Psych CASC / OSCE · Public and community psychiatry — school and workplace mental health
Advise a school and employer on mental health pathways — CASC communication station
MRCPsych/FRANZCP-style communication station: explain multi-tier school supports, SEYLE/YAM evidence in plain language, workplace psychosocial risks, RTW, disclosure ethics, and crisis red flags.
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Target exams
Station brief
Format. Communication station, approximately 7–10 minutes. You are the psychiatry registrar invited to a joint school-industry wellbeing meeting. [1]
Candidate instructions. Explain multi-tier school mental health, what SEYLE implies about universal skills programmes versus screening-only approaches, workplace factors that increase depression risk, how return-to-work should be planned, and when to use emergency services. Avoid jargon overload; check understanding; agree next steps. [1][2][3][4]
Candidate scenario
The deputy principal says: "We should questionnaire every student tomorrow." HR says: "Staff must tell us their diagnosis or they cannot come back." Both fear bad press. [1][3]
Marking domains
- Alliance with non-clinical partners
- Clear MTSS explanation
- Accurate SEYLE message (YAM vs screening)
- Workplace risk factors in plain language
- RTW principles without legal overclaim
- Privacy and voluntary disclosure ethics
- Crisis red flags
- Shared practical next steps [1][3][4]
Reveal assessor key
Open. Thank them; validate fear after serious incidents; set collaborative tone. [1]
School. "Think in three levels: support for everyone (skills, climate, trusted adults), extra help for students struggling, and fast clinical pathways for those who are unwell or unsafe. Large evidence supports social-emotional learning for skills and behaviour. A major European trial found a structured student awareness programme (YAM) reduced suicide attempts compared with usual practice, while screening-as-tested there did not beat control on the main outcomes — so screening without strong care pathways is not the whole answer." [1][2]
Workplace. "Depression risk rises with high pressure and low control, poor support, unfair reward, job insecurity, long hours, and bullying. Fixing those design problems matters more than a yearly motivational talk." [3]
Disclosure. "We cannot force people to hand over diagnoses as a condition of basic dignity. We can ask for functional information needed for safe duties, offer confidential care, and plan return with graded hours and adjusted tasks while treatment continues." [4]
Red flags. "If someone has a suicide plan, is psychotic, or cannot stay safe, call crisis/ED the same day — not the next workshop." [1]
Close. Propose: school crisis protocol review + tiered support map in 4 weeks; workplace psychosocial risk audit + RTW template with occupational health and GPs; reconvene in 3 months with attendance and sick-leave process metrics (not forced diagnosis counts). Invite questions. [1][3][4]
References
- [1]Wasserman D, Hoven CW, Wasserman C, et al. School-based suicide prevention programmes: the SEYLE cluster-randomised, controlled trial Lancet, 2015.PMID 25579833
- [2]Durlak JA, Weissberg RP, Dymnicki AB, et al. The impact of enhancing students' social and emotional learning: a meta-analysis of school-based universal interventions Child Dev, 2011.PMID 21291449
- [3]Harvey SB, Modini M, Joyce S, et al. Can work make you mentally ill? A systematic meta-review of work-related risk factors for common mental health problems Occup Environ Med, 2017.PMID 28108676
- [4]Nieuwenhuijsen K, Verbeek JH, Neumeyer-Gromen A, et al. Interventions to improve return to work in depressed people Cochrane Database Syst Rev, 2020.PMID 33052607