BACKGROUND: Nursing students often feel unprepared to care for patients with psychiatric diagnoses and alcohol use disorder (AUD), leading to low confidence, with fear and stigma impacting care. Simulation offers a way to build these skills. PURPOSE: This project assessed the effectiveness of standardized patients and tag team simulation in increasing nursing students' exposure and confidence managing mental healthcare and AUD. METHODS: A mixed-method pre-post design evaluated student confidence and skills. Students worked in pairs, "tagging" the next pair to continue care. Outcomes measured included the Mental Health Clinical Confidence Scale and student reflections on their simulation experience. RESULTS: Significant improvements were found in empathy ( CONCLUSIONS: Simulation enhances confidence and skills. Research should continue to examine standardized patients and tag team methods in mental health training.