FNP vs. PMHNP: Differences Explained

February 11, 2025

Advanced practice nursing roles provide unique opportunities to provide direct patient care, not only diagnosing illnesses but also planning and implementing treatment plans. For those who wish to provide this level of front-line clinical intervention, one of the most important decisions is selecting an advanced nursing specialization. Since advanced practice nurses may help alleviate the pressures of the ongoing physician shortage, this decision is also critical in ways beyond an individual’s potential career path.

Each specialization has unique duties and responsibilities, along with an emphasis on different patient populations. Two of the most popular options for advanced practice nursing professionals are the family nurse practitioner (FNP) and psychiatric mental health nurse practitioner (PMHNP) roles. Before choosing a particular path, it may be helpful to compare and contrast the FNP and PMHNP positions, both of which are viable options for nurses who pursue postgraduate certification. One of the first steps in assessing the two roles is to consider each one in turn, looking at the range of responsibilities and the population of patients served.

What Is an FNP?

FNPs are primary care nurse practitioners who treat patients of all ages. They provide a range of services, including assessment and diagnosis. They treat both chronic and minor acute illnesses. FNPs take a proactive approach to care delivery, educating patients on preventative care strategies that can potentially reduce medical facility visits. In states allowing full prescriptive authority, FNPs can also prescribe medications to patients. They work in various primary care settings, such as private practice, outpatient and community health clinics and universities.

Duties and Responsibilities of an FNP

The duties and responsibilities of an FNP can vary, but typically include the following:

Diagnosing injuries and illnesses
Creating and executing treatment plans
Performing physical exams
Prescribing medications (in states where advanced practice nurses have prescriptive authority)
Discussing patients’ medical histories
Ordering and interpreting diagnostic tests
Counseling patients and families on wellness promotion and disease prevention
Collaborating with physicians and other nurses to ensure a seamless continuum of care

What Is a PMHNP?

PMHNPs are advanced practice nurses who focus on substance abuse issues and mental health disorders, including anxiety, depression and post-traumatic stress disorder (PTSD). They treat patients of all ages and provide psychological and physical assessments, evaluations and emergency psychiatric interventions. PMHNPs can be employed in various settings, from private mental health practices to long-term clinics. They can work in inpatient or outpatient facilities.

Duties and Responsibilities of a PMHNP

The duties and responsibilities of a PMHNP can vary, but typically include the following:

Assessing and diagnosing patients experiencing the symptoms of mental health disorders
Developing and implementing treatment plans, which may include talk therapy, prescription medications and lifestyle changes
Educating patients and their loved ones about mental health
Conducting both mental health assessments and physical examinations to determine treatment needs

FNP vs. PMHNP: Similarities

Comparing a psychiatric nurse practitioner and a family nurse practitioner reveals a few similarities between the roles.

Core Duties and Purpose

While FNPs and PMHNPs focus their respective practices on different patient demographics, their fundamental responsibilities are the same. Both specialities assess, diagnose and treat patients of various ages. Additionally, the scope of practice for both roles may be subject to state regulations regarding practice and prescriptive authority.

Core Competencies

The fundamental skill sets of these two roles are also similar. Both roles require strong analytical thinking and evaluation skills to properly diagnose a patient’s issues and needs. Because both roles typically build patient care strategies with other medical professionals, such as physicians, it’s important for FNPs and PMHNPs to have solid collaboration competencies.

Advocacy

Both FNPs and PMHNPs may advocate on their patients’ behalf to ensure effective care delivery. They can use their evaluation skills and connection with the patient to speak on behalf of the patient as they develop care strategies.

A Positive Career Outlook

The U.S. Bureau of Labor Statistics (BLS) classifies FNPs and PMHNPs under their category of nurse practitioners, nurse anesthetists and nurse midwives. BLS predicts a strong career outlook for this category in the years to come, projecting a 40% growth between 2024 and 2034.

FNP vs. PMHNP: Essential Distinctions

While both of these positions are advanced practice nursing roles that involve direct patient care and require graduate education, training and certification, prospective APRNs should consider these important differences.

Type of Patients

Both FNPs and PMHNPs provide care to patients of all ages. However, FNPs generally see patients who are seeking physical examinations, injury care or diagnosis for an acute illness. By contrast, PMHNPs see patients who are experiencing or having symptoms of mental health disorders; this may mean more chronic and complex conditions and multifaceted treatment plans.

Education

Both roles require a master’s degree in nursing, followed by a more specialized certification and licensing. Also, while some of the coursework involved will be the same for all advanced practice nurses, some courses will be specific to the FNP or PMHNP. FNP courses are likely to focus on primary care across the lifespan, whereas PMHNP courses will focus on mental health care and interventions.

Students in an FNP post-master’s certificate program may take courses such as:

Advanced Pathophysiology
Clinical Assessment and Management
Clinical Pharmacology
Care of Child/Care of Women

On the other hand, students in a PMHNP post-master’s certificate program may take courses such as:

Psychiatric Assessment and Intervention Across the Lifespan
Therapeutic Interventions
Care of the PMH Patient
Care of the PMH Patient in Crisis

Salary

Another core FNP vs. PMHNP distinction is salary range.

The median annual salary for an FNP is approximately $108,320 as of September 2025, according to Payscale.
The median annual salary for a PMHNP is approximately $125,740 as of September 2025, according to Payscale.

For both of these positions, the salary range can vary according to factors such as years of experience and level of education, as well as geographic location.

The differences existing between an FNP and PMHNP role demonstrate why both positions are critical components of a health care facility. Having both specialists offers a more holistic approach to care that can cover a wider range of patient needs.

Choosing a Path in Advanced Nursing Care

Nurses looking to further their education to provide more direct care to patients have plenty of certification options to choose from. The FNP and PMHNP are merely two of the most popular nursing options.

One way to prepare for a lasting career in advanced practice nursing is to enroll in the online Post-Master’s Certificate – Family Nurse Practitioner (PMC-FNP) or the Post-Master’s Certificate – Psychiatric Mental Health Nurse Practitioner (PMC-PMHNP) programs at Walsh University Online. The programs are designed for working nurses and provide online work with hands-on clinical opportunities to prepare you for success in patient care and advocacy.

Explore the program, and find out how you can gain the skills and knowledge to provide important primary care as an FNP.

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