Genomics in psychiatric Nurse Practitioner practice: Moving from emerging trend to essential competency

Genomics is increasingly influencing psychiatric practice as evidence links genetic variation with neurodevelopmental disorders, treatment response, and complex psychiatric presentations. Psychiatric nurse practitioners are well positioned to incorporate genomics into patient assessment and management; however, familiarity with testing options and clinical indications remains limited. This column reviews key genomic considerations for psychiatric practice, including pharmacogenomics, chromosomal microarray analysis, and exome or genome sequencing. Clinical "red flags," such as developmental delay, dysmorphic features, early-onset psychosis, epilepsy, and strong family patterns of neuropsychiatric disease, can guide decisions on when to refer for further genetic evaluation. Integrating genomics enhances diagnostic clarity, supports precision prescribing, and informs risk assessment, ultimately improving patient outcomes. Strengthening nurse practitioner genomic literacy is essential to advancing person-centered mental health care and ensuring that emerging genomic tools are applied responsibly, ethically, and effectively in practice.