Health care providers have a lot of letters behind their names... MD, DO, LPC, LAC, PhD, DNP, RN. When you need mental health support, it's hard to know whether the care you need, is the care they can provide.
In mental healthcare, the scope of practice is determined by the provider's state of practice. Each discipline (medicine, nursing, social work, psychologists, social workers and behavioral health counselors) are regulated by their state licensing board and the laws within that state determine their scope which means what they can and cannot do in practice.
Team members within the mental health space include:
- Psychiatrists
- Psychiatric Mental Health Nurse Practitioners
- Physician Assistants
- Psychologists
- Licensed Counselors
- Licensed Social Workers
- Peer Specialists
Let's break down some of the basic similarities and differences between mental health providers and when a person might choose one discipline over the other.
· Psychiatrists include D.O. and M.D. trained medical providers who have completed medical school and specialized training/residency in psychiatry, which is the branch of medicine focusing on the study, diagnosis and treatment of mental illness. Their practice may include both medication management, psychotherapy and other interventions such as TMS, ECT and can be hospital based or in the community. People may be seek out psychiatrists when there's a high degree of medical complexity or when they are seeking a specialist in child-adolescent services, addictions or forensic psychiatry. Often they differentiate between child and adolescents or focus on adults. It takes 8-10 years of postgraduate study for a psychiatrist.
· Psychiatric Mental Health Nurse Practitioner (PMHNP): All Psychiatric Nurse Practitioners are Registered Nurses who have completed graduate training focused on psychiatric nursing to include the evaluation, diagnosis and treatment of individuals with mental health disorders. They are able to prescribe medication, provide psychotherapy as their state law dictates; order labs and diagnostic tests and provide care throughout the lifespan (with children, adolescents and adults). Some PMHNPs focus solely on medication management while others have additional training (and interest) to provide therapy. Some PMHNPs have received a Master’s degree while others have completed a Doctorate of Nursing Practice, and training may span 2-3 years postgraduate training with an addition of 1-3 years supervision depending on the state law guiding independent or supervised practice.
· Physician Assistants (PA) undergo graduate training to perform mental health care under the supervision of a medical doctor, though the degree of supervision has changed since 2023. State laws dictate the level of supervision needed. PAs may complete assessments, physicals, ordering and interpreting diagnostic studies, establishing and managing treatment plans which may include medication management. The duration of training is two years of postgraduate education though may include further time of supervised practice for independent practice depending on the state.
· Psychologists are professionals with graduate degrees in psychology and are able to diagnose and treatment mental health disorders. Psychologists implement treatment plans to include different therapeutic approaches including cognitive behavioral therapy, psychoanalytic therapy, and other behavioral therapy approaches. In some states, psychologists are able to prescribe medications depending on state law, while in other states they collaborate with psychiatrists and PMHNPs to provide comprehensive care. Training for clinical psychologists can span from 5-7 years.
· Licensed Professional Counselors (LPC) are professionals who hold a master’s degree in counseling and have met state requirements for licensing in their state. They may be specialists in addiction, marriage and family counseling or focus on individual or group therapy. These professionals have completed at least two years of graduate training. These professionals may have credentials to provide clinical supervision to interns or LPC candidates who are in school for their graduate training as well.
· Licensed Clinical Social Workers (LCSW) are professionals who hold a Masters of Social Work degree and have training in clinical social work practice. They are able to provide social support as well as counseling. They may serve as case managers, program managers, in advocacy, research or administrative roles.
Peer specialists are folks with personal history with mental illness who are able to provide support, help to manage crises and support for recovery. They do not provide formal therapy though are able to provide compassionate support.
The decision of when to seek care for mental health support and who you connect with is very individual. Many people look for those providers who accept insurance networks, those with flexibility in timing or the ability to provide telehealth or in person care.
At Haelen Mental Health, our team is comprised of both Advanced Practice Nurses with certification in Psychiatric Mental Health nursing and licensed professional counselors to provide comprehensive care.
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