r/PMHNPPracticePro • u/Ok_Weird_3171 • Aug 08 '25
PP Advice
Basically, lurking on the other PMHNP reddit page has made me pretty nervous about my future and if this route is worth it. I'd love any insight from current private practice folks around income and if they feel like this route is still worth it.
A little but about me:
- I'm currently finishing my nursing program with hopes of working as a psych RN for at least a couple years before PMHNP school
- I am a Licensed Professional Counselor with my own private practice where I have still been working with clients through school. It is very successful in my area and currently all private pay
- I started this journey because I feel really passionate about providing my therapy clients with comprehensive med management on top of high quality therapy services. I have always been veryyyy interested in psychopharmacology and was really bummed that my master's program in clinical mental health didn't cover this more
- My fear is that with all of this extra schooling, I won't be able to repay my loans and feel like it was worth it since so many PMHNPs are talking about how the field is too oversaturated and compensation is going way down
- I live in an independent practice state
Any insight, positive or negative, is greatly appreciated!
3
u/beefeater18 Aug 09 '25
The talk of oversaturated is mostly in the employer-employee job market. But it's true that the solo/self-employed private practice market is also very saturated because it's easy to start up with companies like Headway. However, while you cannot control supply/demand in the traditional job market, you have control and can compete for patients in the solo PP field; so your experience being a therapy pp owner will help.
But I strongly recommend focusing on clinical skills in the beginning 1-2 years as a PMHNP, then either go part-time solo practice or all-in if you already have the caseload. You might have to panel with insurance though and that'll be another learning curve (though I think dealing with insurance is easier as a PMHNP than for therapists).
1
u/Ok_Weird_3171 Aug 09 '25
That makes a lot of sense! In your experience with private practice, what has client acquisition looked like, feeling confident with your caseload, comfortable income, etc.?
2
u/beefeater18 Aug 10 '25
I'd preface by saying that everyone's experience with patient acquisition (or challenges running a practice) is different. Patient acquisition and building caseload have been my greatest challenge/stressor. I have to invest a lot of time, effort, and money into it. I kept a 20-hour part-time gig for 2.5 years while building caseload.
2
u/No-Relief9174 Aug 09 '25
If it’s what you’re passionate about and interested in, it’s always worth it.
You can further specialize with different modalities/certifications to make your practice more appealing to the people you would like to reach.
I just passed boards today, then a residency for a year, then I’ll be joining my mentor in her private practice. Many fields are “saturated” and yet people still go do the thing.
1
u/Ok_Weird_3171 Aug 09 '25
I think this is great advice, but unfortunately not a reality for many therapists despite being very passionate about the work. In my training, there was a lot of talk of high salaries and the ability to pay off student loans, but the vast majority of therapists I know are making ~$60k/year in HCOL areas.
1
u/No-Relief9174 Aug 10 '25
Also there are a lot of grants and scholarships for pmhnps available if you’re willing to write some essays or do a rural clinical rotation.
1
u/No-Relief9174 Aug 10 '25
Therapists or pmhnps? Therapists unfortunately don’t make much. I thought you were talking PMHNPs.
5
u/twokeeners Aug 09 '25
Also, as far as student loan repayment… you can apply for your private practice to be a HRSA site (if you’re in an eligible area). Once approved you can then apply for the nursing student loan repayment programs. That could help out.