Psychiatrists (MD/DO) and psychiatric mental health nurse practitioners (PMHNPs) can both diagnose mental health conditions and prescribe medication. Psychologists and therapists provide talk therapy and, in Texas, generally do not prescribe. Many people see a prescriber and a therapist together.
If you are looking for mental health care, the number of titles can be confusing. Psychiatrist, psychiatric nurse practitioner, psychologist, therapist, counselor: who does what, and who should you call first?
Here is a plain-language guide.
Psychiatric mental health nurse practitioners (PMHNPs)
A psychiatric mental health nurse practitioner is an advanced practice registered nurse (APRN) with a graduate degree, such as a Master of Science in Nursing (MSN), and specialized training in psychiatric care. Those who pass the national board exam earn the credential PMHNP-BC (board certified).
PMHNPs can:
- Complete comprehensive psychiatric evaluations
- Diagnose mental health conditions
- Prescribe and manage psychiatric medications
- Provide supportive therapeutic interventions and patient education
Nursing education emphasizes the whole person, including physical health, relationships, environment, and daily life, which shapes how many PMHNPs approach care. In Texas, nurse practitioners prescribe under a prescriptive authority agreement with a physician.
Kayla Canon, the founder of Your Own Grounds, is a board-certified PMHNP. You can read more about her approach.
Psychiatrists
A psychiatrist is a medical doctor (MD or DO) who completed medical school and a residency in psychiatry. Psychiatrists diagnose mental health conditions and prescribe medication, and some also provide psychotherapy. Psychiatrists often care for people with the most complex or severe conditions, including in hospital settings.
Psychologists
A psychologist holds a doctoral degree (PhD or PsyD) in psychology. Psychologists provide psychotherapy and psychological testing, such as evaluations for learning differences. In Texas, psychologists generally do not prescribe medication.
Therapists and counselors
Licensed professional counselors (LPC), licensed clinical social workers (LCSW), and licensed marriage and family therapists (LMFT) provide talk therapy: cognitive behavioral therapy (CBT), trauma-focused therapy, couples and family therapy, and more. They do not prescribe medication.
Which provider do I need?
- You want to explore whether medication could help, or you already take a psychiatric medication: a psychiatric provider (PMHNP or psychiatrist). Start with a comprehensive psychiatric evaluation.
- You want regular talk therapy to work through patterns, relationships, or trauma: a therapist or psychologist.
- Both: many people do best with a psychiatric provider and a therapist. Your providers can coordinate care when you would like them to.
The most important factor
Credentials matter, but so does fit. You deserve a provider who listens, explains their reasoning, respects your preferences, and makes decisions with you. That is the heart of shared decision-making.
If you are in Texas and would like to talk with Kayla, visit our new patient page or email hello@yourowngrounds.org.
Frequently asked questions
Can a psychiatric nurse practitioner prescribe medication?
Yes. Psychiatric mental health nurse practitioners (PMHNPs) are advanced practice registered nurses who can evaluate, diagnose, and prescribe psychiatric medication. In Texas, nurse practitioners prescribe under a prescriptive authority agreement with a physician.
Is a PMHNP as good as a psychiatrist?
Both are qualified to provide psychiatric evaluations and medication management. Psychiatrists complete medical school and a psychiatry residency; PMHNPs complete graduate nursing education and national board certification in psychiatric mental health. The best fit depends on your needs, availability, and the relationship you build with your provider.
Do I need a therapist and a psychiatric provider?
Many people benefit from both: a psychiatric provider for evaluation and medication decisions, and a therapist for ongoing psychotherapy. Some psychiatric visits also include supportive therapeutic interventions.
This article is for general education and is not a substitute for personal medical advice. If you are in crisis, call or text 988.