MBBS OSCE · Psychiatry
OSCE — Suicide Risk Assessment & Prevention
Eight-minute OSCE station on Suicide Risk Assessment & Prevention: focused history, examination priorities, investigations, emergency and definitive management.
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Brief (to candidate)
You will assess a patient with a presentation consistent with Suicide Risk Assessment & Prevention.
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.
Clinical context
Suicide is a leading cause of death worldwide. Risk assessment is a core clinical skill: ask directly about ideation, plan, intent, means, and preparatory acts. Risk factors (male sex, older/young adult age, psychiatric disorder — depression in 60 percent, previous attempt = strongest predictor, hopelessness, substance use, access to lethal means) are weighed against protective factors (social support, reasons for living). Risk stratification drives disposition: high risk = urgent admission; moderate = crisis team, remove means, safety plan; low = outpatient plus safety plan. ALWAYS document.
Candidate tasks
- Clarify onset, severity, associated features, and red-flag symptoms.
- State focused examination priorities.
- List first-line investigations and any named score/criteria.
- Give immediate resuscitation steps.
- Outline definitive management with doses/routes where standard.
- Name complications and disposition (ward / HDU / theatre / discharge safety-net).
- Mention one special-population modifier (pregnancy, child, elderly, CKD).
Examiner checklist
| Domain | Pass behaviours |
|---|---|
| Definition | Correct working diagnosis language |
| Assessment | Focused, prioritised, red flags sought |
| Investigations | Appropriate first-line + interpretation |
| Emergency care | ABC / time-critical actions first |
| Definitive care | Specific drugs/procedures, not generic phrases |
| Safety | Active suicidal ideation with a specific plan, access to means, and intent - psy |
| Safety | Patient who has attempted suicide - medical stabilisation then urgent psychiatri |
| Safety | Sudden calmness after a period of severe agitation/depression - may indicate dec |
| Communication | Clear plan and safety-netting |
Model outline
Lead with the working diagnosis and life threats. Resuscitate before definitive tests when unstable. Use guideline-standard therapy with named agents and doses. Document escalation criteria and follow-up. A safe candidate is specific, structured, and never delays critical care for non-urgent imaging.