Working as a psychiatric nurse is a challenging career choice. Psychiatric nurses work in a range of settings that include hospitals, the community, and private practice. The job setting and the level of clinical responsibility largely dictate salaries; however, educational qualifications, certifications relevant to psychiatry, and experience also play a part in this process. The mental health service faces a severe staffing shortage, so those specializing in psychiatric nursing should have no difficulty finding a job in the area that interests them.
Psychiatry or mental health offers considerable scope for nurses looking to specialize in the field. There are no entry-level positions in psychiatric nursing in the strictest sense, as all applicants must be registered nurses to be considered for a position. There are other positions within the field of psychiatry that may be open at an entry level.
Completing the required qualification to become a registered nurse (RN) is the first step to becoming a specialist psychiatric nurse. There are two ways to do this:
Upon completion of the chosen qualification, graduates must pass the National Council of State Boards of Nursing Certification Examination to become licensed to practice in a given state.
It is becoming increasingly common for healthcare organizations to require RNs to complete a bachelor’s degree rather than an associate degree. This is not yet mandatory, but the signals from the profession are that it may become compulsory in the next few years.
Those looking to become psychiatric nurses should consider beginning their careers on an inpatient unit. It is the ideal setting to build a knowledge bank of mental health issues and the different acute presentations due to the wide range of patients admitted to these facilities.
There is an increasing trend for healthcare providers to require RNs planning on building a career in mental health to complete the Psychiatric-mental health nursing certification.
This requires a minimum of two years experience as an RN, 2,000 hours of clinical practice in psychiatry or mental health nursing, and 30 hours of continuing education, both within the previous three years. Often the RN is given a timeframe for completion when hired.
Continuing education is a requirement for all medical professionals, psychiatric RNs included. The requirements vary by state but generally require a set number of hours to be completed in a specified period.
In almost all states, continuing education is required to maintain licenses, which are a requirement to practice.
There are six key areas that psychiatric nurses can specialize in, depending on their interests.
Most entry-level positions in mental health are in caregiver-type roles. However, there is one relatively unknown position that may also create a foot in the door.
A psychiatric technician provides support to the other medical professionals on their team. They provide hands-on care for those with mental illness. Often they prepare daily patient summaries to update their team with the patient’s current presentation. They are often the first port of call for patients and typically have daily contact with the patients. The information they gather is used to inform treatment and discharge decisions. Other roles include completing admission paperwork, helping with therapy sessions, and writing up formal care plans for more senior professionals on the team.
While there are some one-year courses available, a number of psychiatric technicians get their training on the job. Advancement requires additional training as a nurse or other specialist worker. The role gives the technician a good grounding and understanding of mental health. For someone studying to be a psychiatric nurse, it would complement their studies perfectly.
Psychiatric nurses looking to advance their careers will usually aim to become nurse practitioners or move into leadership positions.
Psychiatric nurse practitioners take on a higher level of clinical responsibility and have a degree of autonomy over their practice. Most are supervised by a psychiatrist or doctor but work independently on a day-to-day basis.
As psychiatric nurses gain experience, there are often opportunities to take on leadership positions within the field. This may see nurses move into different roles, such as community outreach manager. This position is responsible for allocating the community staffing resources to ensure patients are seen early and admissions minimized.
If practicing in a specialist field, team leader positions are an option for experienced nurses. The role manages the team’s resources efficiently and effectively to maximize their benefit.
Based on data collated by scale.com, as of April 2021, the average salary range for psychiatric nurses in the U.S. is $81,829 to $100,547. The average salary is $91,343.
In terms of an hourly rate, psychiatric nurses in the U.S. can expect to receive between $39 to $48 per hour. The average hourly rate is $44 per hour.
New graduates can expect to earn an average salary of $64,195, with most graduates earning between $57,589 and $73,390.
As with most jobs, psychiatric nurse’s salaries vary between states. There are several variables to be considered when comparing the wage data of the different states.
The following table presents the average salary of a new graduate psychiatric nurse for each state, the average salary of a psychiatric nurse for each state, the average salary range, and the cost of living in each respective state.
The cost of living and average wages have a degree of interdependence. The cost of living may mean a salary has a higher absolute value than the monetary value suggests. This must be taken into account when considering job options.
Another consideration is the state tax laws; Alaskans, for example, do not pay state sales or income tax. This makes it an attractive option, especially if you’re a fan of winter.
|State||Average Salary New Graduate Psychiatric Nurse||Average Salary Psychiatric Nurse||Salary Range Psychiatric Nurse From||Salary Range Psychiatric Nurse To||Cost of Living +/- U.S. Average|
|District of Columbia||$71,404||$101,601||$91,019||$111,839||+56.1%|
In terms of the best paying states, Alaska has the highest average salary for psychiatric nurses at $102,396. Close on Alaska’s heels are California and the District of Columbia. All three have a cost of living that is well above the national average.
The state with the lowest salary for psychiatric nurses is Mississippi, with an average salary of $79,469, followed by West Virginia and Wyoming. All three have a negative or low cost of living.
For new graduates, California, the District of Columbia, and New Jersey are the top payers, while South Dakota and Mississippi are at the lower end of the spectrum.
One caution, when comparing the cost of living, the figure presented is the average cost of living in the major cities in the state. In some states, there is a wide variation between cities. In California, for example, Visalia has a cost of living of -3.2%, while at the other end of the scale, San Francisco has a cost of living of +86.1%. This must be kept in mind as it distorts the figures.
The law of supply and demand has a significant role in dictating the salaries offered in a particular state. This explains some of the variances between states. Less popular states that are hard to staff and those busy states that do not have enough psychiatric nurses to fill their rota will typically offer better salaries to attract talent.
The District of Columbia, for example, offers one of the highest average salaries, but it has been estimated that the mental health service is only meeting 5% of the population’s needs. A high salary is designed to entice professionals to the area so that the population’s needs are better met.
The same is true within states, where smaller towns and rural areas struggle to fill positions. Salaries are used to attract talent out of the city and into rural settings.
Some states and rural providers also offer attractive work benefits for those that accept positions. These include generous student loan repayment options and signing incentives, neither of which have been accounted for here.
The mental health system is reaching a critical point, with specialty services at capacity, insufficient bed numbers and treatment options, and a shortage of administrative and clinical personnel across the board, meaning many in urgent need of care are not getting the help they need.
According to the leading American medical magazine, JAMA, mental health has the highest financial cost, death rates, and disabilities of any health condition. Currently, only 26.9% of those who need help are getting it.
The mental health service before the pandemic was struggling to cope, with the number of people seeking assistance trending rapidly upward. Inpatient units were seeing an increase in the number of both voluntary and involuntary admissions.
The mental health service reached saturation point some time ago. There are widespread difficulties in staffing facilities for treatment. Patients who would previously have been admitted are increasingly being treated in the community due to these acute shortages. The pandemic has served to emphasize the seriousness of these issues.
There are significant staff shortages across the board in mental health. Psychiatric nurses are certainly no exception. Unfortunately, the U.S. Bureau of Labor Statistics doesn’t break down its RN category to individual specialties such as psychiatry; however, the figures do offer some insights.
It was predicted in 2019 that nursing numbers needed to increase by 7% over the next ten years to meet demand. This is generally considered to be a gross understatement by those working in mental health.
Nurse practitioners working in mental health are taking on more responsibility due to the current shortages. It is predicted the number of practicing nurse practitioners will need to increase by 45% over the next ten years to cope with the influx of patients.
Even before the pandemic, the mental health system was on shaky ground; the pandemic has turned this shaky ground into quicksand. The number of young people suffering isolation or loneliness increased to 66%, and the associated mental issues followed suit.
In June 2020, it was estimated 40% of U.S. adults were struggling with mental illness or substance abuse up from pre-pandemic numbers due in part to the effects of isolation and loneliness.
In December 2019, 11% of U.S. adults were suffering from anxiety. In December 2020, this had increased to 42%. Depression rose from 10% to 19% in three months.
The impact of social isolation, first through lockdowns and subsequently by the lack of social interactions due to not attending school, in some cases for over a year, is already showing devastating effects on the mental health of children and adolescents.
The effects of the pandemic on mental health will be severe and long-reaching. Many experts have cautioned that the pandemic’s full impact on mental illness will be realized over the next five to ten years.
For nurses looking to move into this specialty, the opportunity is there and waiting. A number of these patients are seen in the community, which lends itself to a nurse-based model of care, given nurses have been seen as a perfect fit for the community outreach/interaction-based care.
There are several specialties within the mental health field that present potential opportunities for psychiatric nurses.
Substance abuse and addictions have escalated rapidly over the last few years, fueled by the opioid endemic. More Americans are addicts than ever before.
This trend shows no signs of slowing, with 13% of Americans saying they had either started using or were using more substances due to the pandemic.
The number of professionals working in the area was woefully inadequate. When the impact of the last 12 months is added to the equation, it is clear there are plenty of opportunities for a skilled psychiatric nurse.
Child and adolescent psychiatry is likely to grow considerably over the next few years. There is already volumes of evidence suggesting this group has been impacted most by lockdowns and lack of social contact. Experts suggest that many will require an intensive effort to regain the social aspects of development they have missed.
The U.S. has an aging population. With people living longer, the impact of degenerative brain diseases such as Alzheimer’s and dementia are becoming more common. Although they are organic diseases, they usually come with significant psychiatric symptoms.
Psychiatric nurses specializing in this area will become an increasingly popular commodity as the need for skilled professionals escalates. The growing aging population means that significant investment needs to be made in this area sooner rather than later.
Psychiatry is a field of medicine that requires experience to be successful. Unlike the medical-based specialties, in most instances, there is no test or x-ray to confirm that a patient is, in fact, suffering a mental illness. It comes down to the individual medical professional’s knowledge and skill in recognizing the symptoms and ways they can present.
Those who are successful in psychiatry have done their time and built their knowledge base to recognize the symptoms of mental illness and the different presentations.
Generally speaking, psychiatric nurses are rewarded for their work history and the experience they have gained over the years. As the above table illustrates, a psychiatric RN beginning their career will earn anywhere from $15,000 to $35,000 less than their more experienced counterparts.
Over their career, an RN can expect to see their salary increase in the region of 35% to 60%; however, it is difficult to ascertain what portion of this increase relates to increased experience, as most RNs also complete additional certifications and educational qualifications while practicing.
Senior RNs with experience can also benefit by taking on leadership roles. These could include becoming a nurse manager or charge nurse. A charge nurse on the inpatient unit will receive an average salary of $103,989. The range of psychiatric charge nurse salaries is $87,876 to $118,190.
Investing in education is one way for nurses to add to their base salaries.
When choosing the course of study to qualify as an RN, those considering the ADN path must be aware they are likely to earn less than those with a bachelor’s degree. The ADN RN will earn on average $5,000 less at each career stage.
A psychiatry nurse practitioner is typically involved in assessing, diagnosing, and recommending treatments for mentally ill patients. They are also known as advanced practice psychiatric mental health nurses. Part of their day involves reviewing patients and interacting, not only with the patients but their families as well.
Nurses who want to specialize in psychiatry will typically complete some form of post-graduate study. A Master’s degree is the minimum requirement for pursuing the nurse practitioner qualification, which opens the door to more clinical responsibility and the increase in salary that comes with it.
Most nurse practitioners will also complete the post-graduate nurse practitioners certificate.
APNs have an average salary of $108,630, with most salaries falling in the $97,100 to $118,890 range. There is variation similar to that seen with psychiatry RNs, detailed in the table above. Salaries in this role are very much dependent on the level of clinical responsibility taken on.
Three certifications have been shown to have the most significant impact on the salary of an RN working in mental health.
Psychiatric nurses who have completed the cardiopulmonary resuscitation and basic life-saving techniques certification receive $1,500 to $2,000 more in their annual salary package than those who have not.
This is a competency-based examination that provides a basic assessment of the RN’s knowledge in psychiatry. The certification lasts for three years before it needs to be renewed. Obtaining this certification can increase the nurse’s pay packet up to $2,000 annually.
Jobs requiring the nurse practitioner certification have increased by 225% since 2018, with those holding this qualification earning on average 27.42% more than their peers. The average salary varies depending on the data source, with several suggesting the average salary is around $119,673, with top performers earning up to $185,000.
The salary a nurse practitioner can command is dependent on their workplace setting. Private practice offers enormous opportunities for competent nurse practitioners, with a number of nurse practitioners reporting salaries over $150,000.
The field of psychiatry is dynamic, challenging and for anyone interested in working in the medical field, one worth giving some serious thought. With psychiatric nurses a hot commodity, there is plenty of scope for career advancement. There are plenty of sub-specialties to choose from for those looking to focus on a particular area, with specialization bringing its own financial rewards.