1. Licensure at levels of role and population foci
APRN Regulatory Model
APRN Specialties
Focus of Practice beyond role and population focus
Linked to health care needs
Examples include but are not limited to: Oncology, Older Adults,
Orthopedics, Nephrology, Palliative care
POPULATION FOCI
Adult-
gerontology
Gender
Specific
Neonatal
Pediatrics
Psych/Mental
Health
Family/individual
Across lifespan
Licensure at levels of role and population foci
APRN ROLES
Nurse
Anesthetist
Nurse
midwife
Clinical Nurse
Specialist
Nurse Practitioner
New Role
Primary care
Acute care

2. Options for Advanced Practice Psychiatric Nursing
A new role
As a Specialty
As a Role and Population

3. A New Role
Would require vetting of new role among all national and state regulatory organizations.
Would require vetting of new role among all third party reimbursers.
Would require creating a new title, identity and recognition by the public, clients, other health and mental health professionals.
Would require creation of competencies, perhaps new affiliations or creations of new organizations.
Would require creation of new certification exams.

4. As a Specialty
Would first be educated, certified and licensed in a role (CNS or NP) and a population (Family/Lifespan, Gender, Adult/Gerontology, Pediatrics, Neonatal).
Then one could chose the specialty of PMH (Adult, child etc.)
More focused area of practice than role and population foci
In addition to role and population focus preparation—cannot replace preparation for role and population foci
Definition built on ANA (2004) Criteria for Recognition as a Nursing Specialty
Cannot expand scope of practice beyond the role or population focus
Addresses a subset of the population focus
Title may not be used in lieu of licensing title
Is developed, recognized and monitored by the profession

5. As a Role and Population
Would create a foundation for practice as an advanced practice psychiatric nurse with a role as CNS or NP and a population focus of psychiatric-mental health.
Is consistent with the trends in education and certification.
Would increase workforce for psychiatric-mental health services in underserved areas where the APRN-PMH is the only mental health person in the area.
Would support life span continuity and movement among age groups with mental health needs. Ex. Someone who sees adolescents could follow them into young adulthood. Someone who sees the nineteen- year-old brother could see the younger sister.
As a population-focus, the profession would determine needed specialties and what would constitute acquisition of that knowledge and skill.
Maintains existing identities, titles, competencies, and supports.

6. ANCC Certification/Exam Trends 2003 to 2006% n
Change
CNS-Adult Psych
7356
6,699
-8.9%
CNS-Adolescent Psych
825
964
16.8%
Adult Psych NP
454
1,587
249.6%
Family Psych NP
118
540
357.6%
8753
9,790
11.8%

7. Parallel Processes
Adult Psychiatric Nurse Practitioner Certification Exam—2002
Family Psychiatric Nurse Practitioner Certification Exam--2003
Psychiatric-Mental Health Nurse Practitioner Competencies--2003
Logical Job Analysis—2005
Psychiatric Mental Health Nursing Scope and Standards--2007
Revision of certification exam--2007
Joint APNA-ISPN Child and Adolescent Taskforce--2007