Psychiatric Nurse Practitioner vs. Psychiatrist: What’s the Difference?

Nurse Types / Nurse Practitioner / Psychiatric Nurse Practitioner vs. Psychiatrist

Psychiatrists and nurses are two completely different positions, right? There’s a type of nurse called the psychiatric nurse practitioner (PNP) who shares a lot in common with a psychiatrist. The two positions are almost identical in their job duties. However, the path to get there and the scope of their practice is different. 

This post will go into more detail about the positions and how they align and differ. 

Specifically, we will cover: 

• What is a psychiatrist?
• What is a psychiatric nurse practitioner?
• What are the job duties for each role?
• What is the level of education required for each role?
• How much does each position earn?

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What is a psychiatrist?

According to the American Psychiatric Foundation, a psychiatrist is a physician who specializes in mental health. They are trained to deal with the mental and physical aspects of psychological issues. Individuals may see a psychiatrist for several reasons. They may need help with acute psychological stressors such as hearing voices, thoughts of suicide, or panic attacks. Or they may struggle with long-term issues such as depression or generalized anxiety. 

People often confuse psychiatrists with psychologists. Psychiatrists can prescribe medications and perform procedures, while psychologists can only provide counseling and nonmedical support. 

What is a psychiatric nurse practitioner?

Psychiatric nurse practitioners are nurse practitioners whose concentration is treating mental health. The PNP assists patients struggling with mental illness, gender dysphoria, and substance use disorders, just like psychiatrists. 

The main difference between the two roles is that the psychiatrist is a medical doctor and the PNP is an advanced practice nurse. However, there are subtle differences in the steps to become a PNP and a psychiatrist and the salary for each role.

What are the job duties for each role?

The psychiatric nurse practitioner and the psychiatrist’s job duties are the same. The only real difference between each role is the fact that in some states nurse practitioners need to work under the supervision of a psychiatrist.

According to the American Association of Nurse Practitioners, psychiatric nurse practitioners hold prescriptive privileges in all 50 states and DC. The scope of their practice depends on the state they live in. 

There are three categories that an NP can fall under: full practice (OR, WA, MN), reduced practice (NY, WI, UT) and restricted practice. 

In the states with full practice authority, the PNPs do not have to work under a doctor’s supervision. In the reduced and restricted states, PNPs must comply with and get a doctor to sign off on specific patient care decisions. 

Psychiatrists and PNPs perform the following tasks: 

• Diagnose and treat common acute psychiatric problems
• Provide individual, group, and family psychotherapy
• Educate clients on wellness practices
• Check the patient’s medical state and refer to a medical specialist if necessary
• Work with healthcare team to provide comprehensive support for clients 

Both roles treat the following disorders and illnesses:

• Anxiety
• Bipolar disorder
• Eating disorder
• Gender dysphoria 
• Attention deficit hyperactivity disorder/Attention deficit disorder
• Substance abuse 
• Trauma, PTSD, adjustment disorders
• Schizophrenia 
• Autism spectrum disorder
• Panic disorders

Again, the only real difference here depends on the scope of practice for the PNP. In many states, they have full authority. 

What is the level of education required for each role?

A psychiatrist must attend medical school and can expect to take around four years to earn a Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO). After graduating from medical school, the individual can become a doctor by earning their license and becoming a resident. 

A PNP doesn’t have to go to medical school to earn their license. They are required to get a Master of Science in Nursing degree, which generally takes two years, assuming they have their Bachelor of Science in Nursing. 

How much does each position earn?

According to the BLS report from May 2021, psychiatrists make $249,760 a year compared to nurse practitioners, who make $118,040 per year.

There is a large difference in salary between the two positions even though they perform similar, if not identical roles. However, the discrepancy has to do with the difference in education levels.