Psych CASC / OSCE · Public and community psychiatry
The 17-year-old who says school is pointless — CASC climate distress and post-bushfire assessment station
FRANZCP/MRCPsych-style station: assess an adolescent with combined post-bushfire trauma exposure and climate-related distress, distinguish proportionate distress from disorder, screen suicidality, and respond without catastrophising or dismissing. FRANZCP-primary, globally tagged.
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Study tools
Target exams
FRANZCPMRCPsychABPNMD-DNB
Prompt
A 17-year-old boy attends the community clinic with his mother. The family home burned in a bushfire two summers ago and they are still in rental accommodation. He is not sleeping, has stopped attending sport, and told his mother there is no point finishing school 'if the next one comes'. He is guarded, says he is 'not depressed, just realistic', and becomes irritable when his mother calls it anxiety.
Candidate instructions (10 minutes)
Take a focused history from the young person. Establish whether a disorder is present. Address his climate-related distress without pathologising it or dismissing it. Do not attempt a full formulation to his mother.[1][19]
References20ShowHide
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- [11]Bryant RA, Gibbs L, Colin Gallagher H, et al. The dynamic course of psychological outcomes following the Victorian Black Saturday bushfires Aust N Z J Psychiatry, 2021.PMID 33176436
- [12]Kemel P, Porter JE, Remedios L, et al. Bushfire and adolescent mental health: A systematic review Aust N Z J Psychiatry, 2025.PMID 41020783
- [13]Dückers MLA, Stroebe MS, Baliatsas C, et al. The Long-Term Mental Health Impact of Disasters: A Systematic Review and Multilevel Meta-Analysis of Longitudinal Epidemiological Studies Harv Rev Psychiatry, 2026.PMID 41706503
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- [18]Trott M, Lockett C, Arnautovska U, et al. Natural disasters and suicidality in Australia: a systematic review Soc Psychiatry Psychiatr Epidemiol, 2026.PMID 42360423
- [19]Wasmus H, Fleck L, Schmidt T, et al. Addressing youths' climate change-related distress: a qualitative study on the experience of burden, triggering and protective factors BMJ Ment Health, 2025.PMID 41043970
- [20]Yarlagadda S, Maughan D, Lingwood S, et al. Sustainable psychiatry in the UK Psychiatr Bull (2014), 2014.PMID 25505629