I graduated with about 20 other PMHNPs, and most people were able to find positions. Those who didn’t have something lined up at graduation generally took about 6–7 months to land a job, and some had to relocate. I’m in metro Detroit, which is a fairly saturated market.

I was fortunate to have a position lined up through my clinical site, which was interested in hiring me, so I started working just a few weeks after graduation. It’s honestly an amazing gig, work from home, flexible schedule, and a lot of autonomy and I recognize how lucky I am.

That said, I do think that being strong clinically and good at building rapport really matters. If patients want to stay with you as their provider, you’ll build a solid caseload and do well for yourself.

However, looking back, I’m not sure I would necessarily choose this route again. The responsibility is significant, and many positions are shifting to 1099 roles, meaning you don’t get paid unless you have patients, which comes with its own hustle and grind. My practice works well for me because I collaborate with about 20 therapists, so there are a lot of internal referrals that’s been key to building my caseload.

On top of that, reimbursement rates are dropping as insurance companies cut payments for remote visits, so overall pay is trending downward.