10 Reasons to Go Into Private Practice as a PMHNP

Private Practice

There is no doubt about the fact that Nurse Practitioners are playing a vital role in healthcare due to a critical shortage of doctors. According to the latest statistics published by the American Association of Nurse Practitioners, AANP, there are now more than 355,000 Nurse Practitioners licensed to practice in the United States. Of those, the majority are in Family Practice with 69.7% licensed in Family Practice, as FNPs. Some hold Master of Science degrees and others achieved a terminal degree as a Doctor of Nursing Practice, DNP.

If you are interested in becoming licensed and certified as a Psychiatric Mental Health Nurse Practitioner, you would be one of approximately 4.7% of US NPs. There are many reasons why RNs choose to advance their degrees to become Nurse Practitioners but when it comes to specializing in psychiatry and mental health, their reasons become quite subjective.

Some NPs choose to work under the supervision of a doctor, although in most states it isn’t a requirement, while others seek to work in private practice with a high level of autonomy. Perhaps you know that you want to specialize in psychiatry and mental health but haven’t yet decided what path to take. In this particular field, you might just want to consider going into private practice. To help you make a decision that best suits your needs, here are 10 reasons why you might want to go into private practice as a PMHNP. 

1. A Widespread Lack of Psychiatric and Mental Health Services

This is especially the case in rural America. While it can be said that these areas of the nation are generally underserved, the greatest need seems to be in psychiatry and mental health. Some communities don’t even have a psychiatric ward in their hospitals and so patients with the greatest needs are not being served.

You may be an RN working in communities lacking mental health doctors and programs. This could be your motivation for looking into PMHNP programs online. As you continue to work as an RN, you could begin working toward a degree as a nurse practitioner with a specialty in psychiatry and mental health. You recognize the need within your community and are ready to step up to the plate.

But why go into private practice? This would almost always be for the same reason why you want to earn that degree in the first place. It would be quite difficult to find a placement in a hospital or mental health facility when none exist. You may have a goal of finally being in a position to offer services where none exist today.

2. Personal or Family History With Mental Health Issues

Some families have a history of mental illness. Whether it is genetic or the result of living with mental illness as a child, the fact remains that there are a great number of people suffering from various forms of mental illness and few treatment programs or doctors specializing in the field of psychiatry. If you have a family history of mental illness, this might be a specialty quite important to you on a personal level. Going into private practice would enable you to work with levels of mental illness that prevent patients from living a healthy quality of life, often affecting those in their close circle of family and friends.

3. Personal or Family History With Substance Abuse

Substance abuse is a huge problem in literally every area of the country. Unfortunately, since substance abuse falls within the scope of psychiatry and mental health, there are few resources available for this kind of illness. Perhaps this is important to you on a personal level. Anyone who has lost a family member to overdose or broken families resulting from substance abuse understands the pain involved. 

With few to no services for substance abuse, you may wish to go into private practice because it is an issue you are familiar with and have a high degree of empathy for those affected by the addict. You also understand that addicts were not ‘created’ in a vacuum. They may be struggling with emotional or psychiatric issues themselves and are self-medicating to heal the pain. Knowing what you already know, this would be a perfect specialty for a private practice in underserved communities.

4. Working With Troubled Youth

Even schools today don’t have sufficient social workers to deal with troubled youth. Coupled with a lack of mental health services in most communities, these most vulnerable within our society suffer the consequences well into adulthood. Many times, the emotional issues these kids suffer lead them to criminal activity that perhaps could have been mitigated if help had been available to help them deal with issues they are not equipped to understand. 

Often family life is a contributing factor that mental health services could help resolve to some extent. Although you can’t say that all troubled youth will exhibit violent or criminal behaviors as adults, there is sufficient evidence to indicate that early intervention might have prevented these behaviors as they reached adulthood. 

5. Help for Military Suffering from PTSD

Even today’s veteran’s hospitals are short staffed, and veterans simply aren’t getting the care they need and deserve. A licensed and registered PMHNP can open a practice with a primary focus on those suffering from PTSD. While veterans make up the largest demographic of sufferers of Post Traumatic Stress Disorder, there are others who also have the diagnosis.

Sometimes medication is called for but typically it is in conjunction with other therapeutic treatments. Often group therapy is effective and one of the things a PMHNP could facilitate whether as a leader or a coordinator. Any therapies effective for the treatment of PTSD would be within the scope of this specialty and something that is definitely in need.

6. Treating Children Suffering from ADD/ADHD

More and more children are being diagnosed with Attention Deficit Disorder and/or Attention Deficit Hyperactivity Disorder than ever before. Research is ongoing as to the ultimate underlying cause of these disorders but often medication is necessary for these children to be able to function ‘normally’ in a classroom situation.

Unfortunately, psychiatrists are also in short supply, as are all doctors within general practice and all the specializations within the field of medicine. A nurse practitioner with a specialty in psychiatry and mental health could take a huge load of doctors who are already overwhelmed. 

Part of the reason for such a short supply of treatment options for children suffering from ADD or ADHD is a budgeting issue as mental health is often far down on the list when it comes to allocating tax dollars for budgets from the federal level all the way down to states, counties, and cities. Opening a private practice in mental health with a specialty within a specialty aimed at treating these disorders would give these kids a fighting chance academically.

7. Establishing and Directing a Suicide Hotline

There have been times when someone having real thoughts of harming themselves was unable to get through to national or regional hotlines. Here again, the budget is limited but that doesn’t mean a private hotline couldn’t be established on more localized levels.

It would be within the scope of a PMHNP to establish and direct a suicide hotline within their private practice. Sometimes it’s easier to raise funds locally than lobbying state or federal governments for funds to maintain a hotline.

Volunteers could be trained to assess calls and transfer to professionals if certain criteria were met. Sometimes it may be just a caring voice on the other end of the line to talk a person down from the precipice of suicide. In any case, if this is something that has touched you personally, the right credentials might be all you need to offer hope to those who feel all hope is lost.

8. Help for Loved Ones Suffering the Stages of Grief

Built on what has become known as the Kübler-Ross model of grief counseling, a PMHNP can help those who suffered a recent loss work through the five stages of grief. While there are those who seem to be able to handle grief relatively well, others are at the point of despair when losing someone close to them like a spouse or a child.

Elisabeth Kübler-Ross based her life’s work on the five stages of grief and her methodology over the years has helped countless people return to some semblance of normality. As a nurse practitioner specializing in psychiatry and mental health, you would be in a perfect position to help those suffering tremendous grief through the most difficult stages. 

9. Healing the Emotional Wounds Left by Abuse

Anyone who has ever been abused understands the scars left in its wake. Sometimes the effects of child abuse manifest much later in life and other times, while the abuse is still being perpetrated, the effects are barely discernable. Once recognized, therapeutic intervention can help the victim understand why they are feeling what they feel and that it is not their fault.

Sadly, those who have been abused are often led to believe they are to blame for what they suffered. This is a huge part of therapy when working with anyone who has been victimized by abuse and something that isn’t always easy to heal.

Sometimes it takes working closely with the family doctor or other professional who dealt with the physical aspects of abuse. Whether a patient has been beaten, denied sustenance, or even raped, the devastating effects abuse can have on the person’s mental health can interfere with living unafraid and unencumbered with feelings of guilt. This is a specialty in great demand but here again, there are limited resources.

10. Psychiatric and Mental Health Telemedicine Practice

If there is anything whatsoever that we can thank Covid-19 for it would be the way in which it brought telemedicine to the forefront. Prior to the global pandemic, some hospitals offered services like Dial-a-Nurse meant to limit visits to emergency rooms, but it wasn’t really a widespread practice.

Many doctors and nurse practitioners began offering this service to their patients during the pandemic which made it possible to continue seeing patients for ‘normal’ office visits. During the pandemic the safest place to be proved to be at home, and so many patients requiring regular visits to monitor anything from heart disease to any number of chronic illnesses simply weren’t being seen.

Fear of the contagion wasn’t the only reason for such a rapid rise in telehealth, however. Doctors were in short supply as well. All who were able put in more hours than they had since residency, and some even came out of retirement to treat the number of patients needing care.

This would be an ideal time to open a telemedicine psychiatric service because people are now aware of what it is and how to connect via apps like Zoom to their doctors. As a PMHNP, you could open a practice that was solely telemedicine and thus would be able to work with patients in other areas of the state.

The one thing that would limit where a mental health patient could reside would be if they were being prescribed medications. Unless a doctor or NP is registered to practice or prescribe in other states, patients can’t get prescriptions filled in those areas.

So Many Reasons to Follow Your Calling

While one of the greatest reasons most RNs choose to advance their career to the status of nurse practitioner is because of a higher level of autonomy, others find that they would rather specialize in an area where there is the greatest need. Some choose to follow a career path in psychiatry and mental health because of personal experiences they’ve suffered in their own lives. 

The reasons are many for advancing your career to the level of a specialist nurse practitioner. Having said that, the one thing to know is that there is a shortage of healthcare professionals across the board. No matter why you chose this specialty, know that your services are in great demand and as a result, you have a bright and promising future.


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