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CPSA · OSCE station
Mental state examination & risk
Take a psychiatric history, perform and present a structured MSE, and — critically — a risk assessment.
Mental health is one of the two most heavily-sampled AKT areas (≥12 items) and a reliable CPSA station. Risk assessment is mandatory and examinable — to self (self-harm, suicide, self-neglect) and to others.
A structured approach
The MSE (structured)
- 1Appearance & behaviour — self-care, psychomotor activity, rapport, eye contact
- 2Speech — rate, rhythm, volume, quantity
- 3Mood & affect — subjective + objective; range and congruence
- 4Thought — form (flight of ideas, thought block) and content (delusions, obsessions)
- 5Perception — hallucinations, illusions
- 6Cognition — orientation, attention, brief memory screen
- 7Insight & judgement
Risk assessment (never skip)
- 1Risk to self — thoughts of self-harm/suicide (ideation → plan → intent → means), self-neglect
- 2Risk to others; risk from others (safeguarding/exploitation)
- 3Protective factors; ask directly and calmly — it does not increase risk
What the examiner wants
- A complete, correctly-ordered MSE that you can present fluently
- A genuine, sensitive risk assessment — asking about suicide explicitly
- Rapport and a non-judgemental manner
- An appropriate safety/escalation plan
OSCE tips
- Always do the risk assessment — omitting it can fail the station on patient safety.
- Ask about suicide directly; euphemisms lose clarity and marks.
- Distinguish MSE (now, observed) from psychiatric history (background).
- Escalate clearly if risk is high (senior/crisis team).
Marking domains
Every station is scored against these. The ones this type leans on most are highlighted.
Data gathering
Right questions, focused examination, relevant investigations.
Clinical reasoning & management
Plausible diagnosis, sensible investigations, safe evidence-based management.
Communication
Active listening, clear explanation, exploring concerns (ICE), shared decisions, safety-netting.
Professional behaviour
Rapport, respect, empathy, handling challenge, honesty.
Patient safety
Recognising and responding to safety-critical issues; escalation.
Topics that appear
Appearance & behaviourSpeechMood & affectThought (form & content)PerceptionCognitionInsight & judgementRisk (self & others)Suicide-risk assessmentDepression / psychosis
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