Children of parents with mental illness or substance use — OSCE

Liam is an eight-year-old boy brought to the general paediatric clinic by his mother, Sarah, who has treatment-resistant depression. Liam has started missing school, complains of recurrent tummy aches, and has begun "looking after Mum" — reminding her to take her tablets and making his own lunch. Sarah is tearful and asks whether Liam is "going to get depressed too, because it runs in the family," and whether he should "see someone on his own." During the assessment Liam confides quietly that sometimes Mummy "doesn't wake up properly" and he has to get his little sister ready, and that last week Mummy drove them to school after taking her "calm-down tablets" that made her sleepy.