This chapter presents a simulation activity that incorporates the students’ knowledge of psychiatric illness and risk assessment with a focus on mood disorders and substance abuse. The simulation exercise builds on skills in therapeutic communication, lethality assessment, and recognition of signs and symptoms of major depression and alcohol abuse. Postscenario discussion can assist in clarifying issues in documentation, patient rights, and legal requirements of mental health nursing practice. The simulation activity presented in this chapter specifically helps students to meet objectives for the mental health nursing course in the following areas: identifying risk factors for psychiatric disorders, developing therapeutic communication skills and planning appropriate evidence-based care for psychiatric patients, recognizing ethical and legal issues as they present in patients with psychiatric illness, and understanding the role of the nurse based on the American Nurses Association (2014) standards of practice for psychiatric-mental health nursing.