nursing. That program is a master's degree, a post-graduate certificate or a Doctor of Nursing Practice, and it includes supervised clinical training with patients.

After graduating, the nurse practitioner takes a national board certification examination. The American Nurses Credentialing Center awards the credential PMHNP-BC, which stands for Psychiatric-Mental Health Nurse Practitioner, Board Certified, to those who pass. The credential has to be renewed.

Nurse practitioners are regulated at two levels. Certification is national. A license to practice is granted by each state, and a PMHNP is licensed as an advanced practice registered nurse in the state where patients are seen.

What is a psychiatrist?

A psychiatrist is a medical doctor, an MD or a DO, who specializes in mental health. To become one, a person completes medical school, passes the examinations for a license to practice medicine, and then completes four years of residency training in psychiatry. The first year of residency is typically spent in a hospital, working with patients who have a wide range of medical illnesses.

After residency, most psychiatrists take an examination given by the American Board of Psychiatry and Neurology to become board certified. Some go on to further training in an area such as child and adolescent psychiatry, geriatric psychiatry or addiction psychiatry.

What do both kinds of provider do?

In an outpatient clinic, the work looks much the same. Both a psychiatric nurse practitioner and a psychiatrist are trained to:

• Assess mental health through a detailed conversation about symptoms and history
• Diagnose mental health conditions
• Prescribe psychiatric medication and follow how it is working
• Provide psychotherapy, or recommend it
• Refer to another professional when a problem is outside what they provide

How are the two training paths different?

The main difference is the route. A PMHNP comes through nursing: nursing school, a registered nurse license, then graduate study focused on psychiatric and mental health care. A psychiatrist comes through medicine: medical school covering the whole body, then a residency in psychiatry.

Because psychiatrists are physicians, they are qualified to assess both the mental and physical sides of a problem, and they can order or perform a full range of medical laboratory and psychological tests.

Neither title tells you everything about a provider. Board certification, a current state license, experience with your particular concern, and whether you feel heard at visits all matter when you choose.

How do you choose between them?

For many common concerns, such as depression, anxiety, ADHD or sleep problems, either kind of provider may be a good fit. These questions can help you decide:

• What do I need: an evaluation, medication follow-up, therapy, or a mix?
• Is the provider board certified and licensed in the state where I will be during visits?
• Does the clinic offer the treatment I am looking for?
• Will I see the same person at each visit?
• Does the provider work with my insurance plan?
• Do I have medical conditions that should be managed together with my mental health care?

When might a psychiatrist or another specialist be the better fit?

Sometimes a different provider, or a different setting, serves a person better. It is reasonable to ask about this before you book, and a careful provider of either type will tell you when a referral makes sense.

• Complex medical situations, where mental health symptoms are tangled up with serious medical illness or many medications
• Treatments an outpatient clinic does not provide, such as electroconvulsive therapy or hospital care
• Psychological testing, which psychologists are trained to perform
• Longer-term or specialized psychotherapy with a dedicated therapist
• A second opinion when treatment has not helped enough

Who provides care at DanShalom Behavioral Clinic?

Care at our clinic is provided by Victor Onodjacha, MSN, PMHNP-BC, a board-certified psychiatric-mental health nurse practitioner. He is not a physician and not a psychiatrist. He is licensed as an advanced practice registered nurse in Texas, Idaho, Arizona and Maryland, and patients see him at every visit. You can read about Victor's credentials.

The clinic offers psychiatric evaluation and diagnosis, medication management, brief psychotherapy and mindfulness-based cognitive therapy, all listed on our services page. Visits take place at the Sugar Land office or by secure video for patients who are physically in Texas, Idaho, Arizona or Maryland at the time of the visit.

Medication decisions are made after an evaluation. Not every medication can be prescribed at every kind of visit, some may require an in-person visit, and we explain what applies to you. Our medication management page describes follow-up. If we think a psychiatrist or another specialist would serve you better, we say so and help with a referral.

If you are in crisis, call or text 988, or call 911 if there is immediate danger. DanShalom Behavioral Clinic is not an emergency service. See our crisis resources page for more options.