Psych CASC / OSCE · Emergency psychiatry — self-harm and crisis
Assess self-harm and co-create a crisis safety plan — CASC communication station
MRCPsych/FRANZCP-style CASC: non-stigmatising self-harm assessment, intent continuum, Stanley-Brown safety plan, means restriction, and clear aftercare without no-suicide contracts or graphic method coaching.
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Target exams
Station brief
Format. Communication station, approximately 7–10 minutes active time after reading. You are the psychiatry registrar in the emergency department. The patient is medically cleared. [1]
Candidate instructions. Establish rapport using non-stigmatising language. Assess the self-harm episode including intent continuum and functions. Explore current risk, supports, and means. Collaboratively create a safety plan including means restriction and crisis contacts. Agree follow-up. Do not use a no-suicide contract. Avoid graphic method coaching. Check understanding. The examiner plays the patient. [1][2]
References4ShowHide
- [1]Stanley B, Brown GK, Brenner LA, et al. Comparison of the Safety Planning Intervention With Follow-up vs Usual Care of Suicidal Patients Treated in the Emergency Department JAMA Psychiatry, 2018.PMID 29998307
- [2]Klonsky ED The functions of deliberate self-injury: a review of the evidence Clin Psychol Rev, 2007.PMID 17014942
- [3]Kapur N, Steeg S, Turnbull P, et al. Hospital management of suicidal behaviour and subsequent mortality: a prospective cohort study Lancet Psychiatry, 2015.PMID 26254717
- [4]Posner K, Brown GK, Stanley B, et al. The Columbia-Suicide Severity Rating Scale: initial validity and internal consistency findings from three multisite studies with adolescents and adults Am J Psychiatry, 2011.PMID 22193671