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Paeds Casesmental-behavioural-and-psychosomatic

Paeds Cases · mental-behavioural-and-psychosomatic

Emergency mental-health assessment and disposition — OSCE risk-assessment and disposition station

Observed structured encounter testing the rapid safety and medical screen, structured suicide-risk assessment with a validated tool, risk stratification, matching the level of care to risk, safety planning with means restriction, and the management of intoxication, capacity and a follow-up safety-net.

osce risk-assessment and disposition station3 min readVerification in progress

Target exams

RACP General PaediatricsRACP DCEMRCPCH ClinicalRCPSC Pediatrics
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Target exams

RACP General PaediatricsRACP DCEMRCPCH ClinicalRCPSC Pediatrics
Prompt
Station A is a 15-year-old girl presenting after an overdose requiring a rapid medical screen, a structured risk assessment with a validated tool, and a disposition decision. Station B is a deterioration into intoxication and a capacity question requiring a statutory response and a safety-net.

Station objectives

  1. Perform a rapid safety and medical screen and exclude an organic or toxicological driver. [4] [7]
  2. Conduct a structured suicide-risk assessment using a validated brief screen and synthesise a risk stratum. [1] [3]
  3. Match the level of care to the risk stratum, applying the least-restrictive principle. [7] [5]
  4. Build a safety plan with means-restriction counselling and a confirmed follow-up. [6] [5]
  5. Manage intoxication and capacity and apply local mental-health statute appropriately. [4] [7]
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References7ShowHide
  1. [1]Horowitz LM Ask Suicide-Screening Questions (ASQ): a brief instrument for the pediatric emergency department. Arch Pediatr Adolesc Med, 2012.PMID 23027429
  2. [2]King CA Prospective Development and Validation of the Computerized Adaptive Screen for Suicidal Youth (CASSY). JAMA Psychiatry, 2021.PMID 33533908
  3. [3]Ballard ED Identification of At-Risk Youth by Suicide Screening in a Pediatric Emergency Department. Prev Sci, 2017.PMID 27678381
  4. [4]Asarnow JR The Emergency Department: Challenges and Opportunities for Suicide Prevention. Child Adolesc Psychiatr Clin N Am, 2017.PMID 28916013
  5. [5]Knipe D Risk of suicide and repeat self-harm after hospital attendance for non-fatal self-harm in Sri Lanka: a cohort study. Lancet Psychiatry, 2019.PMID 31272912
  6. [6]Chaudhary S Reducing firearm access for youth at risk for suicide in a pediatric emergency department. Front Public Health, 2024.PMID 38859900
  7. [7]McNamara S Suicide Risk in Children and Adolescents: Assessment and Management. Child Adolesc Psychiatr Clin N Am, 2026.PMID 35015441
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