Question: Are there programs designed for FNPs who want to add a PMHNP specialty and/or switch specialties? (FNP to PMHNP programs)

Answer: Yes – Graduate certificate programs enable Advanced Practice Registered Nurses (APRNs) specializing in family nursing to expand their scope of practice into psychiatric mental health nursing. FNP to PMHNP graduate certificate programs feature courses that prepare students to sit for the Psychiatric Mental Health Nurse Practitioner certification examination offered through the American Nurses Credentialing Center (ANCC).

Family nurse practitioners (FNPs) are APRNs who have earned their Master of Science in Nursing (MSN) and/or Doctor of Nursing Practice (DNP) in advanced practice family nursing from a CCNE or ACEN-accredited program, and who have earned certification through the ANCC or the American Academy of Nurse Practitioners Certification Board (AANPCB). Some FNPs may wish to expand their scope of practice to encompass a more specialized area of advanced nursing, such as psychiatric and mental health nursing. Due to an increasing shortage of mental health care professionals nationwide, FNPs who specialize further in psychiatric and mental health care may have a competitive edge in terms of finding advanced positions in medical and behavioral health care settings.

FNP to PMHNP post-master’s certificate programs that have been accredited by the Commission on Collegiate Nursing Education (CCNE) or the Accreditation Commission for Education in Nursing (ACEN) feature courses that prepare students to earn certification as psychiatric mental health nurse practitioners (PMHNPs). Typically comprised of 20-26 graduate credits and requiring approximately a year of full-time study to complete, post-MSN graduate certificate programs are a convenient, affordable, and efficient pathway for APRNs who have their MSN to expand their scope of practice without completing a DNP program that includes training in a second area of specialization.

American Nurses Credentialing Center Certification for PMHNPs

APRNs who are interested in becoming certified as PMHNPs must earn certification in this specialty through the ANCC’s Psychiatric-Mental Health Nurse Practitioner (Across the Lifespan) Certification (PMHNP-BC™) examination. To qualify for this examination, students must hold an active and current license as a registered nurse in their state of practice and residence, and they must have graduated from an MSN, DNP, or post-MSN graduate certificate program in psychiatric mental health nursing that has been accredited by the CCNE, ACEN, or the National League for Nursing (NLN) Commission for Nursing Education Accreditation (CNEA).

Other criteria that examination candidates must fulfill include the completion of graduate-level courses in advanced physiology and pathophysiology across the lifespan, advanced health assessments, and advanced pharmacology; clinical experience in a minimum of two psychotherapeutic treatment modalities; and advanced knowledge of pharmacologic and non-pharmacologic interventions for disease management. The PMHNP-BC™ examination tests students on five key areas:

• Scientific Foundation: Questions in this category cover topics in advanced pathophysiology, pharmacology, psychopharmacology, neurodevelopment, neuroanatomy and neurophysiology, psychogenomics, and conducting advanced physical assessments.
• Advanced Practice Skills: This category of questions covers students’ clinical interviewing skills, their knowledge of health promotion and disease prevention principles and strategies, their psychiatric emergency and risk management skills, patient psychoeducation, and substance abuse screening and interpretation.
• Diagnosis and Treatment: Questions in this category evaluate students’ knowledge of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the process of differential diagnoses of psychological and mental health issues, evidence-based practice in psychiatry and mental health services, and the use of psychotherapy and pharmacotherapy to manage mental and behavioral health disorders.
• Psychotherapy and Related Theories: This category of questions covers the latest principles and models of psychotherapy and change theory, such as cognitive behavioral therapy, coping with grief and loss, motivational interviewing, and the Transtheoretical Model. In addition, this category includes questions on developmental cognitive theories and interpersonal (including familial) relationship theories and structures.
• Ethical and Legal Principles: Questions in this category cover patient confidentiality and privacy, patients’ rights to informed consent of treatment and comprehensive treatment options, competency of care with diverse individuals, social justice and inequalities in psychiatric and behavioral health care, and the role of the PMHNP in advocating for patient needs.

FNPs typically have a strong academic and clinical background in primary care, including patient assessments and diagnoses, patient education and advocacy, and medical pharmacology. FNP to PMHNP programs build upon this strong foundation in order to give students advanced skills specifically in psychiatric and mental health care assessments, diagnoses, and treatments.

As psychiatric mental health nursing does not generally overlap with family nursing (as family nursing tends to focus more on physical ailments rather than mental or behavioral), FNPs who wish to earn certification as PMHNPs should be prepared to take substantial coursework on the above topic areas covered in the ANCC examination. In addition, the ANCC’s PMHNP-BC™ examination requires candidates to have fulfilled at least 500 hours of clinical experience in psychiatric and mental health care settings.

Gap Analysis for Post-MSN Certificate Programs

Most post-MSN APRN certificate programs are primarily focused on preparing RNs to meet licensing requirements in a specific APRN specialty. As a result, these programs are fundamentally different in structure when compared to MSN programs, in that they do not typically have core primary nursing care courses, nor do they require supplemental or elective courses. FNP to PMHNP post-master’s certificates are typically comprised solely of classes and clinical rotations in psychiatric mental health nursing.

While FNPs’ and PMHNPs’ scopes of practice typically do not overlap substantially, students who have taken coursework in psychiatric mental health nursing principles, concepts, and methodologies, and those who fulfilled clinical internships in psychiatric mental health nursing during their master’s program, may be able to apply those credits and clinical hours to their post-master’s certificate program. This process, which is often referred to as a Gap Analysis, involves evaluating the past graduate coursework and clinical internships that students have completed, and assessing whether credit can be assigned for this past work.

For example, the majority of FNPs have to complete the 3 P’s of Nursing (i.e., Physical/Health Assessment; Pharmacology; and Physiology and Pathophysiology) during their MSN (or DNP) program. Assuming these courses were completed within a specific time period (for example, within five years of applying for a post-MSN certificate program), most post-master’s certificate programs do not require students to repeat these courses. As each school of nursing has different policies around Gap Analyses and the number of course credits and clinical hours that students are allowed to transfer into a graduate certificate program, students who are interested in transferring their past academic work into a post-MSN FNP to PMHNP program should contact the admissions offices of the programs that interest them for more information.

Curriculum for FNP to PMHNP Programs

FNP to PMHNP graduate certificate programs typically consist of 20-26 credits of coursework dedicated to psychiatric and mental health care principles and methodologies. In addition, students are required to complete a clinical residency or internship of at least 500 hours, wherein they integrate what they have learned in their classes into real clinical situations with individual patients, groups, and families. Examples of courses that might comprise a PMHNP post-MSN graduate certificate program include but are not limited to:

• Psychopathology and Clinical Reasoning: The epidemiology and etiology of mental and behavioral health disorders across the lifespan. The role of the PMHNP in applying clinical reasoning to the diagnosis and treatment of mental health disorders within patients’ sociocultural contexts.
• Neurobiology Across the Lifespan: The neurophysiology of mental illness across the lifespan, from childhood into old age. Common mental health conditions that patients may face at different points in their life, and within their sociocultural contexts. The process of clinical diagnosis and management of neuropsychological disorders.
• Foundations in Psychopharmacology: The range of medications used in mental health care, their side effects and interactions, and their applications in the ongoing treatment of acute and chronic mental and behavioral health disorders. Students also explore alternative medicines and complementary treatments, and discuss the role of diversity, social justice, and multicultural considerations when prescribing courses of psychiatric treatment.
• Psychotherapeutic Interventions Across the Lifespan: The theories, principles, and methodologies of psychotherapeutic interventions for individuals, groups, and families, including cognitive-behavioral therapy, motivational interviewing, dialectical behavioral therapy, interpersonal therapeutic approaches, and psychodynamic approaches and interventions.
• Complex Mental Disorders and their Treatment: Complex mental health cases, including those with multiple comorbidities such as substance abuse, self-harm, and trauma-related stress. The role of the PMHNP in identifying complex patient needs and addressing them through multifaceted plans of care.
• Supervised Clinical Practice Internship: Students engage in mental health assessments and diagnoses and work under supervision to determine appropriate therapeutic interventions for patients across the lifespan, and in individual and group therapy contexts.

In some post-MSN PMHNP programs, students are required to fulfill a set number of clinical hours with certain populations. For example, in a post-MSN graduate certificate program that requires 500 hours of clinical internship, students may be required to fulfill 125 hours with children and adolescents, 125 hours with young and middle-aged adults, 125 hours with elderly patients, and 125 hours with patients experiencing severe or complex psychiatric disorders. For specific details on clinical hours requirements and also specific course content for post-MSN FNP to PMHNP programs, prospective students should contact programs that interest them for more information.

Admissions Requirements for FNP to PMHNP Programs

Most post-MSN PMHNP certificate programs have rigorous admission requirements. Applicants must hold at least a Master of Science in Nursing (MSN) from a CCNE or ACEN-accredited institution, and typically they are expected to have maintained a minimum GPA in their graduate nursing coursework. Minimum admissions requirements typically include but are not limited to:

• An active and unrestricted license as a registered nurse in one’s state of residence
• A MSN or DNP from a CCNE or ACEN-accredited institution
• A minimum GPA requirement of 3.0 or higher on a 4.0 scale for all graduate coursework in nursing

Application materials to FNP to PMHNP post-MSN graduate certificate programs also generally include:

• Academic transcripts of all nursing-related graduate coursework
• Two or three letters of recommendation from nursing faculty and/or professional supervisors
• A resume or CV
• A statement of purpose

Prospective applicants to graduate certificate programs should note that the above admissions criteria and materials are considered the minimum for admission, and that even candidates who meet all the standards listed above and submit strong application materials may not be granted admission. For more detailed information on admissions requirements and expectations for their programs of interest, students should always contact the admissions offices of these programs directly with their questions.

Online FNP to PMHNP Programs

Post-MSN graduate certificate programs are designed to be flexible, as the vast majority of students enrolled in these programs also work full-time as nurse practitioners. While some of these programs offer evening or weekend courses to accommodate working students’ schedules, other programs offer online coursework so that students can complete their graduate certificate requirements from anywhere as long as they have an internet connection and a computer that allows them to engage in remote learning, as well as asynchronous and synchronous lessons and discussions. Fully online FNP to PMHNP programs not only offer students the advantage of maximum flexibility, but they also allow nurse practitioners and APRNs who live in regions that are not near a school of nursing to gain additional training without an arduous commute or having to relocate for one year or more.

Online post-MSN FNP to PMHNP programs use learning management systems (LMS) such as Canvas, Blackboard, and Moodle to provide an interactive online learning environment for students. Through their program’s LMS, students can attend lectures, discuss course concepts and engage in projects remotely, and complete class assignments and exams from their home. While all online post-MSN graduate certificate programs include asynchronous course components that students can view or complete on their own time, some programs also include synchronous sessions, otherwise known as live sessions, wherein students engage with faculty and classmates by video or online discussion boards in real-time.

APRNs who are interested in earning their post-MSN certificate online to become a PMHNP should note that all online programs still require students to fulfill clinical practicum hours in-person. In addition, some online programs require one or two on-campus intensives annually, during which students meet course instructors in-person and engage in clinical labs, networking events, and clinical skills assessments, among other academic and professional enrichment activities.

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