Assess violence risk and explain the plan — CASC communication station

Station brief

Format. Communication station, approximately 7–10 minutes active time after reading. You are the psychiatry registrar in ED. The examiner plays a parent of a 28-year-old man with recent-onset psychosis. [1]

Candidate instructions. Take a focused collateral history about threats and violence risk. Explain in plain language how you assess risk without stigmatising all people with mental illness. Outline immediate safety steps and what happens next. Discuss confidentiality limits when others may be at risk. Check understanding. Do not invent specific Mental Health Act section numbers. [1][2]

Candidate scenario

Your patient’s parent says: "He told the neighbour he’d make them pay for ruining his life. He’s barely slept, talking about cameras in the walls. He drinks heavily some nights. We have his father’s old shotgun locked in a shed at the farm. I’m scared but I don’t want him branded as a monster." The patient is in a side room with security nearby and has not yet been fully assessed by you. [3]

Marking domains

• Empathy and non-stigmatising language
• Structured enquiry: threats, intent, target, means (shotgun), substances, sleep, prior violence
• Explains dynamic vs background factors simply
• Immediate safety: weapon, neighbour, observation, assessment plan
• Confidentiality vs duty to protect (principles; jurisdiction-specific detail not invented)
• Clear next steps and safety-net; checks understanding
• Avoids equating psychosis with permanent dangerousness [1][2]