If you want to work in the mental health field, you have many options — including a career as a psychiatric nurse practitioner or a mental health counselor. Both help people who need emotional support, but their education, training, and clinical focus set them apart.
In this article, we’ll compare the differences between a psychiatric nurse practitioner versus a counselor, so you can make a well-informed decision about your career path.
What Does a Psychiatric-Mental Health NP Do?
A psychiatric-mental health nurse practitioner (PMHNP) is an advanced practice registered nurse who specializes in mental health care. They assess, diagnose, and treat patients with mental health conditions.
A PMHNP’s duties can include:
- Evaluate and diagnose patients with psychiatric disorders, such as depression or schizophrenia
- Order and interpret diagnostic tests
- Develop treatment plans and prescribe medications
- Provide psychotherapy to individuals, groups, and families
- Collaborate with other healthcare providers to coordinate care
- Offer guidance to patients and families on mental health treatments
What Does a Mental Health Counselor Do?
Mental health counselors support people with mental health challenges, like depression, anxiety, and grief. Some states allow licensed professional counselors to diagnose mental health illnesses, but not all do. Unlike PMHNPs, mental health counselors can’t prescribe medications.
A mental health counselor’s responsibilities can include:
- Conduct assessments to evaluate clients’ mental health
- Develop, implement, and review treatment goals with clients
- Provide psychotherapy to individuals, couples, and families
- Help clients develop healthy coping strategies
- Document clients’ progress toward treatment goals
- Refer clients to clinical specialists or other resources, like support groups, for additional help
Psych NP vs. Counselor: What Are the Biggest Differences?
While there’s definitely some overlap between psychiatric-mental health nurse practitioners and mental health counselors, they also have plenty of differences. Comparing the education, training, and scope of a psychiatric nurse practitioner versus a counselor can help you decide which career path is best for you.
Education
To become a PMHNP, you’ll need a master’s or a doctoral degree with a specialization in psychiatric-mental health nursing. Most graduate-level programs require you to be a licensed registered nurse (RN) with a bachelor’s degree in nursing. If you’re an RN with an associate degree or diploma in nursing, you can also find schools with an RN to MSN program specifically for psychiatric mental-health nursing.
As a mental health counselor, you’ll need to have at least a master’s degree in counseling. To enroll in a post-graduate counseling program, you usually need a bachelor’s degree in a related field, like psychology or social science.
Licensure and Certification
Both PMHNPs and mental health counselors need a license to practice. Psychiatric nurse practitioners must be licensed as an advanced practice registered nurse in the state where they work. They also need to earn board certification by passing the Psychiatric-Mental Health Nurse Practitioner exam through the American Nurses Credentialing Center.
Each state has its own requirements for becoming a licensed counselor. Most states require counselors to pass an exam and do a set number of counseling hours under clinical supervision.
Scope of Practice
Scope of practice is a major differentiator between these two mental health careers. PMHNPs can diagnose mental health conditions and provide holistic treatment, which may include both therapy and medication management. As nurses, PMHNPs use their clinical expertise to help improve patients’ overall mental and physical health.
In comparison, mental health counselors have a more limited scope of practice. Depending on where they work, counselors may need to refer clients to clinical specialists for diagnosis. They provide therapy to help clients manage mental health issues, but they don’t prescribe medications. Counselors mainly focus on helping people navigate emotional challenges and achieve personal growth.
Specialization
Both PMHNPs and counselors can specialize in areas of mental health. Some common specializations for psychiatric-mental health nurse practitioners include:
- Child and adolescent mental health
- Geriatric psychiatry
- Forensics
- Substance use disorders
- Acute care
Mental health counselors might choose to specialize in these areas:
- Addiction and substance abuse
- Rehabilitation
- School counseling
- Couples or family counseling
- Post-traumatic stress
Workplace
Both nurse practitioners and counselors have the flexibility to work in many types of settings. PMHNPs often work in:
- Hospitals
- Private practices
- Behavioral health or addiction clinics
- Psychiatric mental health facilities
Counselors, on the other hand, may work in these settings:
- Inpatient and outpatient treatment centers
- Residential treatment centers
- Private practices
- Schools
- Hospitals
Psychiatric Nurse Practitioner vs. Counselor: How to Choose Your Path
As you can see, both nurse practitioners and counselors have an active, important role in supporting people’s mental health. Both careers can be incredibly rewarding, so how do you choose? As you make your decision, consider factors like these:
- Your interests: A career as a PMHNP blends therapeutic and medical care, making it a good choice if you’re interested in both. If you prefer a therapy-focused role, becoming a mental health counselor may be a better fit.
- Your background: If you’re already working as an RN, getting a master’s degree in psychiatric-mental health nursing may feel like a natural next step. Counseling programs accept students from a wider range of academic backgrounds.
- Your patient preferences: PMHNPs often work with people who have severe or complex mental health conditions, such as psychosis, bipolar disorder, and schizophrenia. Mental health counselors help people facing a broad range of emotional challenges, like anxiety, stress, and depression. The types of patients you prefer to work with may influence your decision.
Prepare for Your Career in Mental Health at WCU
If you’re deciding whether to train for a career as a psychiatric mental-health nurse practitioner versus a counselor, the choice may come down to the type of care you want to provide.
PMHNPs provide both therapeutic and medical care, while counselors focus on using therapy to support people’s mental health needs. No matter which path you choose, you’ll have the opportunity to make a difference for people living with mental health conditions.
At West Coast University, we’re ready to support you in whatever direction you choose. For aspiring psychiatric nurse practitioners, we offer a Master of Science in Nursing (MSN) – PMHNP program, an RN to MSN – PMHNP program, and PMHNP Post-Master’s Certificate — all available online.
If you’re interested in mental health counseling, check out our Master of Science in Clinical Mental Health Counseling program — which can be completed in less than 2.5 years.
Ready to start your career in mental health? Contact us to schedule an information session today!
WCU provides career guidance and assistance but cannot guarantee employment. The views and opinions expressed are those of the individuals and do not necessarily reflect the beliefs or position of the school or of any instructor or student.
