Elicit and summarise a Mental State Examination — CASC communication station

Station brief

Format. Communication station, approximately 7–10 minutes active time after reading. You are the psychiatry registrar in outpatient/ED assessment. [1]

Candidate instructions. Build rapport. Explore the person's current mental state across core domains without reading a checklist. Elicit mood (quote), observe affect, assess thought form and content (including suicidal ideation), screen for hallucinations carefully, sample cognition, explore insight multidimensionally, and check judgement with a brief real-world probe. Summarise sensitively and outline next steps. Avoid collusion, humiliation, and invented legal section numbers. [1][2]

Candidate scenario

Your patient is 32, English-speaking, referred after family noticed withdrawal and fear of cameras. They appear tense, glance at the door, speak softly with long latency. If asked open questions they may allude to 'people talking about me' and 'comments when I walk past the TV.' They deny 'being mad' but admit sleep is poor. No current agitation. You may ask about thoughts of suicide; if present, clarify wish, intent, plan, and protective factors using structured concepts without sounding like a form. [3]

Marking domains

• Empathy, pacing, non-stigmatising language
• Open-then-focused structure covering appearance/behaviour (observed), speech, mood, affect, thought form and content, perception, cognition, insight, judgement
• Safe hallucination elicitation without heavy leading
• Risk exploration with appropriate depth [3]
• Multidimensional insight (not only good/poor) [2]
• Cultural humility if explanatory models arise [4]
• Clear, non-jargon summary and collaborative next steps
• Professional close [1]