Dual-disability court liaison — CASC communication station

Station brief

Format. Communication station, approximately 7–10 minutes active time after reading. You are the dual-disability psychiatry registrar in court liaison clinic. [2]

Candidate instructions. Meet a 25-year-old man with mild intellectual disability charged with assault after a fight with a flatmate. Support worker interrupts frequently. Solicitor wants a quick “unfit” letter based on old IQ 65. Explain in plain language what you will assess (fitness now, not guilt), check understanding with teach-back, address yes-saying, involve the support worker without letting them take over, and outline next steps (further assessment, possible education/supports, multiagency plan). Do not invent statute section numbers. Do not humiliate. [1][2]

Candidate scenario

Your patient is 25, lives in shared supported housing, mild ID, short-phrase speech, anxious in formal rooms. He says: “The police talked a long time. I said I did it so I could go home.” Support worker: “He doesn’t understand anything — just write he’s unfit.” Solicitor presses for same-day global unfitness opinion. No acute psychosis. Flatmate conflict after money borrowed and not returned; patient has also been hit by peers before (possible victim–offender overlap). [1][4]

Marking domains

• Greets the person first; sets respectful roles for support worker and solicitor
• Plain-language explanation of fitness now vs deciding guilt vs past mental state
• Teach-back; checks for yes-saying and interview pressure (suggestibility pearl)
• Avoids equating IQ 65 with automatic unfitness
• Offers communication supports and possible further sessions / education if needed
• Mentions multi-source information and safety for both parties
• No invented legal section numbers; acknowledges local process
• Empathy, non-stigmatising language, clear summary of next steps [1] [2] [3] [4]