How new AI tools are advancing suicide prevention training
Artificial intelligence is stepping into one of the most sensitive areas of health care: suicide prevention. As part of the STRONG STAR Training Initiative, researchers are working with clinicians to evaluate how AI-based training tools can help build therapist confidence and skill when supporting individuals at risk for suicide. STRONG STAR is a national research network focused on finding the best preventions and treatments for psychological health issues affecting military members, veterans and first responders.
The project is supported through the Face the Fight initiative, funded by USAA, the Humana Foundation and Reach Resilience, to develop several AI-based training programs. Researchers from The University of Texas at San Antonio collaborated with Rush University to develop training programs using Socrates, an AI platform designed to help therapists practice the art of Socratic questioning, a therapeutic technique that helps individuals challenge rigid thinking and discover new perspectives.
Training with Socratic questioning
“Socratic questioning is one of the key mechanisms behind why treatments for PTSD and other mental health conditions work so well,” said David Rozek, PhD, ABPP, associate professor at UT San Antonio and senior scientific adviser of Face the Fight. “When people feel trapped in their own thinking, it can feel impossible to move forward. Socratic questioning helps them break that cycle and see more realistic possibilities they couldn’t see before — and that can change everything.”
Training therapists to use Socratic questioning effectively, Rozek noted, can be difficult, especially when working with individuals at risk for suicide.
“Socratic questioning is difficult even under the best conditions, and adding suicide risk can make it feel overwhelming for new clinicians.” Rozek said. “A tool that lets you practice, make mistakes and learn safely before you’re using it in the therapy room can make all the difference. That’s what these AI training tools could make possible. Even after training, it can remain a valuable tool to help us think through complex situations in our work.”
Enhancing traditional training with AI
In traditional therapist training, clinicians often attend a two-day workshop on new therapies followed by several months of consultation to support implementation — a process considered the gold standard. The AI-based approach adds another layer, with a virtual coach available around the clock to practice with, provide feedback and reinforce learning between sessions.
One AI-assisted training program, Socrates Coach, allows therapists to role-play scenarios with simulated individuals experiencing suicidal thoughts. Another AI-assisted training program, Socrates, flips the script, letting trainees adopt the patient role while the AI provides structured practice responses based on established therapeutic approaches. By reviewing how these practice conversations unfold, researchers can identify where interactions succeed, where they go wrong and how to refine both therapist training and AI-supported training tools themselves.
A safe place to practice high-stakes skills
Rozek said the AI tools can also help clinicians become more comfortable initiating difficult but essential conversations, such as talking about suicide, firearm safety or building crisis response plans. “Having those conversations can be intimidating, especially for newer clinicians,” he said. “AI provides a safe, low-pressure environment to practice and build confidence before they’re in the room with a real person.”
As of Oct. 9, more funding has been approved for two additional AI-based training tools through Face the Fight. One will prepare clinicians to have respectful, supportive and effective conversations about firearm safety and secure storage, which is a critical area of focus given that firearms are used in approximately 72% of veteran suicides and more than half of suicides nationwide. The second will guide the development of crisis response plans, which help individuals manage overwhelming stress and build problem-solving skills.
Simulated conversation builds clinician confidence
The feedback on the training so far has been overwhelmingly positive. Clinicians report that being able to train anytime, across a wide variety of scenarios, makes the experience both accessible and effective.
The platform also allows customization of the characteristics of the AI-simulated individual. Characteristics like age, race and gender can be adjusted to support training across a wide range of scenarios. Clinicians can also select from a broad range of traumatic events for the AI-simulated patient, from car accidents to combat exposure, as well as fictional scenarios to reflect the types of challenges they commonly encounter in their work. All practice scenarios are fictional, and no personal or identifiable patient information is entered into the system.
“When I think back to being an early-career clinician, I remember how stressful it was trying something new that I’d just learned in training,” Rozek said. “As an early-career clinician, a tool like this would have changed everything for me. Being able to practice in private, without fear of judgment, accelerates learning in a way I wish I had access to. You can just focus on mastering the skill.”
Maintaining safety
While using AI in mental health training does come with challenges, Rozek emphasized that sensitivity and safety are the top priority when developing this kind of technology.
“Strong safety guardrails that are reviewed and updated by clinical experts are built into the programs from the start and continuously refined,” he said. “Like any new training tool, it is not perfect yet. Socrates and Socrates Coach may occasionally miss nuances that an experienced clinician would catch, but the goal here isn’t to replace human training or supervision — it’s to strengthen it. The opportunity now is to learn where these tools fit safely and how they can help clinicians build confidence and skill as they deliver the highest-quality, evidence-based care to their patients.”
Veteran focus with wide impact
While Face the Fight is primarily a veteran-focused initiative, its impact extends beyond military populations. The training incorporates common experiences among veterans, such as trauma and suicidal ideation, but is designed for community clinicians, not those working exclusively with veterans or active-duty members. “Our military and veteran communities continue to drive important advances in suicide prevention,” Rozek said. “The progress we make with veterans and military personnel lifts the whole system. Every skill we strengthen, every tool we improve, helps clinicians provide better care to anyone who walks through their door.”