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Clinical Atlas Prestige · Evidence-first

Psychiatry Fellowship CASC / OSCE

Psych · CASC / OSCE

CASC / OSCE

252 units across 175 domains — CASC / OSCE communication and clinical stations with assessor keys.

Back to PsychJump to first domain
Units
252
Domains
175
Addiction psychiatryfoundations — advanced EBM and evidence synthesisPublic and community psychiatry — school and workplace mental healthEmergency psychiatry — suicide riskConsultation-liaison — capacity and consentEmergency psychiatry — self-harm and crisisEmergency psychiatry — violence riskOld age psychiatry — capacity, guardianship and end of lifePsychotherapyFoundations — cognitive psychology / psychological therapiesFoundations — behavioural science / psychological therapiesFoundations — social psychology / early psychosisPsychotherapy — communication and psychoeducationProfessional — communication and psychological therapiesPsychotherapy — behavioural therapiesChild and adolescent psychiatry — child protection for psychiatristsPsychopharmacology — atypical and multimodal antidepressantsProfessional — formulationChild and adolescent psychiatry — children of parents with mental illnessPsychopharmacology — pregnancy and lactationConsultation-liaison — hepatic encephalopathy and advanced transplant psychiatryProfessional — cultural formulation and Indigenous mental healthEmergency psychiatryPsychopharmacology — long-acting injectable antipsychoticsProfessional practice — epidemiology and public mental healthIntellectual disability — forensic dual disabilityOld age psychiatry — elder abuse and vulnerabilityProfessional skills — mental state examinationfoundations — descriptive psychopathologyProfessional — psychological therapiesProfessional — psychosocial interventionsPublic-community — disaster and mass casualty psychiatryIntellectual disability psychiatry — genetic syndromesForensic psychiatry — civilFoundations — rating scales and measurement-based careConsultation-liaison psychiatry — abnormal illness behaviourEmergency psychiatry — absconding and missing patientsGeneral adult psychiatry — trauma and stressor-relatedChild and adolescent psychiatry — depressionForensic psychiatry — arson and fire-settingChild and adolescent psychiatry — neurodevelopmentalGeneral adult psychiatry — anxiety disordersOld age psychiatry — Alzheimer diseaseForensic psychiatry — expert evidenceSpecialty psychiatry — eating disordersSpecialty psychiatry — sexual dysfunction and paraphiliasGeneral adult psychiatry — feeding and eating disordersGeneral adult psychiatry — personality disordersAddiction psychiatry — hallucinogen-related disordersFoundations — basic neuroscience for psychiatryGeneral adult psychiatry — OCRDChild and adolescent psychiatry — elimination disordersGeneral adult psychiatry — bipolar and related disordersOld age psychiatry — dementia neuropsychiatryGeneral adult psychiatry — psychotic disordersChild and adolescent psychiatry — service interfaceAddiction psychiatry — cannabis and psychosisSpecialty psychiatry — sleep medicine interfaceChild and adolescent psychiatry — OCRDAddiction psychiatry — inhalant-related disordersGeneral adult psychiatry — clinical high risk / attenuated psychosisAddiction psychiatry — pharmaceutical and OTC misusePublic and community psychiatry — collaborative care and primary carePsychotherapy — combined treatmentGeneral adult psychiatry — trauma and stressor-related disordersForensic psychiatry — mental health lawForensic psychiatry — duty to warn and third-party riskOld age psychiatry — delirium and acute cognitive syndromesOld age psychiatry — Lewy body dementiasGeneral adult psychiatry — mood disordersIntellectual disability psychiatry — Down syndromeFoundations — psychiatric classificationGeneral adult psychiatry — dissociative disordersChild and adolescent psychiatry — DMDDIntellectual disability psychiatryAddiction psychiatry — dual diagnosis and integrated careIntellectual disability psychiatry — neurodevelopmental dual diagnosisChild and adolescent psychiatry — early-onset psychosisFoundations — EEG and clinical neurophysiologySpecialty psychiatry — sexual medicine interfaceOld age psychiatry — falls polypharmacy frailtyIntellectual disability — neurodevelopmentalChild and adolescent psychiatry — eating disordersForensic psychiatry — homicide and mental disorderForensic psychiatry — FII / medical child abuseGeneral adult psychiatry — early psychosis pathwayForensic psychiatry — fitness and criminal responsibilityForensic psychiatry — risk assessmentOld age psychiatry — neurocognitive disordersAddiction psychiatry — behavioural addictionsSpecialty psychiatry — gender and sexualityAddiction psychiatry — public health and systemsGeneral adult psychiatry — somatic symptom and relatedintellectual disability psychiatrySpecialty psychiatry — clinical paraphilic disordersGeneral adult psychiatry — impulse controlOld age psychiatry — grief and lossOld age psychiatry — mood disordersOld age psychiatry — anxiety disordersOld age psychiatry — psychosisGeneral adult psychiatry — secondary / organic psychosisAddiction psychiatry — substance use disordersAddiction psychiatry — stimulant and methamphetamine usefoundations — philosophy of mindGeneral adult psychiatry — psychosisAddiction psychiatry — neonatal abstinenceChild and adolescent psychiatry — disruptive behaviourgeneral-adultGeneral adult psychiatry — mood disorders / women's mental healthGeneral adult psychiatry — perinatalForensic psychiatry — prison mental healthFoundations — history of psychiatryGeneral adult psychiatry — psychosis rehabilitationChild and adolescent psychiatry — attachment disordersGeneral adult psychiatry — reactive attachment and disinhibited social engagementChild and adolescent psychiatry — childhood trauma and maltreatmentOld age psychiatry — psychopharmacologyChild and adolescent psychiatry — school refusal and school anxietyPublic-community psychiatry — restrictive practicesForensic psychiatry — sexual offendingForensic psychiatry — stalking and harassmentAddiction psychiatry — acute stimulant syndromesFoundations — psychoneuroendocrinology and psychoimmunologyAddiction psychiatry — substance-induced mood and anxiety disordersGeneral adult psychiatry — substance/medication-induced psychosisGeneral adult psychiatry — factitious disorder and malingeringForensic psychiatry — therapeutic securityForensic psychiatry — victimologyGeneral adult psychiatry — OCRD / BFRBChild and adolescent psychiatry — anxiety disordersForensic psychiatry — young offendersPsychopharmacology — pharmacogenomicsPsychopharmacology — first-generation antipsychoticsPsychopharmacology — stimulants and ADHD medicationsPsychopharmacology — antidepressantsPsychopharmacology — antipsychoticsPsychopharmacology — metabolic syndrome and psychotropic monitoringPsychopharmacology — phototherapy and chronotherapyGeneral adult psychiatryfoundations — neuroscience for fellowship psychiatryPsychopharmacology — clozapineConsultation-liaison psychiatryPsychopharmacology — cognitive enhancersPsychopharmacology — fitness to drivePsychopharmacology — ECT and neurostimulationPsychopharmacology — ketamine and esketaminePsychopharmacology — lamotriginePsychopharmacology — lithiumPsychopharmacology — mood stabilisersPsychopharmacology — monoamine oxidase inhibitorsPsychopharmacology — renal and hepatic diseasePsychopharmacology — drug interactions and QTcPsychopharmacology — rTMS, VNS and DBSPsychopharmacologyFoundations — psychiatric genetics and epigeneticsProfessional — teaching and supervision skillsProfessional — boundary violations and sexual misconductFoundations — social determinants of mental healthFoundations — biostatistics for psychiatry examsFoundations — research methods and study designFoundations — epidemiologic methods for psychiatryAddiction psychiatry — psychosocial interventionsPsychopharmacology — anxiolytics and hypnoticsConsultation-liaison — burns and critical illness psychiatryConsultation-liaison — transplant and ICU psychiatryPublic-community — military and veteran psychiatryProfessional — complaint management and regulationPublic and community psychiatry — rural and remoteProfessional — stigma, recovery and rights-based careProfessional — spirituality and religion in psychiatryPsychopharmacology — SSRIsPsychopharmacology — SNRIs and NRIsProfessional — doctor health, burnout and impairmentPublic and community psychiatry — telepsychiatryFoundations — prevention and early intervention
AtlasPsychCASC / OSCE

Domain

Addiction psychiatry

5

communication

Addiction in older adults — CASC communication station

A 69-year-old retired teacher attends with her adult son. Since retirement she drinks a bottle of wine most days 'to relax' and takes zopiclone 7.5 mg most nights. She has had two falls. She is insulted by the word 'addiction' and says older people deserve a drink. The son wants everything stopped this week before a cruise.

Open

communication

Benzodiazepine dependence counselling — CASC communication station

A 58-year-old man has taken diazepam 5 mg three times daily for 8 years since a workplace accident for 'nerves and sleep'. He also drinks 4–6 standard drinks most nights. After reading online about dependence he wants to stop this weekend before a family wedding. His partner fears seizures because an uncle had fits stopping 'sleeping tablets'.

Open

communication

Explaining alcohol withdrawal, seizures, DT, and thiamine — CASC communication station

A 46-year-old man is day three after admission for alcohol withdrawal complicated by a seizure. He is now oriented. His partner is angry: 'You said he was just drying out — he fitted and went mad seeing things. Why diazepam if alcohol is the problem? Why injections of vitamins? Can he ever stop safely at home next time?'

Open

communication

Explaining alcohol withdrawal, thiamine, and recovery medications — CASC communication station

A 44-year-old man is recovering on the medical ward after treated alcohol withdrawal. He is now oriented. His partner is present, angry that 'nobody ever warned us he could fit or go mad when he stopped'. They want to know what delirium tremens is, why thiamine injections were given, whether he is 'an alcoholic forever', and which tablets prevent relapse. He is motivated for abstinence but fearful of 'addiction-swapping' onto benzodiazepines.

Open

communication

Explaining Wernicke, Korsakoff, and long-term supports — CASC communication station

A 52-year-old man is day five after admission for confusion and heavy alcohol use. He received high-dose IV thiamine and is more alert, but still cannot retain new information and confabulates about having discharged home yesterday. His sister is angry: 'They said he has dementia like Mum — is that true? Why the huge vitamin drips? Will he ever live alone again?' She wants plain language about Wernicke, Korsakoff, MRI, and what supports he needs.

Open

Domain

foundations — advanced EBM and evidence synthesis

1

communication

Advanced journal club facilitation — CASC/teaching station

You are the psychiatry registrar leading a 10-minute advanced journal club with a junior doctor, pharmacist, and nurse practitioner. The paper is a random-effects meta-analysis of antidepressants with high I-squared, an asymmetric funnel plot, and a GRADE summary rating moderate-to-low certainty. A consultant has asked whether the team should switch the ward default SSRI based on a network ranking figure in the discussion section.

Open

Domain

Public and community psychiatry — school and workplace mental health

1

communication

Advise a school and employer on mental health pathways — CASC communication station

Joint meeting: secondary school deputy principal and a factory HR manager. They want practical advice on student suicide prevention after a cluster scare, and on staff depression sick leave without violating privacy.

Open

Domain

Emergency psychiatry — suicide risk

1

communication

Assess and safety-plan after suicidal ideation — CASC communication station

A 35-year-old outpatient discloses active suicidal ideation with a vague plan after job loss; you must assess risk and co-create a safety plan.

Open

Domain

Consultation-liaison — capacity and consent

1

communication

Assess capacity for treatment refusal — CASC communication station

A medical inpatient refuses recommended IV antibiotics for pneumonia; you must assess capacity, explore reasons, support understanding, and explain next steps without coercion or invented legal sections.

Open

Domain

Emergency psychiatry — self-harm and crisis

1

communication

Assess self-harm and co-create a crisis safety plan — CASC communication station

A 24-year-old in ED after self-harm wants to leave; you must assess intent, engage without stigma, and co-create a safety plan with means restriction and follow-up.

Open

Domain

Emergency psychiatry — violence risk

1

communication

Assess violence risk and explain the plan — CASC communication station

A family member is distressed after their adult son with psychosis threatened a neighbour; you must assess risk information, communicate non-stigmatisingly, and outline a safety plan without breaking confidentiality unlawfully.

Open

Domain

Old age psychiatry — capacity, guardianship and end of life

1

communication

Capacity for treatment refusal and goals of care — CASC communication station

An older outpatient with early dementia and metastatic cancer wishes to stop disease-modifying treatment and focus on comfort; spouse is distressed and pushes for more treatment. Candidate must assess understanding, explore values, lightly structure capacity, introduce advance care planning, and manage family dynamics without coercion or invented legal sections.

Open

Domain

Psychotherapy

9

communication

CASC: Behavioural activation — evening withdrawal in depression

CASC: Behavioural activation — evening withdrawal in depression

Open

communication

CASC: Supportive psychotherapy — demoralisation after job loss

CASC: Supportive psychotherapy — demoralisation after job loss

Open

communication

Explain ACT and set a values-based action — CASC communication station

An anxious adult wants thoughts eliminated before living; explain ACT, psychological flexibility, and co-create one committed action without anti-medication messaging or jargon overload.

Open

communication

Explain CAT and negotiate a time-limited reformulation plan — CASC communication station

A young adult with cutting after criticism wants 'proper CAT'. You must validate, explain reciprocal roles and the letter/map in plain language, set a realistic time-limited contract, address ending fears, check risk briefly, and avoid jargon piles or cure promises.

Open

communication

Explain couples therapy and negotiate a safe dual-client plan — CASC communication station

A depressed adult and their partner want couples therapy explained, model options sketched without jargon overload, medication questions answered, and a clear safety/consent frame.

Open

communication

Explain group CBT and limited confidentiality — CASC communication station

A depressed adult is offered a closed outpatient group CBT programme and needs a clear, non-frightening explanation of how group works, why it can help, and what confidentiality means — without overselling absolute privacy or dismissing individual therapy preference.

Open

communication

Explain IPT and choose a focus — CASC communication station

A depressed adult wants a clear explanation of IPT, the sick role, and a shared primary interpersonal focus after job loss, without jargon overload or anti-medication messaging.

Open

communication

Explain MBT and negotiate structured care — CASC communication station

A young adult with recurrent self-harm after breakups wants 'real MBT now'. You must validate, explain mentalising in plain language, set realistic expectations about dual-format programmes and waitlists, co-create a safety-focused plan, and avoid jargon piles or cure promises.

Open

communication

Explain schema therapy and negotiate structured care — CASC communication station

A young adult with recurrent self-harm after breakups and a deep sense of being 'damaged' wants 'real schema therapy now'. You must validate, explain EMS and modes in plain language, set realistic expectations about long specialised programmes and waitlists, co-create a safety-focused plan, and avoid jargon piles or cure promises.

Open

Domain

Foundations — cognitive psychology / psychological therapies

1

communication

CASC: Explaining cognitive maintenance of panic and setting a behavioural experiment

CASC: Explaining cognitive maintenance of panic and setting a behavioural experiment

Open

Domain

Foundations — behavioural science / psychological therapies

1

communication

CASC: Explaining exposure and dropping safety behaviours in panic

CASC: Explaining exposure and dropping safety behaviours in panic

Open

Domain

Foundations — social psychology / early psychosis

1

communication

CASC: Explaining family EE and stigma after first-episode psychosis

CASC: Explaining family EE and stigma after first-episode psychosis

Open

Domain

Psychotherapy — communication and psychoeducation

1

communication

CASC: Family psychoeducation after first-episode psychosis

CASC: Family psychoeducation after first-episode psychosis

Open

Domain

Professional — communication and psychological therapies

1

communication

CASC: Motivational interviewing — alcohol cut-down in dual diagnosis

CASC: Motivational interviewing — alcohol cut-down in dual diagnosis

Open

Domain

Psychotherapy — behavioural therapies

1

communication

CASC: Negotiate first ERP session for contamination OCD

CASC: Negotiate first ERP session for contamination OCD

Open

Domain

Child and adolescent psychiatry — child protection for psychiatrists

1

communication

Child protection disclosure — CASC communication station

An adolescent discloses physical abuse and fear of a caregiver; you must respond with empathy, private exploration, clear explanation of confidentiality limits, safety planning, multi-agency next steps, and parental-capacity-aware communication without inventing legal section numbers.

Open

Domain

Psychopharmacology — atypical and multimodal antidepressants

1

communication

Choosing bupropion after SSRI sexual dysfunction (CASC)

A 36-year-old with moderate–severe unipolar MDD improved partially on sertraline 100 mg but developed marked delayed orgasm and reduced libido. They smoke 10 cigarettes daily, fear weight gain, and read online that mirtazapine 'makes you sleep and fat' while bupropion 'causes seizures in everyone.' They want a clear shared decision.

Open

Domain

Professional — formulation

1

communication

Co-construct a formulation with the patient — CASC communication station

A young adult with depression and panic wants to understand 'why this is happening'; you must co-construct a simple biopsychosocial/4P formulation in plain language and link it to a collaborative plan without jargon overload or blame.

Open

Domain

Child and adolescent psychiatry — children of parents with mental illness

1

communication

COPMI family discussion — CASC communication station

Explain to a parent with mental illness why the team asks about dependent children, outlines family-focused support and prevention, addresses fears of automatic removal, clarifies confidentiality limits when safety is concerned, and agrees a relapse childcare plan — without inventing legal section numbers.

Open

Domain

Psychopharmacology — pregnancy and lactation

1

communication

Counselling psychotropics in an unplanned pregnancy (CASC)

A 29-year-old woman with bipolar I disorder and her partner attend after a positive home pregnancy test (about 5–6 weeks). She takes valproate 1000 mg daily and is terrified after reading online that 'all psychiatric drugs cause birth defects'. She wants to stop medication today. Partner asks whether lithium is 'poison'.

Open

Domain

Consultation-liaison — hepatic encephalopathy and advanced transplant psychiatry

1

communication

Covert HE, driving concern, and pre-listing depression — CASC communication station

A patient with cirrhosis is referred after 'personality change' and near-miss driving; you explain covert HE, safety, lactulose adherence, and link mood/adherence issues to transplant evaluation without shame or invented legal sections.

Open

Domain

Professional — cultural formulation and Indigenous mental health

1

communication

Cultural formulation interview with an Aboriginal woman — CASC communication station

An Aboriginal woman referred for low mood and social withdrawal; you must engage respectfully, elicit cultural identity and explanatory model, explore SEWB and racism-related stressors, assess risk, offer cultural supports, and avoid stereotyping.

Open

Domain

Emergency psychiatry

7

communication

De-escalation and rapid tranquillisation explanation — CASC communication station

A 41-year-old man with schizophrenia is moderately agitated on the ward after de-escalation partially succeeds. He may accept oral medication. His sister is present and asks what will happen if he refuses and whether you will 'knock him out'.

Open

communication

Explaining ABD care and contested labels — CASC communication station

After a severe acute behavioural disturbance is controlled in ED, the patient's sister asks why police said it was 'excited delirium', whether that means he is 'crazy and dying from adrenaline', and what you did with medication and restraint.

Open

communication

Explaining NMS and emergency plan to family — CASC communication station

A 35-year-old man with schizophrenia developed fever, rigidity, and confusion after antipsychotic escalation. He is being transferred to HDU. His sister arrives distressed, asking whether you have 'poisoned him with psychiatric drugs' and whether he will ever be able to take medication again.

Open

communication

Explaining overdose care and means restriction after self-poisoning — CASC communication station

A 33-year-old woman is medically recovering on the short-stay ward after a deliberate overdose of venlafaxine and paracetamol treated with N-acetylcysteine. She is now alert and tearful. Her mother is present, angry that 'psych meds are poison' and demanding all tablets stop forever. They want to know what happened medically, why blood tests and an antidote were needed, whether antidepressants can ever be restarted, and how to stop this happening again.

Open

communication

Explaining serotonin toxicity and medication safety — CASC communication station

A 45-year-old man is recovering on the ward after moderate serotonin toxicity from combining an MAOI with tramadol given in ED for pain. He is now alert. His partner is present and angry that 'psych meds nearly killed him'. They want to know what happened, whether he can restart antidepressants tonight, and how to prevent recurrence.

Open

communication

Lithium toxicity counselling — CASC communication station

A 48-year-old woman with bipolar disorder is recovering on the ward after chronic lithium toxicity precipitated by over-the-counter ibuprofen during a viral illness. She is now alert; lithium is held; level falling. She asks whether she can never take lithium again, why this happened, and what her partner should watch for at home.

Open

communication

Suicidal crisis safety planning and least-restrictive care — CASC communication station

A 24-year-old woman presents after a near-lethal overdose. She is now medically cleared, tearful, ambivalent about admission, and her partner is in the waiting room.

Open

Domain

Psychopharmacology — long-acting injectable antipsychotics

1

communication

Discussing a long-acting injectable with a young adult and parent (CASC)

A 22-year-old with first-episode schizophrenia and his mother attend. He stopped oral aripiprazole twice 'because I felt fine' and was re-admitted. The team suggests a monthly injection. He fears needles and 'being controlled'. Mother wants 'anything that stops the hospital'.

Open

Domain

Professional practice — epidemiology and public mental health

1

communication

District public mental health briefing — CASC/communication station

You are the psychiatry registrar invited to a 10-minute briefing with the Primary Health Network board. Members include a GP lead, a finance officer, a school principal, and a consumer representative. They want a plain-language plan after a community survey showed high 12-month prevalence of common mental disorders and substantial untreated severe illness.

Open

Domain

Intellectual disability — forensic dual disability

1

communication

Dual-disability court liaison — CASC communication station

Young adult with mild intellectual disability charged with assault; solicitor and support worker present; assess communication needs, explain fitness concept in plain language, address suggestibility concerns, and outline next steps without inventing legal section numbers.

Open

Domain

Old age psychiatry — elder abuse and vulnerability

1

communication

Elder abuse disclosure — CASC communication station

An older outpatient with depression discloses controlling and physically abusive behaviour by an adult child carer; you must respond with empathy, private exploration, capacity-sensitive safety planning, and clear multi-agency next steps without coercion or invented legal sections.

Open

Domain

Professional skills — mental state examination

1

communication

Elicit and summarise a Mental State Examination — CASC communication station

A 32-year-old presents with two months of social withdrawal, fearfulness, and possible voices. You must conduct an empathic interview that covers core MSE domains, explores risk, avoids leading or collusion, and summarises findings without delivering a blunt diagnostic monologue.

Open

Domain

foundations — descriptive psychopathology

1

communication

Elicit descriptive psychopathology safely — CASC communication station

A 29-year-old is referred after family noticed withdrawal and fear of cameras. You must elicit perceptual experiences, thought content, passivity phenomena, mood and affect, and risk without leading or colluding, then summarise findings in plain language.

Open

Domain

Professional — psychological therapies

2

communication

Engage and orient to DBT / skills-based care — CASC communication station

A young adult with recurrent self-harm after breakups wants 'DBT now'. You must validate, explain what comprehensive DBT involves, set realistic expectations about partial programmes, co-create a Stage 1 safety focus, and introduce one distress-tolerance concept without turning the station into a lecture.

Open

communication

Explain CBT and co-design a first experiment — CASC communication station

A patient with social anxiety wants to understand what CBT actually involves and leaves with a shared formulation fragment and a first behavioural experiment plan, without jargon overload or false promises.

Open

Domain

Professional — psychosocial interventions

1

communication

Engaging a high-EE family after first-episode psychosis (CASC)

Parents of a 19-year-old with first-episode psychosis want answers: mother is tearful and critical of the young person's 'attitude'; father wants 'stronger medication'. They ask if they 'caused' the illness.

Open

Domain

Public-community — disaster and mass casualty psychiatry

1

communication

Evacuation centre survivor after bushfire — CASC communication station

A recently evacuated adult in a crowded shelter after a bushfire; you must engage compassionately, assess suicide risk and exposure, distinguish acute distress from evolving disorder without pathologising, offer Psychological First Aid principles and practical supports, avoid forcing a graphic trauma dump or promising mandatory debriefing, and agree a stepped follow-up plan.

Open

Domain

Intellectual disability psychiatry — genetic syndromes

1

communication

Explain 22q11.2DS psychosis risk and supports to parents — CASC communication station

Parents of a 16-year-old with confirmed 22q11.2 deletion syndrome, repaired cardiac disease and mild intellectual disability want a plain-language explanation of mental health risks, early signs of psychosis, what monitoring looks like, and whether this means 'schizophrenia is inevitable'.

Open

Domain

Forensic psychiatry — civil

1

communication

Explain a civil forensic disability opinion to counsel — CASC communication station

Insurer-instructed counsel is frustrated that your preliminary view does not simply 'confirm total permanent disability'. You must explain your IME role, what you assessed, how diagnosis differs from disability and job fitness, why validity and records matter, and what your report will and will not say — without inventing statute section numbers.

Open

Domain

Foundations — rating scales and measurement-based care

1

communication

Explain a symptom score and negotiate a treatment change — CASC communication station

A 41-year-old on sertraline 50 mg for 6 weeks completes PHQ-9 = 16 (item 9 = 0) and GAD-7 = 11. They feel 'forms are pointless.' You must explain scores without jargon, complete a brief risk check, and collaboratively propose a measurement-based treatment adjustment.

Open

Domain

Consultation-liaison psychiatry — abnormal illness behaviour

1

communication

Explain abnormal illness behaviour and a collaborative plan — CASC communication station

A 41-year-old medical outpatient is angry after a physician said their symptoms are ‘abnormal illness behaviour.’ They fear being labelled as faking. They have had extensive normal GI investigations, check their abdomen repeatedly, miss work, and want ‘one more scope to be sure.’ PHQ-9 is 12; denies suicide plan. Partner attends and reinforces that ‘something serious is being missed.’

Open

Domain

Emergency psychiatry — absconding and missing patients

1

communication

Explain abscond response and engage family — CASC communication station

A patient's partner arrives distressed after being told their partner is missing from the psychiatric ward; you must explain what is happening, gather collateral, and outline the response plan.

Open

Domain

General adult psychiatry — trauma and stressor-related

2

communication

Explain adjustment disorder and brief therapy plan — CASC communication station

A 38-year-old teacher was made redundant 7 weeks ago. She wants to know if she has depression, why you are not starting an antidepressant today, what 'adjustment disorder' means, how problem-solving therapy works, how to manage sleep without long-term sleeping tablets, and when to seek urgent help for suicidal thoughts.

Open

communication

Explain prolonged grief and grief-focused therapy — CASC communication station

A 47-year-old woman whose partner died of COVID-related illness 15 months ago wants to know if she is 'going mad', whether she has depression, why you are recommending talking therapy rather than only sleeping tablets, what prolonged grief disorder means, how Complicated Grief Treatment/CBT works, how cultural or family expectations fit in, and when to seek urgent help for suicidal thoughts of joining her partner.

Open

Domain

Child and adolescent psychiatry — depression

1

communication

Explain adolescent depression and fluoxetine plan to a parent — CASC communication station

You are seeing a 14-year-old with moderate major depression and her mother. The young person has agreed to fluoxetine plus CBT. Mother fears 'addiction', 'personality change', and the black-box suicide warning she read online.

Open

Domain

Forensic psychiatry — arson and fire-setting

1

communication

Explain adolescent firesetting risk to worried parents — CASC communication station

Parents of a 15-year-old who has set three small outdoor fires in six months ask whether he is a 'pyromaniac', whether he will definitely burn the house down, whether this means schizophrenia, and what should happen now. You must communicate the behaviour vs crime vs diagnosis triad, risk humility with concrete safety steps, pathways for help, and avoid inventing statute section numbers or terrorising the family.

Open

Domain

Child and adolescent psychiatry — neurodevelopmental

3

communication

Explain adult ADHD diagnosis and treatment plan — CASC communication station

A 26-year-old software engineer referred after incomplete projects and relationship conflict. Partner attends. Childhood school reports show chronic unfinished work. ASRS is elevated. They ask whether this is 'just laziness', whether stimulants are addictive, and whether they can drive on medication.

Open

communication

Explain autism diagnosis and irritability treatment to parents — CASC communication station

Parents of an 8-year-old newly confirmed to meet ASD criteria want a plain-language explanation of the diagnosis, what helps, whether medicines treat autism, and options for severe aggression after behavioural measures.

Open

communication

Explain language disorder and the school plan to parents — CASC communication station

Parents of a 5-year-old attend after the preschool teacher said he is 'behind in talking', 'doesn't listen', and may need 'autism testing'. History supports delayed phrases, limited vocabulary, and need for visual cues. No restricted interests or repetitive behaviours. Mild sound repetitions when tired. Home is bilingual. Parents fear lifelong disability, blame the second language, and ask for a medicine that will make him talk.

Open

Domain

General adult psychiatry — anxiety disorders

6

communication

Explain adult separation anxiety and a graded plan (not lifelong diazepam) — CASC communication station

A 32-year-old office worker with inability to be alone when her partner travels wants an explanation of adult separation anxiety disorder, why you are not diagnosing only panic disorder, why graded exposure and reducing checking are recommended, and why daily long-term diazepam is not the main plan.

Open

communication

Explain GAD and start sertraline with CBT — CASC communication station

A 33-year-old teacher newly diagnosed with generalised anxiety disorder wants an explanation of the diagnosis, why CBT and an SSRI are suggested, side-effects including early activation, why long-term diazepam is not the plan, and how long treatment lasts.

Open

communication

Explain panic disorder and treatment plan — CASC communication station

A 27-year-old teacher with new panic disorder and mild agoraphobia wants an explanation of what is happening to her body, whether she is 'going crazy' or having heart attacks, why CBT and an SSRI are suggested, and whether she will need diazepam forever.

Open

communication

Explain selective mutism and a school speech plan (not forced assembly talking) — CASC communication station

Parents of a 6-year-old who talks at home but not at school want an explanation of selective mutism, why you are not calling it stubbornness, why graded school practice is recommended instead of public forced speaking, and when medicine might be considered.

Open

communication

Explain social anxiety disorder and start sertraline with CBT — CASC communication station

A 25-year-old graduate newly diagnosed with social anxiety disorder wants an explanation of the diagnosis, why CBT and an SSRI are suggested, side-effects including early activation, why pre-drinks and long-term diazepam are not the plan, and how long treatment lasts.

Open

communication

Explain specific phobia and start exposure (not daily diazepam) — CASC communication station

A 29-year-old office worker with flying phobia and needle phobia wants an explanation of the diagnoses, why you recommend exposure therapy and possibly a long intensive session, why applied tension matters for needles, and why daily long-term diazepam is not the main plan.

Open

Domain

Old age psychiatry — Alzheimer disease

1

communication

Explain Alzheimer disease diagnosis and treatment plan to patient and spouse — CASC communication station

A 71-year-old man with probable mild Alzheimer disease dementia and his wife want a plain-language explanation of the diagnosis, what tests mean, why donepezil is suggested, what to expect from treatment, safety (driving, wandering), and how behavioural changes will be handled without jumping to strong sedatives.

Open

Domain

Forensic psychiatry — expert evidence

1

communication

Explain an expert report boundary to instructing counsel — CASC communication station

Instructing counsel is pressuring you to rewrite a preliminary forensic psychiatric opinion to guarantee a favourable ultimate conclusion, omit inconvenient prior records, and invent a confident statute citation. You must explain your expert role, method, report limits, and professional boundaries — without inventing law and without collapsing into hostility.

Open

Domain

Specialty psychiatry — eating disorders

1

communication

Explain anorexia nervosa care and refeeding safety to a parent — CASC communication station

Parent of a 15-year-old recently admitted with restricting anorexia nervosa wants a clear explanation of the diagnosis, why heart rate is dangerous, what refeeding syndrome is, why the family will lead meals in FBT after discharge, and whether olanzapine is needed now.

Open

Domain

Specialty psychiatry — sexual dysfunction and paraphilias

1

communication

Explain antidepressant sexual side-effects and paraphilia thresholds — CASC communication station

A 33-year-old man whose depression has remitted on escitalopram wants to stop the drug because of delayed ejaculation and low desire. He also nervously asks whether having fetishistic interests with a consenting partner means he is a 'paraphiliac who needs antiandrogens.' Explain medication-related sexual dysfunction options, clarify paraphilia vs disorder, and set a collaborative plan without stigma.

Open

Domain

General adult psychiatry — feeding and eating disorders

2

communication

Explain ARFID and graded food exposure to a parent — CASC communication station

Parent of a 13-year-old recently assessed with ARFID (sensory selectivity plus fear of choking after a school canteen incident) wants a clear explanation of how this differs from anorexia nervosa, why medical checks matter even if the child 'isn't trying to be thin,' what CBT-AR and family involvement look like, and whether a medication will fix picky eating.

Open

communication

Explain rumination disorder and diaphragmatic breathing to a patient — CASC communication station

A 28-year-old referred from gastroenterology after normal endoscopy and failed PPIs wants a clear explanation of why food 'comes back up,' how this differs from bulimia and from reflux, what diaphragmatic breathing involves, whether a tablet will fix it, and when to seek urgent care if weight falls.

Open

Domain

General adult psychiatry — personality disorders

10

communication

Explain ASPD, risk and treatment limits — CASC communication station

A 31-year-old man on community probation is told he has antisocial personality disorder. He is angry: 'So you are calling me a psychopath and saying I am untreatable.' He wants to know what the diagnosis means, whether medication will fix him, and what will happen about risk reporting to probation.

Open

communication

Explain avoidant PD and therapy plan — CASC communication station

A 29-year-old man has just been told he has avoidant personality disorder. He fears this means he is 'broken forever' and asks whether tablets will make him confident. He wants to know how therapy works and whether he is 'just shy' or 'on the spectrum.'

Open

communication

Explain avoidant personality disorder and therapy plan — CASC communication station

A 26-year-old man has been told he may have avoidant personality disorder. He fears the label means he is 'broken and untreatable.' He wants to know how this differs from social anxiety, whether tablets will fix him, and what therapy involves.

Open

communication

Explain BPD diagnosis and therapy plan — CASC communication station

A 23-year-old woman has just been told she has borderline personality disorder. She fears the label means she is 'attention-seeking and untreatable.' She wants to know what the diagnosis means, whether medication will fix it, and what therapy involves.

Open

communication

Explain dependent personality disorder and autonomy-focused plan — CASC communication station

A 27-year-old woman has been told she may have dependent personality disorder. She fears the label means she is 'weak and untreatable.' She wants to know how this differs from being a caring partner, whether tablets will fix her, and what therapy involves. She also worries you will abandon her if she tries to be independent.

Open

communication

Explain histrionic personality disorder and the treatment plan — CASC communication station

A 27-year-old woman has been told she may have histrionic personality disorder. She fears the label means she is a 'drama queen' who will never be taken seriously after self-harm. She wants to know how this differs from bipolar and borderline, whether tablets will fix her personality, and how therapy works.

Open

communication

Explain ICD-11 personality disorder diagnosis — CASC communication station

A 29-year-old woman asks what her new 'ICD-11 personality disorder, moderate, with negative affectivity and disinhibition, borderline pattern' means. She fears it means she is 'broken and untreatable' and asks whether medication will fix it.

Open

communication

Explain NPD formulation and treatment limits — CASC communication station

A 36-year-old woman has been told she has 'narcissistic traits / possible NPD' after repeated workplace conflicts. She is offended, fears the label means she is 'evil and untreatable,' and asks whether medication will fix her personality. She recently had passive death wishes after a public performance review.

Open

communication

Explain paranoid personality disorder and treatment limits — CASC communication station

A 41-year-old man has been told he has paranoid personality disorder after years of workplace conflict and relationship jealousy. He is angry: 'So you are saying I am crazy and that I am untreatable. Just give me a pill or admit I am right about them.' He wants to know what the diagnosis means, whether medication will fix him, and whether you will write a letter supporting his lawsuit against his employer.

Open

communication

Explain schizotypal PD and care plan — CASC communication station

A 24-year-old man has just been told he may have schizotypal personality disorder. He fears this means he will 'definitely become schizophrenic' and that medication will be forced on him forever. He wants to know what the diagnosis means, what therapy involves, and how you will monitor him.

Open

Domain

Addiction psychiatry — hallucinogen-related disorders

1

communication

Explain bad trip care, HPPD risk, and why trial psilocybin is not a microdosing script — CASC communication station

A 23-year-old is clearing after a mushroom bad trip managed with talk-down. His mother fears he has schizophrenia and wants lifelong depot. He wants a 'microdosing prescription like in the depression studies.' He has mild residual anxiety, no ongoing psychosis, and asks whether he can drive home tonight.

Open

Domain

Foundations — basic neuroscience for psychiatry

1

communication

Explain basic brain science of psychosis and treatment to a family — CASC communication station

Parents of a 19-year-old with first-episode psychosis ask whether this is a chemical imbalance, whether a brain scan will prove it, whether antipsychotics 'damage dopamine forever,' and how cannabis fits. You must explain multilevel neuroscience accurately, simply, and non-stigmatisingly while addressing organic screening and shared decision-making.

Open

Domain

General adult psychiatry — OCRD

3

communication

Explain BDD, CBT-BDD and SSRI to a patient — CASC communication station

A 27-year-old woman newly diagnosed with BDD wants a plain-language explanation of the diagnosis, why specialised CBT with exposure and stopping checking will help, how an SSRI such as fluoxetine might help at higher doses over months, why rhinoplasty is not recommended as treatment, and what her partner should stop doing (endless reassurance and mirror checks).

Open

communication

Explain hoarding disorder, CBT and home safety to a patient — CASC communication station

A 48-year-old woman with primary hoarding disorder wants a plain-language explanation of the diagnosis (how it differs from OCD and from being 'lazy'), why specialised CBT with practice discarding and reducing free-item acquisition will help, why a secret total cleanout by relatives is unlikely to last, what fire-safety goals mean this month, and how her partner should stop buying 'just in case' storage boxes that enable acquiring.

Open

communication

Explain OCD and ERP to a patient — CASC communication station

A 29-year-old woman with newly diagnosed contamination OCD wants a plain-language explanation of the diagnosis, why ERP is recommended, what response prevention means, how an SSRI might help, and what her partner should stop doing (reassurance and extra cleaning).

Open

Domain

Child and adolescent psychiatry — elimination disorders

1

communication

Explain bedwetting and soiling without shame — CASC communication station

Parents of a 7-year-old attend angry and embarrassed. They believe their son soils 'on purpose' and want a tablet for camp. Father has been making him hand-wash sheets. They fear he has a serious psychiatric disease. They ask whether they failed at toilet training.

Open

Domain

General adult psychiatry — bipolar and related disorders

4

communication

Explain bipolar diagnosis and lithium — CASC communication station

Partner of a 29-year-old man recovering from a first manic episode wants an explanation of bipolar I diagnosis, lithium treatment, monitoring, and prognosis.

Open

communication

Explain bipolar I diagnosis and lithium plan — CASC communication station

A 29-year-old man recovering from a first manic episode wants an explanation of bipolar I, why lithium is recommended for maintenance, side-effects and blood tests, suicide risk framing, and why an antidepressant alone is not the plan if he becomes depressed later. His partner is present with consent.

Open

communication

Explain bipolar II, stopping the antidepressant, and starting quetiapine plus planned lamotrigine — CASC communication station

Partner of a 29-year-old woman wants to understand why the GP's 'depression tablet' was stopped, what bipolar II and hypomania mean, and what quetiapine and future lamotrigine involve.

Open

communication

Explain mixed features, suicide risk, and stopping the antidepressant — CASC communication station

Partner of a 34-year-old woman admitted with mixed-features mania wants an explanation of why sertraline was stopped, what mixed features and rapid cycling mean, and what lithium plus olanzapine will involve.

Open

Domain

Old age psychiatry — dementia neuropsychiatry

1

communication

Explain BPSD management and antipsychotic risks to a family carer — CASC station

Daughter of an 84-year-old man with Alzheimer disease is distressed after he hit a carer once during showering. Staff suggested 'a sedating tablet long-term'. She wants a clear plan and is terrified of both violence and overmedication.

Open

Domain

General adult psychiatry — psychotic disorders

4

communication

Explain brief vs schizophreniform psychosis to parents — CASC communication station

Parents of a 20-year-old with a first 5-week psychotic episode want plain-language explanation of diagnosis name, whether this is schizophrenia forever, why medicine is offered, cannabis, and what happens next.

Open

communication

Explain delusional disorder and safety plan — CASC communication station

Partner of a 44-year-old man with a working diagnosis of delusional disorder, jealous type, wants a clear explanation of the diagnosis, why it is not ‘just jealousy,’ what treatment involves, and how to stay safe at home.

Open

communication

Explain first-episode psychosis and treatment — CASC communication station

Parents of a 20-year-old man with first-episode psychosis want an explanation of diagnosis, treatment and prognosis.

Open

communication

Explain schizoaffective disorder and treatment plan — CASC communication station

Partner of a 31-year-old with a new working diagnosis of schizoaffective disorder, bipolar type, wants a clear explanation of what the diagnosis means and how treatment differs from 'just bipolar' or 'just schizophrenia.'

Open

Domain

Child and adolescent psychiatry — service interface

1

communication

Explain CAMHS to adult transition plan — CASC communication station

A 17-year-old and parent attend the final CAMHS planning clinic. Adult CMHT has not accepted referral for 'not severe enough'. The young person is on fluoxetine 20 mg oral daily for depression with residual symptoms, occasional self-harm thoughts without plan, and wants to leave school for work. Parent fears 'falling through the cracks'. They ask what transition means, who will prescribe, and whether you are 'dumping' them.

Open

Domain

Addiction psychiatry — cannabis and psychosis

1

communication

Explain cannabis and psychosis to parents — CASC communication station

Parents of a 19-year-old with cannabis-associated first-episode psychosis want plain-language answers on causation, medication, stopping cannabis, CBD, university, and whether this is lifelong schizophrenia.

Open

Domain

Specialty psychiatry — sleep medicine interface

5

communication

Explain CBT-I and hypnotic taper for chronic insomnia disorder — CASC communication station

A 38-year-old professional with chronic insomnia disorder and mild GAD wants indefinite zolpidem repeats. They fear CBT-I is 'just sleep hygiene leaflets' and believe they cannot function without a nightly tablet.

Open

communication

Explain CBT-I and hypnotic taper to a patient with chronic insomnia — CASC communication station

A 35-year-old professional with chronic insomnia and mild GAD wants a long-term zolpidem script. They fear CBT-I is 'just sleep hygiene leaflets' and believe they cannot function without a tablet.

Open

communication

Explain OSA, CPAP, and sedative risks to a patient with depression — CASC communication station

A 48-year-old office worker with residual depression after two antidepressants is angry that you will not increase temazepam. Partner came to clinic: loud snoring, witnessed apnoeas, BMI 36. Patient believes 'it's just depression and stress' and fears CPAP will make them look 'like a hospital patient.'

Open

communication

Explain RLS diagnosis, iron, and treatment switch after dopamine-agonist augmentation — CASC communication station

A 48-year-old patient with long-standing evening leg restlessness has been on pramipexole for 3 years. Symptoms now start mid-afternoon and involve the arms. They request a higher dose and fear any medication change will destroy sleep. Ferritin is 55 ng/mL.

Open

communication

Explain suspected narcolepsy, MSLT, and driving advice — CASC communication station

A 26-year-old delivery driver with EDS, laughter-triggered knee buckling with preserved awareness, and one near-miss on the road is angry that 'everyone thinks I'm depressed or lazy.' They want a tablet today so they can keep working nights.

Open

Domain

Child and adolescent psychiatry — OCRD

1

communication

Explain childhood OCD and treatment options to parents — CASC communication station

Parents of a 10-year-old attend after teachers report endless rewriting and handwashing. History supports contamination and symmetry OCD for 18 months with high family accommodation. Parents fear the child is 'going psychotic', ask if antibiotics will cure it because of an internet article on PANDAS, and worry that 'antidepressants will make him suicidal'.

Open

Domain

Addiction psychiatry — inhalant-related disorders

1

communication

Explain chroming risks and N2O numbness without stigma — CASC communication station

A 16-year-old and his mother. He chromes paint most weekends; last week he nearly blacked out after bagging then sprinting. Mother wants a 'tablet like methadone so he stops.' He minimises risk. Separately (or as second phase), he mentions friends using nitrous oxide balloons and one friend who 'can't feel his feet properly.'

Open

Domain

General adult psychiatry — clinical high risk / attenuated psychosis

1

communication

Explain clinical high risk to parents — CASC communication station

Parents of a 17-year-old with attenuated psychotic symptoms want a plain-language explanation of whether this is schizophrenia, conversion risk, treatment options, cannabis, medication, and school.

Open

Domain

Addiction psychiatry — pharmaceutical and OTC misuse

1

communication

Explain codeine dependence and OAT to a sceptical patient — CASC communication station

A 42-year-old teacher with 4 years of escalating codeine–paracetamol combination use (previously OTC, now multiple private scripts) is medically stable after an ED attendance for abnormal LFTs. She is offended by the referral to addiction services, says ‘I’m not a junkie — it’s from the chemist,’ and wants only ‘a letter so pharmacists stop judging me.’ She is ambivalent about methadone because of stigma but worried about her liver and her job.

Open

Domain

Public and community psychiatry — collaborative care and primary care

1

communication

Explain collaborative care to a GP practice team — CASC communication station

A GP practice manager and two GPs ask the psychiatry registrar to explain collaborative care, how it differs from their current co-located counsellor, what PHQ-9 follow-up means, and how psychiatric caseload review works.

Open

Domain

Psychotherapy — combined treatment

1

communication

Explain combined treatment and co-design a plan — CASC communication station

A patient with moderate–severe depression on an SSRI wants to know if they must choose between tablets and CBT, leaves with a shared understanding of complementary roles, a concurrent combination plan, and clear crisis/side-effect pathways.

Open

Domain

General adult psychiatry — trauma and stressor-related disorders

2

communication

Explain complex PTSD and a trauma-informed treatment plan — CASC communication station

A 32-year-old woman with childhood abuse history meets features of ICD-11 complex PTSD. She wants to understand what complex PTSD means, how it differs from 'just PTSD' and from borderline personality disorder, what therapy involves, and whether an antidepressant will help.

Open

communication

Explain PTSD diagnosis and trauma-focused treatment plan — CASC communication station

A 27-year-old man develops PTSD 3 months after a serious assault. He wants to understand the diagnosis, why trauma-focused therapy is recommended, what an SSRI involves if he chooses medication, and how risk will be monitored.

Open

Domain

Forensic psychiatry — mental health law

1

communication

Explain compulsory admission and rights — CASC communication station

A patient with acute mania has just been made subject to compulsory inpatient treatment under local mental health legislation. You must explain what this means, why it was necessary, rights of review and advocacy, and least restrictive intentions — without inventing section numbers — and respond to anger about coercion.

Open

Domain

Forensic psychiatry — duty to warn and third-party risk

1

communication

Explain confidentiality limits and protective steps after a threat — CASC communication station

A patient who made a serious threat against a named person needs a clear, non-punitive explanation of why confidentiality may be breached, what will be shared, what care continues, and what happens next — without invented legal section numbers.

Open

Domain

Old age psychiatry — delirium and acute cognitive syndromes

1

communication

Explain delirium in an older adult to family — CASC communication station

The adult daughter of an 80-year-old woman with pneumonia and new fluctuating confusion wants a plain-language explanation of delirium, why Mum is 'not herself', what the team will do first, why sleeping tablets are being stopped, and whether antipsychotic medicine is needed.

Open

Domain

Old age psychiatry — Lewy body dementias

1

communication

Explain dementia with Lewy bodies and treatment plan to patient and spouse — CASC communication station

A 73-year-old man with probable DLB (fluctuating cognition, visual hallucinations, RBD, mild parkinsonism) and his spouse want a clear explanation of the diagnosis, how it differs from Alzheimer disease and Parkinson disease dementia, why antipsychotics are dangerous, why a cholinesterase inhibitor is recommended, what monitoring means, and how to keep sleep and home safe.

Open

Domain

General adult psychiatry — mood disorders

5

communication

Explain depression diagnosis and antidepressant plan — CASC communication station

A 32-year-old woman with a new diagnosis of major depressive disorder wants an explanation of the diagnosis, why an SSRI is suggested, side-effects, suicide risk monitoring, and how long treatment lasts.

Open

communication

Explain melancholic vs atypical depression and treatment choices — CASC communication station

A 38-year-old patient with recurrent depression and their partner ask why the registrar keeps saying 'melancholic features' and why a friend with 'atypical depression' was offered different options, including discussion of an older MAOI medicine. They want plain-language criteria, why ECT was mentioned for severe non-eating depression, what mood reactivity means, suicide-risk honesty, and bipolar screening rationale.

Open

communication

Explain psychotic depression and combination treatment — CASC communication station

A 50-year-old woman recovering from severe depression with guilt delusions asks why she needs both an antidepressant and an antipsychotic, what STOP-PD-style evidence means in plain language, how long the antipsychotic might continue after she feels better, what metabolic monitoring involves, and when ECT would have been considered. Her partner is present and worried about 'being labelled schizophrenic'.

Open

communication

Explain treatment-resistant depression and next-step options — CASC communication station

A 40-year-old woman with two failed adequate antidepressant trials wants a plain-language explanation of 'treatment-resistant depression', why lithium is being offered, what monitoring involves, when ECT would be considered, and how long treatment might continue after she improves.

Open

communication

Explain winter depression, light therapy and autumn prevention — CASC communication station

A 36-year-old graphic designer with recurrent winter major depression wants a clear explanation of 'seasonal affective disorder', how to use a light box safely, whether an SSRI is as good as light, and how bupropion in autumn might prevent next winter's episode.

Open

Domain

Intellectual disability psychiatry — Down syndrome

1

communication

Explain depression versus dementia risk to carers of an adult with Down syndrome — CASC communication station

Parents of a 48-year-old woman with Down syndrome and moderate intellectual disability are distressed after an online article said 'everyone with Down syndrome gets Alzheimer disease by 50'. Their daughter has been quieter for 6 weeks after a friend moved away. They want to know if she already has dementia, whether anything can be treated, and what you will do next.

Open

Domain

Foundations — psychiatric classification

1

communication

Explain diagnosis systems to a sceptical family — CASC communication station

Parents of a young adult with first-episode psychosis ask why different doctors use different labels (schizophrenia vs 'psychosis' vs ICD codes), whether the diagnosis is 'real', and whether research terms they googled (RDoC, HiTOP) mean the hospital is using the wrong system.

Open

Domain

General adult psychiatry — dissociative disorders

1

communication

Explain dissociative symptoms, differential and treatment plan — CASC communication station

A 31-year-old patient with chronic depersonalisation, time loss, and possible self-states after childhood trauma wants to understand whether they have DID, what assessment involves, why safety comes first, and what therapy looks like without forced memory recovery.

Open

Domain

Child and adolescent psychiatry — DMDD

1

communication

Explain DMDD vs bipolar and the care plan to parents — CASC communication station

You are seeing the parents of an 8-year-old with chronic severe irritability and explosive outbursts who was told online he has 'childhood bipolar'. They want lithium started today. You have assessed multi-setting DMDD with comorbid ADHD and no manic episodes.

Open

Domain

Intellectual disability psychiatry

1

communication

Explain dual diagnosis and psychotropic review to carers — CASC communication station

Carers of a 28-year-old man with moderate intellectual disability want a plain-language explanation of whether new self-injury could be mental illness rather than 'just ID', what assessment will involve, and why his long-term risperidone is being reviewed.

Open

Domain

Addiction psychiatry — dual diagnosis and integrated care

1

communication

Explain dual diagnosis integrated care — CASC communication station

Parents of a young man with first-episode psychosis and daily cannabis want a plain-language explanation of dual diagnosis, why treatment should not wait for abstinence, stages of change, and the care plan.

Open

Domain

Intellectual disability psychiatry — neurodevelopmental dual diagnosis

1

communication

Explain dual diagnosis, AAC and behaviour plan to carers — CASC communication station

Parents of a 9-year-old with moderate intellectual disability have just been told he also meets criteria for autism. They want plain-language explanation of dual diagnosis, communication supports including AAC, epilepsy vigilance, and what will be done about self-injury before any medicine is considered.

Open

Domain

Child and adolescent psychiatry — early-onset psychosis

1

communication

Explain early-onset psychosis care to parents — CASC communication station

Parents of a 15-year-old with early-onset psychosis want a plain-language explanation of diagnosis, medical checks, medication and metabolic risk, cannabis, school, and what happens if the first tablet does not work.

Open

Domain

Foundations — EEG and clinical neurophysiology

1

communication

Explain EEG and clozapine seizure risk to a patient and partner — CASC communication station

A 34-year-old with treatment-resistant schizophrenia had a first seizure on clozapine titration. Partner asks whether EEG will prove the diagnosis, whether clozapine has 'fried the brain,' whether all medicines must stop forever, and whether staring spells mean the person is 'just zoning out.' You must explain EEG purpose and limits, clozapine seizure risk, NCSE concern in plain language, and shared next steps with neurology.

Open

Domain

Specialty psychiatry — sexual medicine interface

2

communication

Explain erectile treatment safety and PE options — CASC communication station

A 45-year-old man wants 'the blue pill' after seeing online adverts. He has diet-controlled diabetes, takes no nitrates, and also describes lifelong PE with severe embarrassment. Partner is waiting outside. Explain assessment priorities, PDE5 inhibitor expectations and safety, PE behavioural options, and a collaborative plan without shame.

Open

communication

Explain FSIAD care and negotiate SSRI options — CASC communication station

A 35-year-old woman with stable depression on sertraline is distressed by low desire and poor arousal. She has read about 'Addyi' online and wants it today. She drinks wine most evenings. She feels ashamed and worries her partner will leave.

Open

Domain

Old age psychiatry — falls polypharmacy frailty

1

communication

Explain falls risk and deprescribing to family — CASC communication station

The son of an 85-year-old residential care resident with frailty, two recent falls, Alzheimer disease, night temazepam, and long-term low-dose risperidone wants to know why you are reducing medicines, whether you are 'giving up' on Mum's sleep and behaviour, and how you will keep her safe from further falls without 'drugging her into a chair.'

Open

Domain

Intellectual disability — neurodevelopmental

2

communication

Explain FASD diagnosis and supports to kinship carers — CASC communication station

Kinship carers of a 9-year-old recently assessed as meeting criteria for FASD want a plain-language explanation of the diagnosis, whether medicines cure it, what school can do, and how to talk to a teenage relative about alcohol and pregnancy.

Open

communication

Explain fragile X diagnosis and family implications — CASC communication station

Parents of a 6-year-old boy with newly confirmed full-mutation fragile X syndrome want a plain-language explanation of the diagnosis, inheritance, whether there is a cure, what school can do, and what testing means for mum (who had early menopause) and other relatives.

Open

Domain

Child and adolescent psychiatry — eating disorders

1

communication

Explain FBT and medical risk to parents of a teen with AN — CASC communication station

Parents of a 14-year-old recently diagnosed with anorexia nervosa want a plain-language explanation of the diagnosis, why hospital might be needed if vitals worsen, what family-based treatment involves (especially Phase 1), why fluoxetine is not the main treatment for AN weight restoration, and how capacity/consent works if she refuses food when medically unstable.

Open

Domain

Forensic psychiatry — homicide and mental disorder

1

communication

Explain FEP homicide risk and responsibility to a worried family — CASC communication station

Parents of a 19-year-old with emerging untreated psychosis ask whether he will 'definitely kill someone', whether schizophrenia means he is legally insane if he ever did, and what should happen now. You must communicate absolute vs relative risk, warning signs, urgent help pathways, and legal-clinical distinctions without sensationalism and without inventing statute section numbers.

Open

Domain

Forensic psychiatry — FII / medical child abuse

1

communication

Explain FII concern and safeguarding plan to a paediatric consultant colleague — CASC communication station

A senior paediatrician is uneasy about 'accusing a devoted mother' and wants either complete certainty of FDIA or discharge home. You must communicate the dual-frame model (child harm vs caregiver diagnosis), red flags, multi-agency process, and what happens next — without inventing statute section numbers or colluding to avoid reporting.

Open

Domain

General adult psychiatry — early psychosis pathway

1

communication

Explain first-episode psychosis care to parents — CASC communication station

Parents of a 19-year-old with first-episode psychosis want a plain-language explanation of diagnosis, treatment, cannabis, medication duration and whether university must stop.

Open

Domain

Forensic psychiatry — fitness and criminal responsibility

1

communication

Explain fitness concerns to counsel — CASC communication station

Defence counsel is frustrated that the trial keeps being delayed. You must explain your fitness concerns, the difference from a mental impairment defence, what restoration means, and what you need next — without inventing statute section numbers and without over-promising outcomes.

Open

Domain

Forensic psychiatry — risk assessment

1

communication

Explain forensic risk assessment and leave plan to a family member — CASC communication station

A sibling of a medium-secure patient seeks clear explanation of how risk is assessed before leave, without stigmatising language, and wants to know if an actuarial 'high' score means leave is impossible.

Open

Domain

Old age psychiatry — neurocognitive disorders

2

communication

Explain frontotemporal dementia diagnosis and plan to patient and partner — CASC communication station

A 57-year-old man with probable bvFTD and his wife want a plain-language explanation of the diagnosis, why this is not simply 'bad behaviour' or bipolar disorder, what tests including genetics mean, what treatments can and cannot do, and how to manage safety at home.

Open

communication

Explain young-onset dementia diagnosis and plan to patient and partner — CASC communication station

A 55-year-old accountant and his partner want a plain-language explanation of why this is called young-onset dementia, whether it is the same as Alzheimer disease, what tests including genetics mean, how treatment works, and what to do about work, driving, and their teenage children.

Open

Domain

Addiction psychiatry — behavioural addictions

2

communication

Explain gambling disorder, CBT, and naltrexone — CASC communication station

A 38-year-old man with severe online sports betting debts asks for 'the naltrexone injection so I never want to bet again.' His partner wants him banned from all bank accounts today. He minimises alcohol use.

Open

communication

Explain gaming disorder and a CBT plan — CASC communication station

Parents of a 16-year-old demand you 'admit him for gaming detox and start the addiction injection.' The young person says 'it's just a hobby' and rolls his eyes. School has emailed about non-attendance.

Open

Domain

Specialty psychiatry — gender and sexuality

1

communication

Explain gender dysphoria, affirming care and mental health support — CASC communication station

A 22-year-old non-binary person (they/them) newly assessed in clinic wants a plain-language explanation of gender dysphoria versus identity, what affirmative mental health care involves, why depression and suicide risk are addressed in parallel, what hormone pathways roughly entail (specialist-led, fertility counselling), why conversion therapy will not be offered, and how their partner can support without pressure.

Open

Domain

Addiction psychiatry — public health and systems

1

communication

Explain harm reduction and naloxone to a sceptical family — CASC communication station

A 24-year-old man who injects opioids is about to leave ED after a non-fatal overdose. His mother believes needle exchange and take-home naloxone will 'encourage him to use more' and wants him sent to a 7-day detox with no medication. He is ambivalent about methadone but willing to carry naloxone.

Open

Domain

General adult psychiatry — somatic symptom and related

1

communication

Explain illness anxiety, CBT and collaborative care — CASC communication station

A 40-year-old woman newly diagnosed with illness anxiety disorder (care-seeking) after repeated normal breast imaging for fear of breast cancer wants a plain-language explanation of the diagnosis, why specialised CBT with stopping checking and internet searching will help, how an SSRI might help, why another MRI 'for peace of mind' is not planned tonight, how her partner should stop endless reassurance, and what to do if mood or suicidal thoughts worsen.

Open

Domain

intellectual disability psychiatry

1

communication

Explain intellectual disability diagnosis and assessment plan to parents — CASC communication station

Parents of a 9-year-old with newly confirmed intellectual disability want a plain-language explanation of what the diagnosis means, how severity is decided, what tests look for causes, whether medicine can fix intelligence, and what supports help.

Open

Domain

Specialty psychiatry — clinical paraphilic disorders

1

communication

Explain interest versus disorder and stepped care for ego-dystonic paraphilic urges — CASC communication station

A 38-year-old professional voluntarily seeks help for ego-dystonic fetishistic urges that cause marked shame and relationship conflict but involve only consenting adult contexts. They fear being 'labelled a deviant' and ask whether they need chemical castration. No nonconsent risk identified after careful screening.

Open

Domain

General adult psychiatry — impulse control

1

communication

Explain kleptomania and treatment options — CASC communication station

A 34-year-old woman referred after court diversion says: 'So you think I am a criminal and a junkie if you put me on naltrexone. Just tell the judge I cannot help myself and leave me alone.' She wants to know what kleptomania means, whether medicine will stop the stealing, and what you will write about risk.

Open

Domain

Old age psychiatry — grief and loss

1

communication

Explain late-life bereavement and prolonged grief to family — CASC communication station

The adult daughter of an 80-year-old man who lost his wife 14 months ago wants a plain-language explanation of why Dad is 'stuck', whether this is dementia or depression, whether sleeping tablets will help, and what treatment works.

Open

Domain

Old age psychiatry — mood disorders

2

communication

Explain late-life bipolar mania and lithium plan to patient and son — CASC communication station

A 70-year-old man recovering from a manic relapse of early-onset bipolar I disorder and his adult son want a plain-language explanation of late-life bipolar illness, why lithium is still being recommended at a lower blood-level target, what monitoring and interaction risks matter, and how suicide safety is handled.

Open

communication

Explain late-life depression and SSRI plan to patient and daughter — CASC communication station

A 72-year-old woman with new late-life major depression and her adult daughter want a plain-language explanation of the diagnosis, why it is not 'just grief' or 'just dementia', why sertraline is suggested, sodium and suicide safety monitoring, and how long treatment lasts.

Open

Domain

Old age psychiatry — anxiety disorders

1

communication

Explain late-life GAD treatment and benzodiazepine taper to patient and daughter — CASC communication station

A 73-year-old woman with late-life generalised anxiety disorder and her adult daughter want a plain-language explanation of the diagnosis, why CBT and an SSRI are recommended, why long-term diazepam should be tapered, sodium monitoring, and when to seek help for low mood or suicidal thoughts.

Open

Domain

Old age psychiatry — psychosis

1

communication

Explain late-onset psychosis and treatment plan to patient and niece — CASC communication station

A 74-year-old woman with new VLOSLP-type persecutory and partition delusions and her niece want a clear explanation of what is happening, why medical tests and a brain scan are needed, why a low-dose antipsychotic is suggested, what side-effects and dementia-related risks mean if cognition declines, and what supports will help at home.

Open

Domain

General adult psychiatry — secondary / organic psychosis

1

communication

Explain medical work-up for new psychosis to a worried partner — CASC communication station

Partner of a 49-year-old with first-episode psychosis wants plain-language explanation of why blood tests, possible scan, and medical review are needed, and whether this is 'schizophrenia forever'.

Open

Domain

Addiction psychiatry — substance use disorders

2

communication

Explain methadone, buprenorphine, COWS, and naloxone — CASC communication station

A 26-year-old woman with heroin dependence is day 1 post-overdose. She is in moderate withdrawal (COWS 14). She fears 'methadone is liquid handcuffs' and her sister wants rapid home detox with 'Nurofen and willpower.' You propose buprenorphine–naloxone induction and take-home naloxone.

Open

communication

Explain opioid agonist treatment and naloxone — CASC communication station

A 29-year-old man with severe heroin use disorder is offered buprenorphine–naloxone after an overdose. He fears 'replacing one addiction with another,' asks about methadone vs buprenorphine, and his mother wants him detoxed in 5 days.

Open

Domain

Addiction psychiatry — stimulant and methamphetamine use

1

communication

Explain methamphetamine care to a partner — CASC communication station

Partner of a 28-year-old with crystal methamphetamine binge and paranoid psychosis wants plain-language explanation of diagnosis, whether it is schizophrenia forever, medical risks, withdrawal, and what treatments actually work.

Open

Domain

foundations — philosophy of mind

1

communication

Explain multilevel mind-body formulation — CASC communication station

Parents of a young adult with first-episode psychosis ask whether illness is 'all brain' or 'all psychological weakness,' whether medication means free will is gone, and how decisions about treatment will respect their child's values. You must explain multilevel causation, avoid dualist traps, address free-will fears without legal overclaim, and outline collaborative decision-making.

Open

Domain

General adult psychiatry — psychosis

2

communication

Explain negative and cognitive symptoms and the care plan — CASC communication station

A 31-year-old man with schizophrenia and his sister want a plain-language explanation of 'negative symptoms' and 'thinking problems', why staff say some of his quietness may be from medication side-effects, what can realistically help (including activity programmes and cognitive training), and whether a new medicine will 'fix the personality'.

Open

communication

Explain treatment-resistant schizophrenia and clozapine — CASC communication station

A 30-year-old man with two failed adequate antipsychotic trials wants a plain-language explanation of 'treatment-resistant schizophrenia', why clozapine is being offered, what blood tests and monitoring involve, what constipation and early fever mean as safety warnings, and how long treatment might continue after he improves.

Open

Domain

Addiction psychiatry — neonatal abstinence

1

communication

Explain neonatal abstinence to parents after OAT pregnancy — CASC communication station

Parents of a day-2 term infant. Mother is on methadone 70 mg daily for OUD, stable for pregnancy. The midwife said the baby ‘has addiction.’ Father is angry and wants methadone stopped. They fear child protection will remove the baby because of NAS scoring.

Open

Domain

Child and adolescent psychiatry — disruptive behaviour

1

communication

Explain ODD/CD formulation and parent training plan — CASC communication station

Parents of an 8-year-old attend after the school threatens exclusion. They say he is 'just naughty like his uncle who went to prison' and ask whether he has ASPD and whether risperidone will 'make him obedient'. They feel blamed by previous advice about parenting.

Open

Domain

general-adult

1

communication

Explain OSFED and atypical anorexia to a family — CASC communication station

Parents of a 16-year-old who lost 15 kg from a higher weight (current BMI 21.8) with restriction, fear of fatness, and bradycardia want a plain-language explanation of why clinicians say 'atypical anorexia / OSFED', why this is still serious, what medical monitoring means, how family-supported renourishment and CBT-E work, and what not to say about 'looking healthy'.

Open

Domain

General adult psychiatry — mood disorders / women's mental health

1

communication

Explain PMDD, diary confirmation and intermittent SSRI options — CASC communication station

A 27-year-old woman with severe premenstrual irritability and tearfulness wants a clear explanation of PMDD versus 'ordinary PMS', why she needs two months of daily symptom ratings, whether she can take an SSRI only before her period, and how to stay safe when passive death wishes return each luteal week.

Open

Domain

General adult psychiatry — perinatal

2

communication

Explain postnatal depression treatment and infant-safety thoughts — CASC communication station

A 31-year-old woman 5 weeks postpartum is distressed by unwanted images of harming her baby and has been offered sertraline for postnatal depression. She fears she is a 'monster', that medication will harm breastfeeding, and that social services will remove her child if she discloses the images.

Open

communication

Explain postpartum psychosis, admission and treatment to a distressed partner — CASC communication station

A 34-year-old partner of a day-6 postpartum woman waits outside the assessment bay. The mother is manic, sleepless and believes the baby is 'possessed.' The partner is terrified, asks if she is 'going mad forever,' whether the baby will be taken away, whether lithium will poison breast milk, and whether this will happen again if they have another child.

Open

Domain

Forensic psychiatry — prison mental health

1

communication

Explain prison mental health plan to a custody manager — CASC communication station

A wing manager is frustrated about 'psychiatric prisoners' self-harming and wants them all moved to long-term segregation 'where they can't hurt themselves'. You must explain clinical priorities, why segregation is not treatment, what observation and healthcare options mean, dual diagnosis, and when hospital transfer is considered — calmly, without inventing statute section numbers, and while maintaining a collaborative safety alliance with custody.

Open

Domain

Foundations — history of psychiatry

1

communication

Explain psychiatric history and treatment milestones to a sceptical family — CASC communication station

Parents of a 22-year-old with first-episode mania ask whether psychiatry is 'just asylums and shock treatment', whether lithium is an old Australian experiment without evidence, and whether diagnosis is a social label (they read about Rosenhan online). They fear lifelong institutionalisation.

Open

Domain

General adult psychiatry — psychosis rehabilitation

1

communication

Explain psychosocial rehabilitation after psychosis — CASC communication station

Parents of a 22-year-old man remitting from first-episode psychosis want a plain-language explanation of why medication alone is not enough, what IPS and family psychoeducation mean, and whether 'recovery' means the team will stop treatment.

Open

Domain

Child and adolescent psychiatry — attachment disorders

1

communication

Explain RAD/DSED and refuse coercive therapy — CASC communication station

Adoptive parents of a 3-year-old previously institutionalised child attend distressed. They say a Facebook group diagnosed 'RAD' and urged paid holding therapy. They fear they have failed as parents because the child still approaches strangers. They also ask if tablets will 'create attachment.'

Open

Domain

General adult psychiatry — reactive attachment and disinhibited social engagement

1

communication

Explain residual DSED risk and refuse coercive attachment therapy — CASC communication station

You meet the adoptive parents of a 16-year-old with a past diagnosis of disinhibited social engagement disorder after early institutional care. Residual overfamiliarity with strangers continues. They have been offered 'holding therapy' by a private clinic and want to know if he will have 'RAD for life' as an adult, whether medication will fix attachment, and what they should do about stranger risk and low mood.

Open

Domain

Child and adolescent psychiatry — childhood trauma and maltreatment

1

communication

Explain safeguarding and TF-CBT after childhood maltreatment — CASC communication station

A non-offending mother of an 11-year-old who disclosed physical abuse by a partner wants to understand what happens next: child protection notification, whether her child has PTSD, what TF-CBT involves, and whether medication is needed.

Open

Domain

Old age psychiatry — psychopharmacology

1

communication

Explain safer prescribing and antipsychotic risks to family — CASC communication station

The daughter of an 84-year-old residential care resident with Alzheimer disease and recurrent falls wants to know why you are reducing risperidone and temazepam, why staff should not 'just give more tablets' for calling out, and what you will do if severe aggression returns. She has read about black-box warnings online.

Open

Domain

Child and adolescent psychiatry — school refusal and school anxiety

1

communication

Explain school refusal plan and possible SSRI to parents — CASC communication station

Parents of a 12-year-old with separation/social anxiety and 6 weeks of near-complete school non-attendance want a plain-language explanation of why this is not 'just laziness', how graded return and exposure CBT work, why open-ended home schooling is unhelpful, when an SSRI such as sertraline might be considered (including simple CAMS combination rationale and Melvin caution), and how you monitor for activation and suicidal thoughts.

Open

Domain

Public-community psychiatry — restrictive practices

1

communication

Explain seclusion and repair trust after restrictive practice — CASC communication station

Yesterday a patient with acute psychosis was secluded for 90 minutes after assaulting staff. Today they are calmer on oral medication and demand to know why they were 'locked in a box', whether it was punishment, which section authorised it, and whether it will happen again. You must explain seclusion as last-resort safety (not treatment), what was tried first, rights/review principles without inventing section numbers, monitoring that occurred, and collaborative prevention planning.

Open

Domain

Forensic psychiatry — sexual offending

1

communication

Explain sexual-offence risk assessment and community conditions to a family member — CASC communication station

An adult sibling of a man nearing community forensic step-down after sexual offences seeks a clear, non-sensational explanation of how risk is assessed, what static scores mean, what conditions will protect others, and whether treatment 'cures' risk.

Open

Domain

Forensic psychiatry — stalking and harassment

1

communication

Explain stalking risk and safety planning to a victim's support person — CASC communication station

An adult sibling of a woman subjected to ex-intimate stalking wants a clear, non-sensational explanation of what stalking is, what risks the team considers (not only assault), why 'meeting to talk it out' is unsafe, what treatment of the stalker can and cannot achieve, and how multi-agency safety works in principle.

Open

Domain

Addiction psychiatry — acute stimulant syndromes

1

communication

Explain stimulant crash and why there is no methadone for ice — CASC communication station

A 30-year-old man is medically clearing after ice intoxication with brief MAP. He wants 'a craving tablet like methadone' before discharge. His sister fears schizophrenia and demands lifelong depot. He is day 2 post-binge, tearful, craving, passive SI without plan.

Open

Domain

Foundations — psychoneuroendocrinology and psychoimmunology

1

communication

Explain stress hormones, inflammation, and prolactin side-effects to a patient and partner — CASC communication station

A 31-year-old with major depression and recent interferon-treated hepatitis C asks whether blood tests for cortisol and inflammation can diagnose depression. Their partner worries that childhood trauma 'broke the stress system forever.' Separately they ask why a friend on risperidone had milk leakage and missed periods. Explain psychoneuroendocrine and immune concepts accurately, simply, and without false certainty; address investigation limits; outline prolactin logic; safety-net organic red flags.

Open

Domain

Addiction psychiatry — substance-induced mood and anxiety disorders

1

communication

Explain substance-induced depression and dual plan to a partner — CASC communication station

Partner of a 40-year-old with heavy alcohol use and recent depressive symptoms wants plain-language explanation of induced versus independent depression, why we may wait briefly for abstinence effects, when antidepressants are used, suicide safety, and dual follow-up.

Open

Domain

General adult psychiatry — substance/medication-induced psychosis

1

communication

Explain substance-induced psychosis and follow-up to parents — CASC communication station

Parents of a 20-year-old with first cannabis-associated psychosis want plain-language explanation of diagnosis, why medication is offered, conversion risk, cannabis advice, and whether this means lifelong schizophrenia.

Open

Domain

General adult psychiatry — factitious disorder and malingering

1

communication

Explain suspected factitious behaviour and a non-collusive plan — CASC communication station

A 38-year-old inpatient with recurrent unexplained hypoglycaemia is angry after the medical team found insulin syringes in their locker. They demand you 'tell the physicians it's real diabetes' and threaten self-discharge and social media complaints. PHQ-9 is 14; denies current suicide plan. No dependent children in their care.

Open

Domain

Forensic psychiatry — therapeutic security

1

communication

Explain therapeutic security and placement to a general adult consultant — CASC communication station

A general adult consultant is frustrated that a patient with schizophrenia and a serious assault history has waited weeks for a forensic bed. They demand 'just put him in high secure' and threaten to keep him secluded on an acute ward 'until forensic sorts it'. You must explain therapeutic security, why security level is matched not maximised, what medium versus high principles mean, the role of relational and procedural security on the acute ward while waiting, least restrictive practice, and how step-down works later — calmly, without inventing statute section numbers.

Open

Domain

Forensic psychiatry — victimology

1

communication

Explain trauma-informed care after sexual assault to a distressed victim — CASC communication station

A 24-year-old woman is in ED after reporting rape by an acquaintance. Police want a full statement now. She is tearful, hyperventilating, and says every professional is 'making me go through it again.' You must explain secondary victimisation, how assessment will work, safety and next steps, and what mental-health care looks like — without forcing a full trauma narrative or inventing statute numbers.

Open

Domain

General adult psychiatry — OCRD / BFRB

1

communication

Explain TTM, HRT and NAC to a patient — CASC communication station

A 22-year-old woman newly diagnosed with trichotillomania and mild facial skin-picking wants a plain-language explanation of the diagnosis, why habit reversal training (not just 'willpower') will help, how adult N-acetylcysteine might be considered, why olanzapine is not first-line, and what her partner should stop doing (pulling her hand away angrily and constant hair comments).

Open

Domain

Child and adolescent psychiatry — anxiety disorders

1

communication

Explain youth anxiety treatment and school return plan to parents — CASC communication station

Parents of an 11-year-old with separation anxiety and school refusal want a plain-language explanation of the diagnosis, why exposure-based CBT is recommended, when an SSRI such as sertraline might be added (including CAMS combination evidence in simple terms), how you monitor for activation and suicidal thoughts, and how a graded return-to-school plan will work without blaming them.

Open

Domain

Forensic psychiatry — young offenders

1

communication

Explain youth detention mental health plan to a unit manager — CASC communication station

A youth detention unit manager is frustrated about self-harm and 'psychiatric kids' disrupting the wing. They want all such youth placed in long isolation overnight and want you to write that this is medically approved treatment. You must explain high prevalence of mental health needs, why isolation is not treatment, observation and multi-agency alternatives, trauma-informed care, and when hospital transfer is considered — collaboratively, without inventing statute section numbers.

Open

Domain

Psychopharmacology — pharmacogenomics

1

communication

Explaining a commercial PGx report and HLA safety before carbamazepine (CASC)

A 40-year-old woman of Chinese ancestry with bipolar disorder brings a commercial multi-gene report that flags many antidepressants as 'use with caution'. She wants carbamazepine next because a relative 'did well on it', but is terrified of Stevens-Johnson syndrome after reading online about HLA genes. She asks you to 'just follow the report' and to guarantee safety.

Open

Domain

Psychopharmacology — first-generation antipsychotics

1

communication

Explaining a first-generation antipsychotic and EPS risks (CASC)

A 29-year-old man with schizophrenia is offered a switch from olanzapine (marked weight gain) to a first-generation option (oral haloperidol low dose or mid-potency alternative, with depot discussed if adherence fails). He says: 'Aren't those old drugs that give you Parkinson's and lock-jaw? I only want the new ones.'

Open

Domain

Psychopharmacology — stimulants and ADHD medications

1

communication

Explaining ADHD medication start, monitoring and diversion risk (CASC)

A 16-year-old with confirmed ADHD (combined) and his mother attend. Teachers report incomplete morning coverage on IR methylphenidate twice daily; he has lost two scripts in three months. Mother fears 'heart damage' and 'turning him into an addict' after reading social media. Father had an MI at 58. No syncope. BP 110/68, HR 76, growth on 25th centile stable.

Open

Domain

Psychopharmacology — antidepressants

1

communication

Explaining antidepressant start, side-effects and review plan (CASC)

A 29-year-old with moderate-severe unipolar depression agrees to medication but fears 'personality change', addiction, sexual side-effects, and suicide risk from the black-box warning they read online. Partner is in the room and asks how soon it works and what happens if the first tablet fails.

Open

Domain

Psychopharmacology — antipsychotics

1

communication

Explaining antipsychotic choice and metabolic monitoring (CASC)

Parent of a 19-year-old with first-episode psychosis asks why you are not starting 'the strongest tablet', worries about weight and diabetes, and asks if the medicine is addictive.

Open

Domain

Psychopharmacology — metabolic syndrome and psychotropic monitoring

1

communication

Explaining antipsychotic weight gain and a monitoring plan (CASC)

Parents of a 17-year-old with first-episode psychosis are angry that olanzapine has 'made him fat and pre-diabetic' after 10 weeks (plus 8 kg, raised fasting glucose). They want all medication stopped today. The young person is improved and wants to stay well for school exams.

Open

Domain

Psychopharmacology — phototherapy and chronotherapy

1

communication

Explaining bright light therapy for winter depression (CASC)

A 31-year-old with recurrent winter major depression and her partner ask about 'the light box'. They want to know if it is evidence-based, how long each day, whether she can use it at night while watching TV, if it is safer than antidepressants, and what happens if she becomes 'too high'.

Open

Domain

General adult psychiatry

2

communication

Explaining catatonia and treatment plan to family — CASC communication station

A 29-year-old woman with depression has become mute, immobile, and is not eating. The team plans a lorazepam challenge and possible ECT if she does not improve. Her partner is frightened, asks if she has 'turned into a vegetable', and worries ECT will 'wipe her memory forever'.

Open

communication

Explaining functional neurological disorder to a patient — CASC communication station

A 32-year-old woman with sudden leg weakness and Hoover's-positive examination has been told by a friend that conversion disorder means she is 'putting it on'. She wants plain-language explanation of FND, how you know, whether she is crazy, what treatment involves (physio and psychology), and whether she will walk again.

Open

Domain

foundations — neuroscience for fellowship psychiatry

1

communication

Explaining circuits to a junior doctor — CASC/teaching station

You are the psychiatry registrar. A foundation doctor asks you to explain, in 8–10 minutes, how neural circuits help make sense of a patient with first-episode psychosis and a coexisting history of orbitofrontal TBI. Teach without condescension, link anatomy to clinical decisions, and correct the junior's belief that 'an fMRI will confirm schizophrenia'.

Open

Domain

Psychopharmacology — clozapine

1

communication

Explaining clozapine and monitoring to a family (CASC)

Parents of a 24-year-old with treatment-resistant schizophrenia ask why you want 'the dangerous blood tablet', fear agranulocytosis and heart damage, and wonder if another ordinary antipsychotic would be safer.

Open

Domain

Consultation-liaison psychiatry

15

communication

Explaining delirium and the care plan to a family member — CASC communication station

An 81-year-old woman with pneumonia is fluctuating in confusion. At night she tried to climb out of bed; by day she is drowsy. Her son arrives angry that 'psychiatry has not fixed her brain' and demands sleeping tablets and a CT scan 'for dementia'. He asks whether she is going mad and whether she can still sign her house over to him this week.

Open

communication

Explaining dementia diagnosis, BPSD plan, and antipsychotic caution to family — CASC communication station

A 76-year-old woman with progressive memory loss now needs help with cooking and bills. She became agitated in hospital after pneumonia. Junior staff mentioned 'starting an antipsychotic for dementia'. Her son is angry, frightened about nursing-home placement, and asks whether the medicines will 'kill her brain' or 'stop the dementia'.

Open

communication

Explaining demoralisation, adjustment, and mood treatment in medical illness — CASC communication station

A 59-year-old man with newly progressed metastatic lung cancer is on the ward. His partner is distressed that 'psychiatry wants to put him on antidepressants just for being sick' and that he keeps saying there is no point living. The patient, when calmer, says he is not mad but feels trapped and useless. You must explain demoralisation vs depression, why desire for death needs careful assessment, what therapies help, and when medicines are and are not indicated.

Open

communication

Explaining HD irritability, depression, suicide risk, and tetrabenazine to a spouse — CASC communication station

A 48-year-old man with manifest Huntington disease has evening irritability, low mood, and passive death wishes after tetrabenazine was increased. His spouse is angry, believes 'the psychiatry team thinks he is evil and wants a schizophrenia drug that will freeze him,' wants all neurology tablets stopped tonight, and asks you to secretly test their 12-year-old daughter 'so we know her fate.'

Open

communication

Explaining lupus-related psychosis to a partner — CASC communication station

A 29-year-old woman with SLE has been admitted with new delusions and low complements. Rheumatology plans further investigation and possible high-dose steroids with immunosuppression if infection is excluded. Her partner is frightened, believes psychiatric drugs caused the illness, and threatens to take her home against advice.

Open

communication

Explaining MS depression, PBA, and treatment choices to a partner — CASC communication station

A 36-year-old woman with MS has major depression with passive death wishes and brief episodes of uncontrollable crying without feeling sad. Her partner believes she is 'bipolar and attention-seeking,' wants all psychiatric drugs stopped, demands interferon be ceased today, and says 'anyone would want to die with MS — leave her alone.'

Open

communication

Explaining post-ACS depression and the care plan to a family — CASC communication station

A 66-year-old man is 3 weeks after NSTEMI with stents. He has been tearful, withdrawn from cardiac rehab, and started on sertraline 50 mg daily. His partner is distressed: 'Of course he is depressed — just knock him out. Will the tablet stop another heart attack like that big trial? Stop the beta-blocker — it always causes depression. Can he sign the house over to me tomorrow? Is his heart failure going to make the antidepressant useless?'

Open

communication

Explaining post-stroke depression and the care plan to a family — CASC communication station

A 70-year-old man is 4 weeks after ischaemic stroke with mild aphasia. He has been tearful, withdrawn from physiotherapy, and started on sertraline 50 mg daily. His daughter is distressed: 'The left side of his brain is dead so of course he is depressed — just knock him out. Give him fluoxetine so his arm comes back. Can he sign the nursing-home papers tomorrow? Is this dementia forever?'

Open

communication

Explaining postictal psychosis and depression treatment to a partner — CASC communication station

A 39-year-old man with epilepsy developed psychosis two days after a seizure cluster and is now settling on the ward. His partner is frightened, believes 'the epilepsy drugs made him mad', refuses antidepressants for his longstanding low mood, and wants all medication stopped so he can come home today.

Open

communication

Explaining postpartum psychosis and infant safety on the maternity ward — CASC communication station

A partner of a day-3 postpartum woman is angry and frightened. Staff have called psychiatry because she has not slept, is saying the baby was swapped, and tried to walk out with the infant. He wants her discharged home tonight 'to rest in her own bed' and is angry that lithium was ever suggested in pregnancy. You must explain postpartum psychosis, dual safety, why this is not blues, and the outline of hospital care including possible mother-baby unit transfer.

Open

communication

Explaining somatic symptom disorder and a collaborative pain plan — CASC communication station

A 41-year-old woman with multi-system pain and fatigue is angry after a ward round comment that her symptoms are 'functional, so nothing to worry about.' She fears cancer, wants more scans, and is taking increasing oxycodone from two GPs. You are the psychiatry registrar asked to explain the formulation and plan.

Open

communication

Explaining steroid psychosis and thyroid screening in medical illness — CASC communication station

A 55-year-old man on high-dose dexamethasone for brain metastases became sleepless and paranoid on day 4. His partner is angry that 'psychiatry wants to call him bipolar and lock him up.' He also asks whether his lifelong 'anxiety attacks' might have been his undiagnosed Graves disease (recently treated). Staff want standing high-dose haloperidol.

Open

communication

Explaining suspected autoimmune encephalitis to parents — CASC communication station

A 19-year-old woman was admitted with first-episode psychosis. Over a week she has become mute with facial movements. Neurology recommends lumbar puncture, EEG, and possible immunotherapy and pelvic imaging for teratoma. Her parents are distressed, angry that 'psychiatric drugs made her worse', and frightened of LP and 'steroid chemotherapy'.

Open

communication

Explaining TBI personality change and the care plan to a partner — CASC communication station

A 42-year-old man is 3 months after moderate TBI with frontal contusions. He is less inhibited, snaps at staff, and has been started on sertraline for depression. His partner is distressed: 'They broke his personality. Give him something strong to knock him out. Is this dementia forever? Can he sign the house sale next week so we can move closer to family?'

Open

communication

Ward explanation of FND and team alignment — CASC / C-L station

A 38-year-old man on a medical ward has functional left leg weakness after a minor fall. Hoover's sign is positive. A junior doctor told him 'your scans are fine so it must be stress'. He feels dismissed and asks if psychiatry thinks he is faking. You must explain FND, repair the message, outline ward and outpatient care (physio and psychology), and agree safety-nets before discharge planning.

Open

Domain

Psychopharmacology — cognitive enhancers

1

communication

Explaining donepezil and expectations to a carer (CASC)

Daughter of a 76-year-old man newly diagnosed with mild Alzheimer disease wants 'the tablet that stops dementia'. She has read that donepezil is 'useless' (AD2000 headlines) and also asks whether to start memantine and donepezil together today. Father has mild nausea on a trial of donepezil 5 mg started by the GP.

Open

Domain

Psychopharmacology — fitness to drive

1

communication

Explaining driving advice on zopiclone and diazepam (CASC)

A 55-year-old bus driver (commercial licence) with insomnia and anxiety has been using zopiclone 7.5 mg most nights and occasional diazepam from a relative. He becomes angry when you suggest he should not drive the bus until reviewed, saying 'the packet says it's a sleeping tablet not a drug like valium' and that without work he will lose his house.

Open

Domain

Psychopharmacology — ECT and neurostimulation

1

communication

Explaining ECT and cognitive risk to a patient and partner (CASC)

A 45-year-old with severe melancholic depression and previous near-lethal overdose sits with her partner. She has failed two adequate antidepressant trials. She says 'ECT fries your brain and steals your memories'. The partner asks why not 'just do that magnet treatment instead'.

Open

Domain

Psychopharmacology — ketamine and esketamine

1

communication

Explaining esketamine for TRD and safety rules (CASC)

A 45-year-old with treatment-resistant depression and her partner ask about 'ketamine nasal spray'. They fear addiction and bladder damage, wonder if she can take it home, and ask whether it means she will never need ECT.

Open

Domain

Psychopharmacology — lamotrigine

1

communication

Explaining lamotrigine titration and rash safety (CASC)

A 30-year-old with bipolar I depression-predominant course is offered lamotrigine. She is on valproate after a recent manic episode and takes a combined oral contraceptive. She has read online about 'Stevens-Johnson syndrome' and is terrified, but also desperate to prevent another six-month depression.

Open

Domain

Psychopharmacology — lithium

1

communication

Explaining lithium monitoring and suicide benefit to a patient (CASC)

A 31-year-old man with bipolar I disorder and a recent serious suicide attempt is offered lithium for maintenance. He fears 'kidney failure and birth defects if I ever have kids' and prefers 'just valproate like my cousin'.

Open

Domain

Psychopharmacology — mood stabilisers

1

communication

Explaining lithium versus valproate and pregnancy-safe planning (CASC)

A 31-year-old woman with bipolar I, recently manic, attends with her partner. She was told in ED that valproate is a 'strong mood stabiliser'. She wants to start a family in a year. She is anxious about lithium blood tests and 'kidney damage'.

Open

Domain

Psychopharmacology — monoamine oxidase inhibitors

1

communication

Explaining MAOI diet, washouts and patch options (CASC)

A 45-year-old professional with treatment-resistant depression and atypical features is offered phenelzine. She is frightened by 'cheese crisis' stories online, asks whether the selegiline patch is safer, and wonders if she can keep using tramadol for migraines and cold-and-flu tablets in winter.

Open

Domain

Psychopharmacology — renal and hepatic disease

1

communication

Explaining psychotropic choices in CKD and cirrhosis (CASC)

A 58-year-old woman with bipolar disorder (lithium responder), stage 3b CKD (eGFR 42), and compensated cirrhosis asks why her GP stopped ibuprofen, why you will not give ‘normal sleeping tablets’, and whether her new low mood means she ‘needs sertraline like everyone else on dialysis forums’.

Open

Domain

Psychopharmacology — drug interactions and QTc

1

communication

Explaining QTc risk and medicine changes after a near-syncope (CASC)

A 55-year-old woman on citalopram 40 mg and quetiapine, recently started on clarithromycin, had near-syncope. ECG QTc 505 ms, K+ 3.1. She is frightened you will 'stop all her mental health tablets' and leave her depressed and sleepless.

Open

Domain

Psychopharmacology — rTMS, VNS and DBS

1

communication

Explaining rTMS vs implants vs ECT for TRD (CASC)

A 48-year-old man with treatment-resistant depression and his partner ask about 'TMS magnets', 'the vagus pacemaker', and 'deep brain electrodes'. They fear ECT memory loss, want a guaranteed cure, and wonder if implants are better because they are 'more high-tech'.

Open

Domain

Psychopharmacology

1

communication

Explaining tardive dyskinesia and treatment options — CASC communication station

A 45-year-old woman with schizophrenia on long-term risperidone has new chewing and tongue movements. Her partner is angry, saying 'your medicine is poisoning her face,' and asks whether she must stop all antipsychotics forever and whether a 'new tablet for the movements' is experimental.

Open

Domain

Foundations — psychiatric genetics and epigenetics

1

communication

Family genetics counselling after first-episode psychosis — CASC/communication station

You are the psychiatry registrar. A 20-year-old man is recovering from first-episode schizophrenia on the early psychosis unit. His parents request a 10-minute meeting: they feel guilty ('we passed on bad genes'), ask whether their 16-year-old daughter should have a commercial online 'mental illness DNA test', and whether treatment is futile because 'schizophrenia is 80% genetic'. There is no known chromosomal syndrome in the index patient.

Open

Domain

Professional — teaching and supervision skills

1

communication

Give challenging educational feedback to a registrar — CASC communication station

A likeable psychiatry registrar has incomplete risk documentation and a disorganised MSE on observed assessment; you must give specific, respectful feedback, negotiate a learning plan, address overnight independent cover, and avoid collusion or humiliation.

Open

Domain

Professional — boundary violations and sexual misconduct

1

communication

Hold the frame after a romantic invitation — CASC communication station

A current outpatient discloses romantic love, offers an expensive gift, and invites dinner; you must hold a professional frame with empathy, decline dual roles clearly, explore meaning, check for rejection feelings, and outline next steps without humiliation or collusion.

Open

Domain

Foundations — social determinants of mental health

1

communication

Housing, poverty and depression — CASC/communication station

You are the psychiatry registrar on a community team. You have 10 minutes with a 41-year-old man with recurrent major depression, recent job loss, eviction notice in 14 days, and two missed medication pickups. He feels 'lazy and weak'. A housing officer and GP will join for the last 3 minutes. Task: validate experience, reframe social determinants without dismissing illness, co-produce a multi-level plan, and brief the housing officer collaboratively.

Open

Domain

Foundations — biostatistics for psychiatry exams

1

communication

Journal club biostatistics teaching — CASC/communication station

You are the psychiatry registrar running a 10-minute journal club with a foundation doctor. You must teach calculation of NNT from response rates, correct a p-value misinterpretation, and explain why a non-significant HR CI that includes 1 does not prove equivalence.

Open

Domain

Foundations — research methods and study design

1

communication

Journal club design critique — CASC/teaching station

You are the psychiatry registrar facilitating a 10-minute teaching station with a foundation doctor and a medical student. The team has a one-page methods abstract for a study claiming 'Drug Z prevents suicide in bipolar disorder'. Methods text (station material): adults with bipolar disorder attending one tertiary clinic; assigned to Drug Z or usual care by the treating psychiatrist; followed for 12 months; primary outcome suicide attempt; analysis among those with complete follow-up; abstract calls the study a 'randomised real-world trial'. Your job is to teach design identification, redesign principles, bias naming, and which reporting checklist should apply — without humiliating the junior team or overselling nihilism.

Open

Domain

Foundations — epidemiologic methods for psychiatry

1

communication

Journal club epidemiology critique — teaching/CASC-style station

You are the psychiatry registrar facilitating a 10-minute teaching station with a foundation doctor and a medical student. Station material is a one-page abstract: 'Cross-sectional household survey (n=1,200, response rate 48%). Lifetime depression by self-report checklist 28%. Cannabis use associated with depression OR 1.9 (95% CI 1.2–3.0). Authors conclude cannabis causes nearly one-third of depression (PAF 30%) and recommend universal school cannabis screening using a 2-item tool (Sn 80%, Sp 80%) to prevent depression.' Your job is to teach correct measure choice, bias threats, PAF assumptions, and why universal screening PPV will fail — without humiliating juniors or dismissing all observational evidence.

Open

Domain

Addiction psychiatry — psychosocial interventions

1

communication

Negotiate contingency management and mutual-help after stimulant relapse — CASC communication station

A 32-year-old man who uses methamphetamine weekly is offered a 12-week contingency management programme with thrice-weekly urine tests and escalating gift-card rewards. He thinks it is 'bribery' and humiliating. His mother wants him forced into AA daily. He will consider SMART Recovery if it is 'not religious.'

Open

Domain

Psychopharmacology — anxiolytics and hypnotics

1

communication

Negotiating short-term hypnotic use and a deprescribing plan (CASC)

A 71-year-old retired teacher has taken temazepam 20 mg nocte for 4 years after bereavement insomnia. She fell twice last month. Her daughter (in the room) found online that 'Z-drugs are safer' and asks to switch to zolpidem forever. The patient fears she will 'never sleep again' without tablets and becomes tearful when deprescribing is mentioned.

Open

Domain

Consultation-liaison — burns and critical illness psychiatry

1

communication

Post-burn PTSD and body-image avoidance — CASC communication station

A young adult after facial and hand burns avoids mirrors, cancels therapy, and has nightmares of the fire; you explore trauma and body-image distress, suicide risk, and negotiate a graded recovery plan with the burn team.

Open

Domain

Consultation-liaison — transplant and ICU psychiatry

1

communication

Post-ICU PTSD and transplant clinic avoidance — CASC communication station

A kidney transplant recipient misses two post-transplant clinics after a prolonged ICU admission for septic shock; you explore ICU-related trauma symptoms, adherence risk, and negotiate a safe follow-up plan.

Open

Domain

Public-community — military and veteran psychiatry

1

communication

Recently transitioned veteran with combat nightmares and firearm access — CASC communication station

A recently discharged combat veteran with nightmares, hypervigilance, heavy drinking, and passive death wishes; a licensed firearm is at home. You must build alliance despite stigma about 'weakness,' assess suicide and weapons risk, elicit paced service/trauma history without forcing graphic detail, explore moral injury themes if present, and agree a collaborative plan including therapy pathway and safety.

Open

Domain

Professional — complaint management and regulation

1

communication

Responding to a family complaint after unexpected death — CASC communication station

You meet a bereaved parent who has written a formal complaint after their adult child's suicide following a recent psychiatric assessment; you must listen, acknowledge, explain open disclosure principles, outline process, avoid defensiveness or legal speculation, and describe support without inventing statute numbers.

Open

Domain

Public and community psychiatry — rural and remote

1

communication

Rural tele-risk assessment and GP liaison — CASC/communication station

You are the on-call psychiatry registrar providing telepsychiatry support to a rural ED 450 km from the regional base. A 48-year-old grain farmer was brought by his partner after disclosing a plan to shoot himself in the machinery shed. He has been drinking daily for three months during drought, has not seen a GP for a year, and is ambivalent about transfer. The rural GP and ED nurse are in the room; the patient is on video from a private cubicle. You have 10 minutes to assess risk structure, advise on immediate management and legal options, and agree a collaborative plan with the local team.

Open

Domain

Professional — stigma, recovery and rights-based care

1

communication

Shared decision-making and stigma around long-acting antipsychotic — CASC communication station

A young adult with first-episode psychosis declines LAI medication because of stigma and identity fears; you must explore self-stigma, maintain alliance, use SDM structure, support recovery goals, and avoid coercion theatre or pejorative language.

Open

Domain

Professional — spirituality and religion in psychiatry

1

communication

Spiritual history and treatment negotiation — CASC communication station

A middle-aged man with depression and passive suicidal ideation whose faith community frames tablets as weak faith; you must take a respectful spiritual history, assess risk, negotiate care without proselytising, and offer spiritual care pathways.

Open

Domain

Psychopharmacology — SSRIs

1

communication

Starting an SSRI with black-box counselling (CASC)

A 19-year-old with first-episode moderate–severe major depression and social anxiety attends with a parent. They fear antidepressants are 'addictive' and have read online that SSRIs 'cause suicide.' The GP suggested sertraline but they want to refuse all medicine.

Open

Domain

Psychopharmacology — SNRIs and NRIs

1

communication

Starting venlafaxine after SSRI — dual action, BP and discontinuation (CASC)

A 36-year-old accountant with moderate-severe unipolar MDD attends with her partner. Escitalopram 20 mg for 10 weeks helped anxiety slightly but mood remains low (PHQ-9 16). No bipolar history. She read online that SNRIs are 'stronger dual antidepressants' and also that venlafaxine causes 'horrible addiction withdrawals' and 'heart damage'. BP today 122/76. She wants a clear plan.

Open

Domain

Professional — doctor health, burnout and impairment

1

communication

Support a burned-out colleague and hold a safety frame — CASC communication station

A junior doctor colleague discloses exhaustion, cynicism, a near-miss error, and passive suicidal ideation after a complaint; you must respond with empathy, assess risk, plan safety and support, and outline organisational next steps without shaming or colluding.

Open

Domain

Public and community psychiatry — telepsychiatry

1

communication

Telepsychiatry crisis review and local team liaison — CASC/communication station

You are the on-call psychiatry registrar providing telepsychiatry support to a rural ED 400 km from the regional base. A 34-year-old teacher was brought after texting a friend about overdosing on remaining antidepressants. She is on video from a private cubicle; the ED doctor and nurse are present. She lives alone in a rental; Wi-Fi is unstable. She has not yet given a full address on the electronic record. You have 10 minutes to establish tele-safety process, structure suicide risk, advise immediate management, and agree a collaborative plan with the local team.

Open

Domain

Foundations — prevention and early intervention

1

communication

Youth prevention and early intervention service planning — CASC/communication station

You are the psychiatry registrar meeting a school principal, a GP lead, a parent of a 18-year-old with attenuated psychotic symptoms, and a health service finance officer. They have 10 minutes to agree a district youth mental health plan after a spike in emergency presentations and a report of median DUP of 11 months.

Open