Explain the collaborative-care plan and the CAMHS partnership to a family — OSCE

Candidate instructions

Explain what collaborative care means in plain language, who leads the team, how the plan is stepped and tracked, how medication would be shared if needed, how consent and information-sharing work across the clinic, school and CAMHS, and what the family should do if risk rises — while acknowledging that the earlier lost referral was a systems failure you are now designing around. The examiner plays a parent. [1] [2]

Candidate scenario

You are the paediatrician in a clinic that has just embedded a behavioural-health clinician and joined a child psychiatry access program. The parents of a 14-year-old with low mood, declining attendance and a recent superficial self-laceration are frustrated that a CAMHS referral six months ago was never taken up. There is no current plan or intent, no medical instability, and school is willing to meet this week. [1] [4]

Marking domains

• Empathy, structure and agenda-setting, including acknowledging the earlier lost referral
• Accurate plain-language model: what collaborative care is and who is in the team
• Clear stepped plan with a named coordinator and how it is tracked
• Balanced medication discussion (when it might be considered; how it is shared)
• Consent, confidentiality and information-sharing explained in family terms
• Safety-net for escalating risk and a shared written plan with review dates

Model outline

Open. Acknowledge the failure without defensiveness: "I am sorry the earlier referral was not taken up — that is exactly the kind of gap we have redesigned the clinic to prevent. I want to explain how the team works now so you know who is looking after your daughter and what happens at each step." [1]

What collaborative care is. "Collaborative care means your daughter has a small team that works together and shares responsibility — me as her paediatrician, a behavioural-health clinician who is now based in this clinic, and a specialist CAMHS team we link with directly, plus a child psychiatrist we can phone the same day for advice. One person — the care coordinator — holds the plan and the contacts, so you always know who to call." [1] [2]

The stepped plan. "We match the help to how she is. Today we will do a proper assessment, including asking her about her safety. If the risk is higher than it looks, we step straight to urgent support. Otherwise, the plan is therapy with our clinic clinician and the CAMHS team together, regular check-ins where we measure how she is doing with a short questionnaire, and stepping up or down as she recovers. School is part of the plan too." [1] [3]

Medication. "Medicine such as an antidepressant is not automatic. If her depression is moderate or severe, or therapy alone is not enough, we would consider it — and if we do, the CAMHS team starts it and settles the dose, then I look after the ongoing prescribing with them in the background, with clear review dates and a plan to come back to them if anything changes." [1]

Consent and information-sharing. "Your daughter's privacy matters, and she will have a chance to speak with me alone. With her agreement, and yours, the team, the school and CAMHS can share information so we all work from the same plan. The one limit is safety — if we are worried she is at serious risk, we will share what we need to keep her safe, even if she would prefer we did not." [2]

Safety-net and close. "If her mood drops, if there are new thoughts of self-harm, or if you are worried at any time, here is exactly who to call — the coordinator by day and the crisis team after hours. We will meet again within the week, and the school meeting is this week. Here is the written plan. What questions do you have?" [1] [4]