Psych CASC / OSCE · Child and adolescent psychiatry — children of parents with mental illness
COPMI family discussion — CASC communication station
MRCPsych/FRANZCP-style CASC: family-inclusive explanation of COPMI care, dual loyalty, and collaborative safety planning.
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Target exams
Station brief
Format. Communication station, approximately 7–10 minutes after reading. You are the adult psychiatry registrar in clinic.[1]
Candidate instructions. Your patient has depression and two school-age children. They fear that mentioning the children will lead to automatic removal. Explain why services ask about children, how treating their illness can help the children, what family-focused support looks like, confidentiality limits if a child is unsafe, and agree a practical plan for who cares for the children if they become unwell again. Be collaborative, non-collusive, and non-catastrophising. Do not invent statute section numbers.[1][2]
Candidate scenario
The patient says: "If I tell you about my kids, you'll take them. I only came for my tablets. Leave them out of it." English is fluent. No current emergency injuries disclosed.[1]
Marking domains
- Empathy and destigmatising stance toward parental mental illness
- Explains commonness of parental mental illness / children in families
- Links parental treatment and remission to child wellbeing (STAR*D-child principle in plain language)
- Describes family psychoeducation / support without forcing therapy jargon
- Clarifies that diagnosis alone does not equal automatic permanent removal
- Explains honestly that if a child is unsafe, information may need to be shared with child-protection services (principles only)
- Agrees relapse childcare plan and follow-up
- Avoids collusion, threats, or invented legal citations [1][2][3][4]
Reveal assessor key
Open. Thank them for attending; acknowledge fear of child removal is common and understandable; state your goal is to support them as a parent and keep children safe and well — not to punish illness.[1]
Explain why we ask. Many people using mental health services are parents; children can be affected by parental illness stress; asking allows support (school, family meetings, practical help) and a plan if hospital is needed. Prevalence framing: a substantial minority of children live with a parent with mental illness — they are not alone.[1]
Treatment helps children. In plain language: when a parent's depression improves, children's emotional symptoms often improve too — so good adult treatment is also good for the family.[2]
Support options. Family conversation/psychoeducation approaches, parenting support, checking how the children are coping, linking to CAMHS if a child is struggling; preventive family work has evidence of benefit.[3][4]
Dual loyalty / confidentiality. We keep information private where possible, but if a child is at serious risk of harm we may need to share key facts with child-protection services to keep them safe. We would explain this and support you through it. No fake section numbers.[1]
Plan. Who can care for the children if mood drops or admission is needed; school contact consent if appropriate; review of depression treatment; offer family session; crisis contacts. Check understanding; invite questions; close with collaborative next steps.[1][2]
References
- [1]Reupert AE, Maybery DJ, Kowalenko NM Children whose parents have a mental illness: prevalence, need and treatment Med J Aust, 2013.PMID 25369850
- [2]Weissman MM, Pilowsky DJ, Wickramaratne PJ, et al. Remissions in maternal depression and child psychopathology: a STAR*D-child report JAMA, 2006.PMID 16551710
- [3]Siegenthaler E, Munder T, Egger M Effect of preventive interventions in mentally ill parents on the mental health of the offspring: systematic review and meta-analysis J Am Acad Child Adolesc Psychiatry, 2012.PMID 22176935
- [4]Beardslee WR, Gladstone TR, Wright EJ, Cooper AB A family-based approach to the prevention of depressive symptoms in children at risk: evidence of parental and child change Pediatrics, 2003.PMID 12897317