Psych CASC / OSCE · Forensic psychiatry — homicide and mental disorder
Explain FEP homicide risk and responsibility to a worried family — CASC communication station
MRCPsych/FRANZCP-style CASC: communicate homicide risk humility, FEP urgency, substances, and responsibility vs treatment frames to a family.
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Target exams
Station brief
Format. Communication station, approximately 7–10 minutes active time. You are the psychiatry registrar speaking with parents after an early-psychosis assessment clinic visit. [1]
Candidate instructions. Acknowledge fear without amplifying stigma. Explain that absolute risk of homicide is low even though relative risk of violence can be raised. Explain why untreated first-episode psychosis is the period of greatest concern in homicide research among psychotic cases. Cover warning signs (threat content, substances, family fear, weapons access). Outline urgent assessment/treatment pathways. Clarify that a schizophrenia diagnosis is not the same as a legal insanity finding. Do not invent statute numbers. Check understanding and safety plan. [1][2][3][5]
You have read the opening of this CASC / OSCE. The complete unit — every section and its primary-source references — is part of the Psychiatry Fellowship fellowship atlas.
References5Show ledgerHide ledger
- [1]Nielssen O, Large M Rates of homicide during the first episode of psychosis and after treatment: a systematic review and meta-analysis Schizophr Bull, 2010.PMID 18990713
- [2]Taylor PJ, Gunn J Homicides by people with mental illness: myth and reality Br J Psychiatry, 1999.PMID 10211145
- [3]Fazel S, Gulati G, Linsell L, et al. Schizophrenia and violence: systematic review and meta-analysis PLoS Med, 2009.PMID 19668362
- [4]Witt K, van Dorn R, Fazel S Risk factors for violence in psychosis: systematic review and meta-regression analysis of 110 studies PLoS One, 2013.PMID 23418482
- [5]American Academy of Psychiatry and the Law AAPL Practice Guideline for forensic psychiatric evaluation of defendants raising the insanity defense J Am Acad Psychiatry Law, 2014.PMID 25492121