Training language models in simulation for psychiatric intake

The study demonstrates that multi‑turn reinforcement learning (RL) in simulation environments significantly improves a language model’s performance on structured, text‑based psychiatric intake tasks. In a randomized, double‑blind crossover trial involving 60 matched scenario pairs, the RL‑trained agent outperformed its base model in 76.7% of cases, showing higher scores on clinical examination, patient‑centered communication, and differential diagnosis appropriateness. Across 127 validated simulated scenarios, the trained agent nearly doubled the base model’s clinical rubric score and reduced under‑triage of acute safety risks by more than half, indicating that simulation provides a controlled testbed for training and stress‑testing psychiatric conversational agents.

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• llms
• agents
• reinforcement-learning
• safety