Housing, poverty and depression — CASC/communication station

Station brief

Format. Communication / joint planning station, approximately 8–10 minutes. Balance empathy with concrete multi-agency actions. [7]

Candidate instructions. Engage the patient; reframe self-blame using social determinants language without minimising depression as a treatable illness; screen risk (suicide, violence, child/others if relevant); agree a plan covering clinical care, housing, income, and follow-up; brief housing officer respectfully. [1][2][3]

Candidate scenario

Patient materials: PHQ-9 high; drinks 6 beers most nights since job loss; one friend only; eviction notice; stopped sertraline because pharmacy co-payment and shame. No current suicide plan but passive ideation when thinking about sleeping rough. GP concerned about DNA. Housing officer can discuss temporary options if mental health team commits to follow-up. [2][5]

Marking domains

• Warm engagement; explores shame/self-stigma without collusion with hopelessness [4][5]
• Names housing, income, and job loss as determinants maintaining depression [1][3]
• Explains bidirectional poverty–illness loop in plain language [2]
• Risk assessment and safety netting (ideation, alcohol, rough sleeping) [7]
• Multi-level plan: meds/therapy access, benefits, housing pathway, alcohol brief intervention, early review [1][6]
• Collaborative briefing of housing officer; avoids jargon and blame [6][8]
• Time management; shared decision-making; written next steps