Psychiatric-mental health (PMH) nurses and nurse practitioners (NPs) are well poised to address gaps in mental health/substance use care in the United States, but greater numbers of these clinicians and improved awareness of their skills are needed, explained American Psychiatric Nurses Association (APNA) President Leslie G. Oleck, MSN, PMHNP-BC, PMHCNS-BC, LMFT, at the APNA 36th Annual Conference held October 19 to 22, 2022, in Long Beach, California.

Improved funding is also needed. “Policymakers need to know who we are and what we do, including whom we serve,” Oleck said.

Educate the Community

“I’ve noted for many years and research now supports this, that PMH nurses have a very difficult time articulating our value and our expertise because we do so much,” Oleck explained. “The ‘art’ of what we do is often hard to measure for researchers.”

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When educating patients, policymakers, and the community on the PMH nursing field, clinicians should explain that they engage in patient advocacy, assessment, therapeutic communication, listening/active listening, motivational interviewing, and psychotherapy including cognitive behavioral therapy, interpersonal relationship theory, dialectical behavior therapy, and Living in Process techniques, Oleck said. “We distribute hope,” she added.

Legislative Advocacy

Individual PMH nurses and NPs should stay vigilant about what is happening at the state level regarding the profession. “There may be an opportunity to tell your legislator what’s going on in mental health these days,” Oleck said. “As a psychiatric mental health nurse, I’ve also learned that legislators love our stories. They want to know what we did that helped a patient. And remind them that you are a constituent.”

Oleck suggested contacting APNA Councils and task forces that have or may need an individual PMH nurse’s area of expertise. Clinicians interested in advocacy can contact the Council on Mental Health Advocacy and find out what is happening in other states and across the nation in mental health, she added.

PMH Nursing Workforce Report

Oleck highlighted the APNA 2022 Psychiatric-Mental Health Nursing Workforce Report in her discussion on what PMH nurses and NPs need.

In addition to funding, the other key need is for more PMH nurses. The most common barriers to pursuing this career are that individuals felt they needed prior medical-surgical experience before entering a PMH program and that a faculty member told them they needed such experience prior to becoming a PMH-RN, as described in the report. Oleck encouraged the audience to educate and mentor nursing colleagues that these antiquated beliefs are not factual.

High Rates of Workplace Violence Reported

Another essential need is for PMH nurses and NPs to feel safe on the job. Research shows a high rate of violence in the psychiatric treatment setting. Less than two-thirds of respondents surveyed by the APNA reported feeling either safe or very safe in their work setting, as described in the Workforce Report.

Longer orientations are also needed among PMH-RNs. Nurses receiving orientations of 1 month or longer expressed greater satisfaction with orientation than those with shorter times (10-19 days), according to the report. Magnet hospitals that offer preceptors for new hires also showed higher levels of satisfaction.

Spread the Word

“Remember to activate your voice and tell others that you are an expert advocate for persons with mental illness,” Oleck concluded. “Spread the word that psychiatric mental health nurses are highly educated and that you use the latest evidence to assess your patients and the situations at hand. Tell your colleagues and administrators what you need. Use the latest data and evidence. Teach your students and mentees what you do.”

Lastly, she encouraged attendees to develop a plan for change. “Do not be afraid of the enormity of the possible. Do not be afraid to be the one voice. Many will soon join with yours.”


Oleck LG. The unifying voice of psychiatric-mental health nursing. Presented at: APNA 36th Annual Conference, October 22, 2022.

American Psychiatric Nurses Association. APNA 2022 Psychiatric-Mental Health Nursing Workforce Report. Accessed October 19, 2022.