Key Takeaways:
Education and training differs between psychiatrists and psychiatric nurse practitioners.
Scope of practice varies by state. In Washington, DC, the role of psychiatrist and psychiatric nurse practitioner mirror each other.
The most important thing when looking for a mental health provider is to find someone who has the expertise and approach to help you with your specific needs.
Integrative psychiatry offers a comprehensive, holistic approach to treatment.
Even though I am an integrative psychiatrist nurse practitioner, I understand the importance of finding the right mental healthcare provider for your mental health needs – because I have been a patient too!
In this article we are going to discuss the differences between providers and how to effectively find a provider. When it comes to psychiatric treatment, two common options are psychiatrists and psychiatric nurse practitioners. Both professions are qualified to diagnose and treat mental illnesses, but there are some key differences between the two. I'll explore these differences and help you with finding a provider.
Reminder: psychiatrist and psychiatric nurse practitioners are both qualified providers. One role is not better than the other. While I am a psychiatric nurse practitioner myself, I do not believe my role is inherently better.
Here's a quick summary of some of the items we’re going to discuss:
| Psychiatrist | Psychiatric Nures Practitioner |
Education | Medical degress | Nursing degree |
Prescriptive Authority | Yes | Yes* |
Therapy | Yes | Yes* |
*Some states require a collaborative agreement with a supervising physician. Washington, DC and Maryland allow psychiatric nurse practitioners to practice independently to the full extend of their training.
Education and Training for Psychiatrist and Psychiatric Nurse Practitioners
Psychiatrists are medical doctors who have completed medical school and a residency in psychiatry. This means they have extensive training in the biology of mental illnesses and are qualified to diagnose and treat a wide range of conditions. They are also able to prescribe medication and provide therapy.
Psychiatric nurse practitioners have at least a master's degree in nursing with a specialization in psychiatric and mental health. Psychiatric nurse practitioners are qualified to diagnose and treat many common mental health conditions. They are also able to prescribe medication and provide therapy.
It is no secret psychiatrists spend more time in school. The model for psychiatrists and psychiatric nurse practitioners are different. Different doesn’t mean one is better than the other. While psychiatrists spend more time in school, psychiatric nurse practitioners typically spend time as registered nurses working in various settings gaining valuable real world experience.
Generally speaking, both psychiatrists and psychiatric nurse practitioners are educated to treat things like ADHD, depression, anxiety, bipolar spectrum, and more.
Scope of Practice for Psychiatrist and Psychiatric Nurse Practitioners
As we said before both professions are qualified to diagnose and treat mental illnesses. The scope of practice for psychiatrists and psychiatric nurse practitioners is similar, but does vary from state to state. In Washington, DC (and 25 other states) psychiatric nurse practitioners can practice autonomously and assess, diagnose and treat mental health across the lifespan. In the remaining states, nurse practitioners cannot practice independently meaning psychiatric nurse practitioners must have a collaborative agreement with a physician.
Again, this enables both psychiatrists and psychiatric nurse practitioners to treat a range of mental health diagnoses including depression, anxiety, ADHD, bipolar disorder, and more.
(Side note: the tide is changing. States increase access to quality care by allowing nurse practitioners to practice autonomously based on their education, training, and ability. States that prohibit nurse practitioners from practicing to their full extent of training are going against what studies indicate on quality care and access to care. This is another topic, for another post though.)
Integrative Approach
As an integrative psychiatrist nurse practitioner, I believe in taking a holistic approach to mental health treatment. This means addressing not only the biological aspects of mental illness, but also the psychological, social, and spiritual factors that may be contributing to a patient's symptoms.
While both psychiatrists and psychiatric nurse practitioners are qualified to provide therapy, an integrative approach to mental health treatment may be more readily available with a psychiatric nurse practitioners. Psychiatric nurse practitioners are often trained in various forms of therapy, such as acceptance and commitment therapy (ACT) – which is the therapy modality I use. They may also be more likely to incorporate alternative or complementary treatments, such as nutrition, exercise, or other alternative remedies, into their treatment plans.
Let me be clear, this doesn’t mean psychiatrist do not or cannot offer integrative and holistic approaches to care. In fact, I have worked with and learned from many fabulous integrative psychiatrists.
Prescriptive Authority for Psychiatrist and Psychiatric Nurse Practitioners
Both psychiatrists and psychiatric nurse practitioners have prescriptive authority, which means they can prescribe medication to their patients. Interestingly enough, prescriptive authority is granted by each state’s board of medicine or nursing – so specifics vary by state. In Washington, DC, psychiatric nurse practitioners ability to prescribe mirrors that of psychiatrists.
Controlled substances, like stimulants for ADHD, do require DEA approval for prescriptive authority – whether a provider is a psychiatrist or psychiatric nurse practitioner.
Now you didn't think I could discuss prescriptions without also discussing non-prescriptions, did you!? As an integrative provider, I believe medication should only be a piece of the solution - not the entire solution. That's why I think complementary and alternative interventions like nutritional counseling, exercise planning, and root-cause analysis are indispensable when seeking to achieve long-term success. Even for things that seem simple on the surface, like ADHD nutritional counseling and exercise can prove to be critical.
Finding a Psychiatrist or Psychiatric Nurse Practitioner Near Me
I would encourage you not to focus so much on whether a provider is a psychiatrist or psychiatric nurse practitioners and instead focus on finding a provider that specializes in your area of need. Also very important is goodness of fit – meaning how well do you connect with provider. Here are some steps you can take to find a good match for mental health prescriber in your area:
1. Check with your insurance provider:
Before beginning your search, it's important to know what mental health services are covered under your insurance plan. You can contact your insurance provider to find out what services are covered and what your out-of-pocket costs will be. Unfortunately I do not accept insurance, but I do offer streamlined out-of-pocket insurance reimbursement submission through Reimbursify.
2. Ask for referrals:
Your primary care provider or a trusted friend or family member may be able to provide a referral.
3. Use online resources:
There are a number of online resources available to help you find a mental health provider in your area. Websites like Psychology Today allow you to search for providers based on your location, insurance coverage, and specific mental health needs.
4. Research potential providers:
Once you have a list of potential providers, take the time to research their experience and approach. If an integrative or holistic approach is important to you, you’ll want to make sure the providers on your list offer the kind of approach you’re seeking.
Ultimately, truly the most important factor in choosing a mental health provider is finding someone who you feel comfortable talking to and who understands your unique needs and concerns. Whether you choose to see a psychiatrist or a psychiatric nurse practitioner, the most important thing is to seek the help you need to manage your mental health. It's important to remember that mental health treatment is not a one-size-fits-all approach, and what works for one person may not work for another. It may take some trial and error to find the right provider and treatment approach for you.
Conclusion: Psychiatrist and Psychiatric Nurse Practitioners
In summary, both psychiatrists and psychiatric nurse practitioners are qualified to diagnose and treat mental illnesses. Ultimately, the best choice for you will depend on your individual needs and preferences.
Mental health conditions are common and treatable, and seeking help can improve your life tremendously. Remember to take the time to research potential providers and find someone who has the knowledge about your specific needs.
If you or someone you know is struggling with mental health, don't hesitate to reach out for help. There are many resources available, and seeking help is a sign of strength, not weakness. If you’re in Washington, DC, Maryland, or Missouri (and soon to be New York State) – I am here to help! If you're in the DC area, book a free 15 intro minute appointment today.
If you have any additional questions about integrative psychiatry in general, shoot me an email or reach out through my website. If you're looking for a provider and you're in the Washington, DC area, I'd love to help you on your treatment journey!