Mental Health Counseling Career

Mental Health Careers: A Fundamental Component to Public Health

(All career, salary, and job outlook information below is sourced from the Bureau of Labor Statistics from the most recent data available in April, 2020 unless otherwise noted)

Careers in Social and Community Mental Health

Social and community mental health jobs are very flexible and open to candidates with a wide range of education and experience levels. Careers in this category include:

Social and human service assistants

  • Entry-level education – high school diploma or GED
  • Certification or licensure required – no
  • Average salary nationally – $37,050 annually, $17.81 hourly

Professionals in this category help with a wide range of client services in fields like psychology and mental health social work. They can have direct general contact with clients and serve as a liaison between them and their more experienced and qualified colleagues. This can be a highly satisfying career choice, especially for people just getting their foot in the door who want to work with clients but don’t yet have a higher level of education.

Nationally of the 404,450 social and human service assistants, most are employed as follows:

  • 31% work with individual and family services organizations like non-profits and social service agencies
  • 20% work with state and local government agencies
  • 8% work in residential intellectual and developmental disability, mental health, and substance abuse facilities
  • 6% work in community food and housing, and emergency and other relief services

Typically there are no licensing requirements to become a social and human service assistant. While relevant education is usually preferred, usually only a high school diploma is required and on-the-job training is provided.

As professionals in this field gain more experience and education they can earn promotions and move into more specialized and individually impactful positions that deal more adeptly with specific client needs. The 90th-percentile professional at the top of their field in this career earns $54,230 annually.

In the decade leading up to 2028 there’s a 13% increase in job outlook for this profession, which is much faster than average.

Social and community service managers

  • Entry-level education – bachelor’s degree
  • Certification or licensure required – no
  • Average salary nationally – $72,900 annually, $35.05 hourly

Social service programs and community outreach organizations need someone to direct, coordinate, and plan their activities, and that’s just where social and community service managers fit in.

These managerial professions are great for people who’ve risen up the ranks as social and human service assistants, social workers, or substance abuse counselors. These managers have a real-world big-picture understanding of what their mental health professionals, and importantly clients, both need.

It can take years of work experience and promotion to move up the career ladder and become a social and community service manager. Once that level is achieved there’s also plenty of room for advancement within this vertical to more senior management positions and even larger organizations. For example, professionals in this field at the top of their game –in the 90th pay percentile nationally– earn $112,480 per year.

A bachelor’s degree is typically considered to be entry-level in this profession, while many in more senior leadership positions have specialized master’s and doctoral-level degrees. Common fields of study include:

  • Social work – Bachelor of Social Work (BSW) or Master of Social Work (MSW)
  • Business administration – Bachelor’s of Business Administration (BBA) or Master of Business Administration (MBA)
  • Public health – Bachelor of Public Health (BPH) or Master of Public Health (MPH)
  • Other related fields

Of the 156,460 social and community service managers in the nation, most work in the following sectors:

  • 32% work with individual and family services organizations
  • 19% work with state and local government agencies
  • 6% work in residential intellectual and developmental disability, mental health, and substance abuse facilities
  • 6% work in community food and housing, and emergency and other relief services

Social and community service manager jobs are projected to increase by 13% in the decade leading up to 2028, much faster than average.

Careers in Mental Health Social Work

Jobs in this field require a baseline level of prior education and training. However it’s still easy for those curious about these careers to find volunteer opportunities or positions related to mental health social work to get a taste for what’s involved.

States have licensing requirements for social workers. There are also national social worker organizations and related certification and credentialing programs.

Mental health and substance abuse social workers

  • Entry-level education – bachelor’s or master’s degree
  • Certification or licensure required – yes
  • Average salary nationally – $51,670 annually, $24.84 hourly

These professionals help people cope and overcome problems in their everyday lives, especially those related to substance abuse and mental health issues. This can be a very rewarding, albeit challenging, career because professionals can see how they are vitally important for keeping their clients from falling through the cracks. This is accomplished through activities like:

  • Individual and group therapy sessions
  • Case management
  • Crisis intervention
  • Client advocacy

For most states a bachelor’s degree in social work (BSW) or a related field is required to work in this profession. There are good opportunities for advancement up the career ladder as professionals gain valuable work experience and higher levels of education, like a master of social work (MSW). In 10 states an MSW or similar degree is the entry-level requirement to work in this field.

Mental health and substance abuse social workers at the top of their field, who have advanced education and years of experience, earn significantly more than average; the 90th-percentile earn $80,900 annually.

Of the 117,770 mental health and substance abuse social workers nationally, most work in the following sectors:

  • 23% work in outpatient care centers
  • 14% work with individual and family services organizations
  • 12% work with local government organizations
  • 11% work in residential intellectual and developmental disability, mental health, and substance abuse facilities
  • 9% work in psychiatric and substance abuse hospitals

Healthcare social workers

  • Entry-level education – bachelor’s or master’s degree
  • Certification or licensure required – yes
  • Average salary nationally – $59,300 annually, $28.51 hourly

These professionals work with families, individuals, and groups to provide the psycho-social support necessary to cope with serious medical conditions such as terminal, acute, and chronic illnesses. They play a critical role at the intersection of the healthcare and mental health fields.

A bachelor’s degree in social work (BSW) or closely related field is required to become a licensed social worker in most states. 10 states require a master of social work (MSW) or closely related field as the entry-level education for this field.

Even if an MSW isn’t required, it helps healthcare social workers lubricate the promotional gears and move upwards into higher positions with more responsibility and impact. Higher level careers tend to bring greater satisfaction, along with better wages. Healthcare social workers in the 90th-percentile earn $86,130 annually.

Of the 174,890 healthcare social workers in the nation, most are employed in the following work environments:

  • 26% in general medical and surgical hospitals
  • 14% with individual and family services organizations
  • 12% with home health care services
  • 8% in nursing care facilities
  • 7% in outpatient care centers

Process for becoming a social worker

While there’s no national process for licensing social workers, each state’s Board of Social Work or Department of Health and Human Services typically fills that role. While each state licenses social workers uniquely, most do so based on levels of education and scope of practice:

  • Entry bachelor of social work (BSW) level
  • Entry/advanced master of social work (MSW) level
  • Advanced MSW social work level
  • Advanced clinical MSW or doctor of social work (DSW) level

Levels of licensure that correspond with increasing levels of education and experience are great guideposts for marking the path towards career advancement.

Passing the national exam developed by the Association of Social Work Boards (ASWB) is a common state-imposed requirement for licensure. The ASWB similarly offers its exams based on each level of social work education, with exams offered at the associate of social work (ASW), BSW, MSW, advanced generalist, and clinical levels.

State boards typically require social work education programs to be accredited by the Council on Social Work Education (CSWE).

State licensing requirements may also include obtaining a professional social work credential. Candidates can also opt for national credentials to improve their knowledge and competitiveness. One prominent national social work organization that offers credentials is the National Association of Social Workers (NASW).

Relevant NASW credentials for healthcare and mental health-substance abuse social workers include the following, and part of qualifying for each requires either a BSW or MSW:

  • Clinical Social Worker in Gerontology (CSW-G)
  • Social Worker in Gerontology (SW-G)
  • Advanced Social Worker in Gerontology (ASW-G)
  • Certified Hospice and Palliative Care Social Worker (CHP-SW)
  • Advanced Certified Hospice and Palliative Social Worker (ACHP-SW)
  • Certified Clinical Alcohol, Tobacco and Other Drugs Social Worker (C-CATODSW)
  • Certified Social Worker in Health Care (C-SWHC)

Over the decade leading up to 2028 the social work job growth outlook is much higher than average, with a projected 11% growth rate.

Mental Health Counselors and Therapists

While there are some entry points for careers in this field for those with a high school diploma or associate’s degree, mental health counselors and therapists generally require at least a bachelor’s degree in a relevant field.

These are mid-level careers that often have state licensing requirements and the opportunity for advancement into higher-level professions after additional experience and education.

These professionals play an important role in addressing specific mental health needs of clients and patients.

Substance abuse, behavioral disorder, and mental health counselors

  • Entry-level education – bachelor’s to master’s degree
  • Certification or licensure required – often
  • Average salary nationally – $49,950 annually, $24.01 hourly

These professionals are vital in treating substance abuse problems coupled with behavioral disorders and mental health issues in groups, families, and individuals. Close client interaction and care are hallmarks of being a counselor, and it takes an advanced level of education to optimize this kind of delicate relationship. Being able to see concrete improvement and affect positive changes make this career choice particularly rewarding for those with strong empathetic tendencies.

Work environments are typically mental health and substance abuse organizations, and these often have opportunities for aspiring substance-behavioral-mental health counselors with a pertinent bachelor’s degree or even high school diploma. Gaining experience before becoming a full-fledged counselor can be insightful, and there are opportunities for career advancement that coincide with increasing levels of education and experience.

Typically however, a state-granted license and a master’s-level of education are required to become a full mental health counselor. The 90th-percentile annual salary for substance abuse, behavioral disorder, and mental health counselors at the top of their field –often with a doctoral-level of education and many years of experience– is $76,080.

Of the 283,540 professionals working in the field nationwide:

  • 23% work in outpatient care centers
  • 18% work with individual and family services organizations
  • 12% work at residential intellectual and developmental disability, mental health, and substance abuse facilities
  • 10% work at offices of other health practitioners, especially mental health practitioners
  • 7% work with local government organizations

In the decade leading up to 2028, jobs for substance abuse, behavioral disorder, and mental health counselors are projected to grow by a whopping 22%.

Marriage and Family Therapists

  • Entry-level education – bachelor’s to master’s degree
  • Certification or licensure required – often
  • Average salary nationally – $54,590 annually, $26.25 hourly

Often called the strongest unit of society, families and marriages need special attention when they come under stress due to mental, emotional, and behavioral challenges. Enter marriage and family therapists.

While challenging and requiring the innate skill of being able to wear many hats at once, these professionals enjoy a particular level of job satisfaction when their treatment techniques result in families, children, and spouses overcoming painful and even debilitating obstacles.

In addition to natural empathy and analytical skills, working as a marriage and family therapist typically requires state licensure and a master’s-level of education. This relatively high bar for entry is a nod to the powerful influence these mental health professionals can have on a family.

Upon licensure career advancement can proceed through a variety of pathways and depends on each individual’s professional preferences and goals. One route might be to start out at a non-profit with a high volume of clients from many different backgrounds, and with experience and additional education eventually move into private practice focusing on a niche area of marriage and family counseling. Professionals in the 90th-percentile of this career earn $87,700 annually.

Of the 59,050 marriage and family therapists nationwide:

  • 34% work with individual and family service organizations
  • 23% work at offices of other health practitioners, especially mental health practitioners
  • 13% work at outpatient care centers
  • 8% work with state government organizations
  • 5% work at residential intellectual and developmental disability, mental health, and substance abuse facilities

Job growth for marriage and family therapists is projected to be extremely good over the decade leading up to 2028 at 22%.

Process for Becoming a Mental Health Counselor or Marriage and Family Therapist

In general, to become a mental health counselor or therapist a master’s degree is required in fields like:

  • Psychology
  • Mental health
  • Counseling
  • Clinical psychology, counseling, or mental health
  • Related behavioral and social science fields

An internship, clinical, or residency experience is usually a part of the education program. This is a great opportunity to establish professional references.

In addition to a master’s-level education states often license mental health counselors, and this is a process that can also require passing an examination sponsored by a national mental health counseling organization. The exact licensing requirements are determined by each state.

There are two prominent national counselor organizations that sponsor exams often required for state licensure. These organizations also sponsor professional credentials that counselors can earn, including the MAC offered by the NBCC:

Within the licensing framework set up by a state there are often paths for career advancement. For example, an intermediary mental health license could be granted for someone with a bachelor’s-level of education, with successive levels of higher licensure based on more advanced education and greater experience.

Psychiatric-Mental Health Nurse Practitioners

  • Entry-level education – Master of Science in Nursing (MSN)
  • Certification or licensure required – yes
  • Median salary nationally – $131,500 annually, $63.22 hourly

Psychiatric mental health nurse practitioners (PMHNPs) fill an important gap in the nation’s healthcare system between medical doctors and advanced nurses on one side, and psychologists and psychiatrists on the other. PMHNPs are advanced practice nurses (APRNs) who can prescribe medication for patients with mental disorders and challenges with substance abuse. They’re also qualified to assess, diagnose, and treat their own patients independently, as well as provide emergency medical care.

There are 12,690 PMHNPs nationwide according to the American Association of Nurse Practitioners (AANP). It reports the top practice setting for PMHNPs are psychiatric mental health facilities, where PMHNPs see an average of 13 patients every day.

Becoming a PMHNP is the crowning moment of a nursing career’s achievement; it’s the highest possible title in the mental health nursing career vertical that often starts many years earlier with an associate’s degree in nursing (ADN), a passing score on the NCLEX exams, and a state-board-of-nursing-issued registered nurse (RN) license.

After years of experience and additional education nurses can be eligible to become a PMHNP. This means the following:

  • Earning an MSN, postgraduate, or doctoral degree from a PMHNP education program that’s accredited by either the Commission on Collegiate Nursing Education (CCNE) or the Accreditation Commission for Education in Nursing (ACEN)
  • Earning the Psychiatric-Mental Health Nurse Practitioner (PMHNP-BC) Board-Certified credential from the American Nurses Credentialing Center (ANCC) by passing its PMHNP examination
  • Applying for a PMHNP APRN license from one’s state Board/Department of Nursing

According to the AANP, the median annual income for PMHNPs is $131,500. That’s significantly higher than the median annual income for all nurse practitioners –$109,820– reported by the US Department of Labor.

There’s an extremely high demand for advanced practice nurses in general, with a projected growth rate of 26% over the decade leading up to 2028.

Psychologists and Psychiatrists in Mental Health

Psychiatrists are medical doctors and physicians who diagnose, treat, and prevent disorders relating to the mind. This includes the ability prescribe medication. Becoming a psychiatrist means graduating with a doctoral degree from medical school (M.D.) which includes completing a residency program, and then becoming licensed by one’s State Board of Medicine. The average annual salary for the nation’s 25,530 psychiatrists is $220,430 ($105.98 per hour).

Psychologists are not medical doctors or physicians and generally don’t prescribe medication (except on a limited bases in a few states); rather they are experts in psychology from years studying emotional, social, and cognitive behavior. Psychologists commonly work one-on-one with patients to address mental and emotional challenges.

Becoming a psychologist usually involves earning a doctoral degree along with state licensure. However there are incremental career paths prospective psychologists can take on their way to becoming a fully licensed, practicing, independent psychologist.

Psychiatric Aides

  • Entry-level education – high school diploma or GED
  • Certification or licensure required – no
  • Average salary nationally – $31,090 annually, $14.95 hourly

Psychiatric aides work in tandem with nurses and other medical staff. Under their direction, these professionals provide general daily personal attention to individuals who are mentally impaired or emotionally disturbed.

Starting out as a psychiatric aide is a great way to earn experience in the field of psychology, especially for aspiring psychologists and mental health nurses. Of the 56,910 professionals in this field nationally:

  • 40% work in psychiatric and substance abuse hospitals
  • 20% work in state government organizations
  • 15% work in residential intellectual and developmental disability, mental health, and substance abuse facilities
  • 8% work in general medical and surgical hospitals
  • 4% work in the individual and family services sector

Between 2018 and 2028 jobs for psychiatric aides and technicians are projected to grow much faster than average, by 12%.

Psychiatric Technicians

  • Entry-level education – associate’s degree, diploma, or post-secondary certificate
  • Certification or licensure required – no
  • Average salary nationally – $37,550 annually, $18.05 hourly

Under the direction of senior health care practitioners, psychiatric technicians play a vital boots-on-the-ground role in caring for individuals with mental and emotional conditions. This career is a step up from psychiatric aides and a good stopover for gaining experience on the way to becoming a psychologist or mental health nurse.

Typically some associate’s-degree-level training is required in a field like nursing or psychology, along with on-the-job learning. Of the 78,470 psychiatric technicians in the nation:

  • 39% work in psychiatric and substance abuse hospitals
  • 17% work in general medical and surgical hospitals
  • 10% work in residential intellectual and developmental disability, mental health, and substance abuse facilities
  • 8% work in state government organizations
  • 7% work in offices of other health practitioners, especially mental health practitioners

The number of jobs for psychiatric technicians and aides is projected to increase by a solid 12% over the decade leading up to 2028.

Clinical and counseling psychologists; school psychologists

  • Entry-level education – master’s or doctoral degree in psychology
  • Certification or licensure required – yes
  • Average salary nationally – $87,450 annually, $42.04 hourly

Clinical, counseling, and school psychologists are mental health experts at the tops of their fields. They shoulder the responsibility of diagnosing and treating:

  • Mental disorders
  • Emotional problems
  • Learning disabilities
  • Cognitive and behavioral problems

These professionals may work one-on-one with their clients, can design and implement behavior modification programs, and coordinate family or group therapy sessions. Psychologists hold a terminal degree that represents years of educational advancement and gained experience.

Becoming a psychologist means getting licensed by a state’s Board of Psychology. This usually requires a doctoral degree in a chosen path of psychology, and for mental health psychologists this typically means clinical or counseling psychology. Clinical psychology focuses on psychological assessments while counseling psychology focuses on therapy, and there is plenty of overlap between the two.

Common doctoral psychology programs include:

  • Doctor of Philosophy in Psychology – Ph.D.
  • Doctor of Psychology – Psy. D.
  • Doctor of Education – Ed.D.
  • Education Specialist – Ed.S.

State licensing requirements mandate that psychology programs and associated internships must be accredited by the American Psychological Association (APA).

Another common requirement for state licensure is passing the Examination for Professional Practice in Psychology (EPPP), sponsored by the national Association of State and Provincial Psychology Boards (ASPPB).

Even though psychologists hold the highest degree possible in their field, there is still plenty of room for professional development through invaluable experience that can lead to increasingly senior positions with larger organizations. Or careers can advance to more niche specializations within the field of psychology; it all depends on one’s own professional goals. The 90th-percentile annual salary for clinical, counseling, and school psychologists is $132,670.

Of the 113,270 professionals in this field nationally:

  • 40% work in elementary and secondary schools
  • 18% work in offices of other health practitioners, especially mental health practitioners
  • 6% work with individual and family services organizations
  • 6% work in physician offices
  • 5% work in outpatient care centers
  • 3% work in psychiatric and substance abuse hospitals

In the decade leading up to 2028 psychologist jobs are projected to increase much faster than average by 14%.

Professional Resources

  • American Psychological Association (APA)
  • NBCC
  • National Counselor Examination for Licensure and Certification (NCE)
  • National Clinical Mental Health Counseling Examination (NCMHCE)
  • Masters Addiction Counselor (MAC) credential
  • Clinical Rehabilitation Counselor (CRC) Examination
  • ASWB – Association of Social Work Board