Psychiatry - General Adult Interview Questions & Answers

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About this NHS interview question bank

To prepare for a general adult psychiatry NHS interview, expect questions on risk assessment and formulation, the Mental Health Act and Mental Capacity Act, on-call and emergency department referrals, rapid tranquillisation, clozapine and lithium safety, safeguarding, serious incidents and how you work within community and inpatient teams. Build short spoken answers around real cases you have managed, and know GMC Good Medical Practice, the NHS values and how the trust's adult mental health services are organised before you walk in.

This bank contains 40 original practice questions with first-person model answers written for doctors applying for general adult psychiatry posts at Clinical Fellow and Specialty Doctor level, including internationally trained doctors starting their first NHS psychiatry job, with a selection pitched at Specialist and Consultant grade. It covers community mental health teams, acute inpatient wards, crisis and home treatment, liaison and on-call work, and each answer is built around a realistic, non-identifying clinical scenario. Every question explains what a panel of consultants and service managers is really assessing, the points you must hit, the mistakes to avoid and the legislation and guidance worth reading, so you can practise answers that sound safe, thoughtful and like you.

 

What this question bank covers

• Motivation for general adult psychiatry
• NHS values and current mental health priorities
• Risk assessment and formulation
• Mental Health Act 1983 and the doctor's role
• Section 5(2) holding powers
• Section 12 approval and medical recommendations
• Mental Capacity Act 2005
• Rapid tranquillisation and physical monitoring
• Clozapine and lithium safety
• Physical health in severe mental illness
• Emergency department and liaison referrals
• Crisis and home treatment
• Community mental health teams
• Safeguarding adults and children
• Race equality and the Mental Health Act
• Confidentiality, carers and DVLA
• Serious incidents, PSIRF and coroners' inquests
• Supervising juniors and teaching
• Audit and quality improvement
• Portfolio pathway (CESR) and career development
• Wellbeing and burnout

 

40 NHS interview questions with full model answers. The first 8 are free to read below. Unlock the remaining 32 for £2.99 (12 months' access).

These are original practice questions written to reflect how NHS interviews are run. They are not leaked or official questions, and Healthcare Interview Prep is independent of the NHS.

 

 

Free NHS interview questions and model answers

 

 

Question 1: Why have you chosen general adult psychiatry, and why at this stage of your career?

Motivation question  ·  Motivation

 

What the interview panel is assessing

The panel wants a genuine, personal reason for choosing adult psychiatry rather than a vague interest in the mind. They are also checking that you understand the realities of the specialty, including risk, coercion and long-term illness, and that this post fits a sensible career plan.

 

Model answer

I'd like to answer that with a patient rather than a theory. Early in my psychiatry training I looked after a man in his thirties who was admitted with his third episode of psychosis. On the ward round he was guarded and wouldn't say much. Over the next couple of weeks I spent time with him, mostly just checking his bloods and chatting about football, and slowly he told me about losing his job and how frightening the voices were at night. By discharge he'd agreed to try a depot and to meet his care coordinator. What stayed with me was that the medication mattered, but so did the relationship, his housing and his sister, who'd been carrying everything on her own.

That's what draws me to general adult psychiatry. You're thinking about biology, psychology and social circumstances all at once, and you're often seeing someone at the worst point of their life. I like that the formulation actually changes what you do.

I'm also realistic about it. It's a specialty where you sometimes have to use the Mental Health Act and take away someone's liberty, where risk can never be eliminated, and where some patients don't get better as quickly as you'd hope. I've seen how heavy that can feel, and I think I've learned to take it seriously without becoming defensive.

As for timing, I've built a good grounding in acute and on-call work, and this post would let me consolidate that in a structured NHS setting with proper supervision. In the next few years I'd like to gain Section 12 approval and build a portfolio that keeps the door open to the portfolio pathway or a specialist post. I want to grow into the kind of doctor nurses are relieved to see on a busy night.

 

Why this answer works

The answer starts with a believable clinical story rather than a cliche, which makes it memorable. It shows an understanding of the biopsychosocial model, acknowledges the harder parts of the specialty honestly and links the post to a realistic career plan.

 

Key points to include

• A specific patient or moment that shaped your choice
• Understanding of biological, psychological and social factors working together
• Realism about risk, coercion and chronic illness
• Why this post fits now, at your grade
• A sensible next step such as Section 12 approval or the portfolio pathway

 

Common mistakes to avoid

• Saying you have always been fascinated by the human mind with nothing concrete behind it
• Implying psychiatry is an easier or less acute option than other specialties
• Ignoring the use of compulsory powers and the emotional weight of the work
• Giving a career plan that sounds as if you plan to leave the post quickly

 

NHS values and standards

Compassion; Improving lives; Everyone counts; GMC Good Medical Practice: knowledge, skills and development

 

Further reading

• GMC Good Medical Practice
• Royal College of Psychiatrists careers information for general adult psychiatry
• NHS Constitution for England

 

 

Question 2: Which NHS value matters most to you as a psychiatrist, and can you give an example of it in practice?

NHS Values question  ·  NHS Values

 

What the interview panel is assessing

The panel is checking that you know the NHS values and can tie one to real behaviour in a mental health setting. They want an example where the value changed what you did, particularly where patients have less power, such as on a ward or under a section.

 

Model answer

The NHS values are working together for patients, respect and dignity, commitment to quality of care, compassion, improving lives, and everyone counts. In psychiatry the one I hold onto most is respect and dignity, because our patients are so often in a position where they've lost control over what happens to them.

I remember a woman detained under section 2 on an acute ward who'd been brought in by police the night before. When I went to clerk her she was sitting in her nightclothes in a busy corridor because her own clothes had been taken for safekeeping and nobody had found her anything else. She was understandably furious and wouldn't speak to me. I didn't start with the history. I apologised, asked the nurse in charge if we could find her own clothes or something suitable, and we moved to a quiet room. I then explained who I was, what section 2 meant, and that she had the right to appeal to the tribunal and to have an advocate.

That conversation went completely differently once she felt treated as a person rather than a problem. She still disagreed with being detained, which was her right, but she engaged with the assessment and later told the advocate she felt listened to.

For me, dignity in psychiatry is in small things like that, and in bigger ones, such as always using the least restrictive option and explaining people's rights properly. If I keep that value in front of me, I think the others tend to follow.

 

Why this answer works

It names the values accurately, picks one and anchors it in a vivid, realistic example. The answer shows awareness of the power imbalance in compulsory care and links dignity to rights, advocacy and the least restrictive principle.

 

Key points to include

• Name the six NHS values correctly
• Choose one and explain why it matters in psychiatry specifically
• A concrete example where it changed your actions
• Link to patients' rights, advocacy and the least restrictive option
• Brief reflection on the outcome

 

Common mistakes to avoid

• Reciting all the values with no example
• Choosing an example with no link to mental health practice
• Presenting detention as purely a medical decision with no attention to rights
• Overclaiming that the patient was grateful for being sectioned

 

NHS values and standards

Respect and dignity; Compassion; Everyone counts; GMC Good Medical Practice: patients, partnership and communication

 

Further reading

• NHS Constitution for England
• Mental Health Act 1983 Code of Practice (England) on guiding principles
• GMC Good Medical Practice

 

 

Question 3: A detained patient on the ward is angry, demanding to know why he can't go home. How would you handle that conversation?

Communication question  ·  Communication

 

What the interview panel is assessing

The panel wants to see that you can stay calm, de-escalate and explain the legal position honestly without arguing. They are also looking for safety awareness, attention to the patient's rights and appropriate use of the team.

 

Model answer

The first thing I'd do is think about safety, for him, for me and for the staff around us. I'd check with the nurse in charge what's happened so far, whether he's been aggressive, and I'd make sure I'm somewhere I can leave easily with a colleague nearby, without making it feel like I've arrived with a crowd.

Then I'd mostly listen. Someone who's been detained has usually lost a lot in a short space of time, and the anger often makes sense. I'd keep my voice low and slow, sit if he's willing to sit, and let him tell me what's going on. Often it's something specific, such as worrying about his dog, his job or his flat, and sometimes we can actually help with that.

Once he's had the chance to be heard, I'd be honest with him. I'd say plainly that he's on section 3, that the team believes he needs treatment in hospital at the moment, and briefly why, in his terms rather than ours. I wouldn't argue about whether he's unwell, because that rarely helps. I'd make sure he knows his rights: that he can appeal to the tribunal and the hospital managers, that he's entitled to an independent mental health advocate, and that a solicitor can help him for free. If he hasn't had his rights read recently, I'd ask the nurses to do that again.

I'd also give him something to work towards, such as discussing section 17 leave with his responsible clinician at the next review, and I'd tell him exactly when that is.

If he became more agitated, I'd step back, use the team's de-escalation approach and avoid anything that felt like a stand-off. Afterwards I'd document the conversation, what he told me and the plan, and hand it over to the nurse in charge and the consultant. Honest, calm explanation won't always settle things, but in my experience it usually lowers the temperature.

 

Why this answer works

The answer leads with safety without being heavy-handed, puts listening before explaining, and gives the legal position honestly. It includes patients' rights under the Mental Health Act, a constructive next step, and clear documentation and handover.

 

Key points to include

• Check safety and background with the nurse in charge first
• Listen before explaining and look for practical concerns you can address
• Explain the section honestly in plain language without arguing
• Make sure the patient knows his rights: tribunal, managers' hearing, IMHA, solicitor
• Offer a realistic next step and document and hand over

 

Common mistakes to avoid

• Going straight into a lecture on why he is unwell
• Making promises about discharge or leave that only the RC can decide
• Forgetting to mention rights of appeal and advocacy
• Ignoring personal safety or, at the other extreme, escalating to restraint too early

 

NHS values and standards

Respect and dignity; Compassion; Working together for patients; GMC Good Medical Practice: communication and partnership

 

Further reading

• Mental Health Act 1983 Code of Practice (England), chapters on information for patients
• NICE guideline on violence and aggression: short-term management in mental health, health and community settings
• Mental Health Units (Use of Force) Act 2018

 

 

Question 4: You visit a woman in the community whose psychosis is relapsing, and you learn she is the sole carer for two young children. What do you do?

Safeguarding question  ·  Safeguarding

 

What the interview panel is assessing

The panel is checking that you think about children whenever you assess an adult, without assuming that mental illness makes someone an unsafe parent. They want a clear sense of immediate safety, information sharing, involvement of the safeguarding team and the mother's own care.

 

Model answer

I'd think of this as two pieces of work happening at the same time: her mental health and the children's safety. They're linked, but having a mental illness doesn't on its own make someone a risk to their children, and I'd try to go in with that mindset.

In the visit itself, I'd gently find out where the children are right now, who's looking after them, and how her symptoms are affecting day-to-day life. I'd want to know whether the children feature in any of her beliefs, for example if she thinks they're in danger or are part of what's happening to her, because that changes the level of risk considerably. I'd also look at practical things: is there food in the house, are the children getting to school, is there another adult around.

If there were any immediate risk to the children, I'd act on it straight away, which would mean contacting children's social care, or the police if a child was in danger right now, and discussing urgently with my consultant. If the risk wasn't immediate but I had concerns, I'd still make a referral to children's social care and speak to our trust safeguarding team for advice. I'd tell her I was doing that unless telling her would put the children at greater risk, and I'd be honest that the aim is to support the family.

At the same time, I'd plan her care. That might mean increasing contact from the team, a review of medication, the crisis or home treatment team, or considering admission, in which case we'd need a clear plan for the children before anything else.

I'd document what I saw and why I made each decision, and I'd make sure the GP and her care coordinator knew. The Think Family approach has really shaped how I work. Every adult I assess, I ask about children and dependants.

 

Why this answer works

The answer avoids stigma while taking risk seriously, and highlights the key question of whether children are involved in the psychotic content. It sets out immediate action, referral, transparency with the mother, and parallel care planning, all in line with Think Family principles.

 

Key points to include

• Always ask about children and dependants when assessing an adult
• Mental illness alone does not mean a parent is unsafe
• Check whether children feature in delusional beliefs
• Immediate danger means immediate action; otherwise refer to children's social care and seek safeguarding advice
• Plan the mother's care alongside the children's needs, and document clearly

 

Common mistakes to avoid

• Assuming the children must be removed because the mother has psychosis
• Focusing only on her symptoms and forgetting the children
• Keeping concerns to yourself to protect the therapeutic relationship
• Not telling the consultant or the safeguarding team

 

NHS values and standards

Everyone counts; Working together for patients; Compassion; GMC Good Medical Practice and GMC guidance on protecting children and young people

 

Further reading

• Working Together to Safeguard Children (England)
• Children Act 1989 and Children Act 2004
• GMC guidance: Protecting children and young people
• Think Family principles and your trust safeguarding policy

 

 

Question 5: Tell us about a mistake you have made and what you learned from it.

Patient Safety question  ·  Patient Safety

 

What the interview panel is assessing

The panel wants honesty, insight and evidence that you put the patient first when something goes wrong. They are listening for prompt escalation, Duty of Candour, incident reporting and a real change in your own practice.

 

Model answer

I'll give you one I still think about. I was covering a ward and a patient on lithium had been started on ibuprofen by another doctor for a painful knee. A few days later I was asked to see her because she felt sick and slightly shaky. I put it down to a viral illness and asked for her to be reviewed in the morning. I hadn't looked carefully at her drug chart, and I didn't make the link between the anti-inflammatory and her lithium.

The next morning the ward doctor did spot it and sent a lithium level, which came back raised. Thankfully it wasn't at a dangerous level, the ibuprofen and lithium were stopped, the medical team advised on fluids and monitoring, and she recovered without lasting harm. But I was very aware it could have gone differently.

I went to my consultant that day and told her what I'd missed. We spoke to the patient together, explained what had happened and apologised, and I completed an incident report. I found that conversation hard, but the patient appreciated being told straight.

What I learned was practical. Now whenever I'm asked to see someone on lithium or clozapine who feels unwell, I look at the drug chart first and think about toxicity or interactions before anything else. I also suggested at the ward's learning meeting that we add a prompt about NSAIDs and lithium to the electronic prescribing alerts, and the pharmacist took that forward.

It also taught me that the mistake usually isn't knowing too little, it's not stopping to check when you're busy. I build that pause in now, especially overnight.

 

Why this answer works

The answer gives a real, clinically relevant mistake without minimising it. It shows escalation, honest disclosure under the Duty of Candour, incident reporting, personal learning and a system-level change, which is exactly what panels want to hear.

 

Key points to include

• Choose a genuine, clinically meaningful mistake
• Show you acted quickly to make the patient safe
• Duty of Candour: honest explanation and apology
• Incident reporting and reflection with your supervisor
• A specific change to your practice and to the system

 

Common mistakes to avoid

• Choosing a 'mistake' that is really a strength in disguise
• Blaming colleagues or the system entirely
• Leaving out any disclosure to the patient
• Describing a mistake that caused serious harm without showing clear learning

 

NHS values and standards

Commitment to quality of care; Respect and dignity; GMC Good Medical Practice and the professional duty of candour

 

Further reading

• GMC and NMC joint guidance on the professional duty of candour
• Patient Safety Incident Response Framework (PSIRF)
• NICE guidance on bipolar disorder (lithium monitoring principles)
• British National Formulary entry on lithium interactions

 

 

Question 6: You are on call and ED refers a man in his forties who took an overdose of paracetamol and is now medically fit. How would you assess and manage him?

Clinical Scenario question  ·  Clinical Scenario

 

What the interview panel is assessing

This tests your core on-call skills: a structured psychosocial assessment, risk formulation rather than a tick-box score, and safe, collaborative management planning. The panel also wants to hear about medical fitness, capacity, safeguarding and clear communication with ED and the GP.

 

Model answer

Before I see him, I'd check with the ED team that he really is medically fit, that the treatment for paracetamol is complete and his bloods have been reviewed, because I've seen people referred before the medical side is finished. I'd look through his records for previous contact, risk history and any current care plan, and ask the nurses how he's been while waiting.

I'd see him somewhere private and safe, ideally with a colleague such as a liaison nurse. I'd start by letting him tell his story. Then I'd go through the overdose itself: what led up to it, whether it was planned, whether he expected to die, what he did afterwards, whether he told anyone and how he feels now about surviving. I'd ask about ongoing thoughts of suicide, any plans, access to means and protective factors. Alongside that I'd take a full history and mental state examination, looking for depression, psychosis, alcohol or drug use and anything organic.

I'd also ask about children or other people who depend on him, and about anyone who might be harming him or whom he might harm.

Rather than giving him a risk score, I'd write a formulation: why this happened now, what the triggers were, what keeps him safe and what might change. NICE is clear that risk tools shouldn't be used to predict suicide or decide who gets treatment.

The plan would depend on that formulation. If he's still actively suicidal and can't keep himself safe, I'd discuss with my consultant about home treatment or admission. If he's willing to engage and has support, it might be discharge with crisis team or community follow-up within an agreed timeframe. Either way we'd build a safety plan together, involve family with his consent, and think about reducing access to means. I'd write clearly, tell the ED team and GP the plan, and make sure he knows how to get help in a crisis.

If at any point he tried to leave and I thought he lacked capacity or was at high immediate risk, I'd involve senior colleagues straight away, because holding powers like section 5(2) don't apply in ED.

 

Why this answer works

The answer checks medical fitness first, then follows a clear structure: history of the act, current intent, full mental state, safeguarding and formulation. It avoids risk prediction tools in line with NICE, gives a range of plans, and shows awareness of the legal limits in ED.

 

Key points to include

• Confirm medical fitness and review records before assessing
• Explore the overdose in detail: planning, intent, regret, current thoughts
• Full history and mental state, including substances and safeguarding
• Formulate risk rather than relying on scores
• Collaborative safety plan, clear follow-up, communication with ED and GP

 

Common mistakes to avoid

• Using a risk score to decide whether to discharge
• Assessing before he is medically fit
• Forgetting to ask about dependants or safeguarding
• Being unaware that section 5(2) cannot be used in the emergency department

 

NHS values and standards

Compassion; Commitment to quality of care; Working together for patients; GMC Good Medical Practice: good clinical care

 

Further reading

• NICE guideline on self-harm: assessment, management and preventing recurrence
• Mental Capacity Act 2005 and Code of Practice
• Mental Health Act 1983 Code of Practice (England)
• Royal College of Psychiatrists guidance on liaison psychiatry and self-harm

 

 

Question 7: An informal patient on an acute ward is insisting on leaving at 2am and the nurse is worried. Talk us through what you would do, including the use of section 5(2).

Technical question  ·  Technical

 

What the interview panel is assessing

The panel is checking that you understand the holding powers under the Mental Health Act accurately and use them proportionately. They want to hear a proper assessment before any decision, knowledge of who can use section 5(2), its time limit and what must happen next.

 

Model answer

I'd go to the ward straight away rather than giving advice over the phone. While I'm on my way, I'd ask the nurse to try to keep him talking and to remind them that a qualified mental health nurse can use section 5(4) for up to six hours if they think it's necessary and a doctor isn't immediately available.

When I arrive, I'd find out why he wants to leave. Sometimes it's something we can sort out, like a row with another patient or a worry about home, and if he'd agree to stay till the morning to talk to his team, that's the least restrictive outcome. I'd check his notes for risk history and the reason for admission, and do a focused mental state examination.

If I thought he needed to stay because of a real risk to his health or safety or to others, and he wouldn't agree, I'd consider section 5(2). It can only be used for someone who is already an informal inpatient, by the doctor or approved clinician in charge of their treatment or their nominated deputy. On call at night, I'd be acting as the nominated deputy, and I'd check the trust's arrangements for that. I'd also ring my consultant on call, because it's a significant decision.

Section 5(2) lasts up to 72 hours, but it's a holding power, not a treatment section, so the aim is for an assessment for possible detention under section 2 or 3 to happen as soon as possible, not at the end of the 72 hours. I'd complete the correct form, make sure he's told his rights, and hand over to the day team and the AMHP service first thing so the assessment can be arranged. The holding power ends if the assessment decides he doesn't need detention.

If he was calmer after we talked and agreed to stay, I'd document that he's staying informally, with a clear plan for review in the morning. Either way, I'd write a careful note explaining my reasoning.

 

Why this answer works

The answer shows a proper sequence: attend, understand, try the least restrictive option, then use the holding power accurately. It correctly states who can use section 5(2), the 72-hour maximum, the need for prompt assessment, and the related nurse holding power.

 

Key points to include

• Attend in person and assess properly before deciding
• Try to resolve the reason for wanting to leave first
• Section 5(2): informal inpatients only, by the doctor or AC in charge or their nominated deputy
• Up to 72 hours; arrange a Mental Health Act assessment as soon as possible
• Inform your consultant, give rights, complete forms and document reasoning

 

Common mistakes to avoid

• Using section 5(2) over the phone or without seeing the patient
• Thinking section 5(2) can be used in the emergency department or for outpatients
• Treating 72 hours as a target rather than a maximum
• Forgetting the nurse's section 5(4) holding power and the patient's rights

 

NHS values and standards

Respect and dignity; Commitment to quality of care; GMC Good Medical Practice: good clinical care

 

Further reading

• Mental Health Act 1983, section 5
• Mental Health Act 1983 Code of Practice (England), chapter on holding powers
• Mental Health Act 1983 Code of Practice for Wales, where applicable
• Your trust's policy on nominated deputies

 

 

Question 8: How do you work as a doctor within a community mental health team? Give an example of good multidisciplinary working.

Teamwork question  ·  Teamwork

 

What the interview panel is assessing

The panel wants to know that you see yourself as part of a team rather than the person who makes all the decisions. They are looking for respect for other professions, good communication and a sense of how the CMHT actually functions day to day.

 

Model answer

I think the doctor in a CMHT brings particular things: diagnosis, medication, physical health, the legal frameworks and holding clinical risk with the consultant. But most of the day-to-day relationship with a patient sits with the care coordinator, who might be a nurse, a social worker or an occupational therapist, and they often know far more about how the person is really doing than I do in a twenty-minute review.

An example that comes to mind is a young man with schizophrenia who kept missing his clinic appointments. My first thought was that he was disengaging and that we might need to think about a depot. At the team's weekly meeting, his care coordinator, an occupational therapist, explained that he'd lost his bus pass and was embarrassed to say he couldn't afford the fare. The support worker had also noticed he wasn't eating properly. The psychologist suggested his avoidance might partly be about social anxiety rather than his psychosis.

So we changed the plan. I did his next review at home with the care coordinator, the support worker helped him with benefits and a new bus pass, and we offered a referral for psychological work. His attendance improved a lot over the next couple of months, and the medication question looked very different once we understood him better.

What I took from that is to ask the team before I decide what something means. I try to go to the MDT meeting with questions rather than conclusions, write clear letters that the whole team can use, and make myself easy to reach when a care coordinator is worried between appointments. If I'm honest, the doctors who are most effective in a CMHT are the ones the rest of the team find approachable.

 

Why this answer works

The answer describes the doctor's distinctive contribution while recognising the expertise of other professions. The example is realistic and shows how team input changed a medical assumption, leading to a better outcome for the patient.

 

Key points to include

• What the doctor brings: diagnosis, medication, physical health, law and risk
• Respect for care coordinators and other professions
• A concrete example where MDT input changed the plan
• Practical habits: approachable, clear letters, responsive between appointments
• Patient outcome at the centre

 

Common mistakes to avoid

• Describing the doctor as the head of the team who directs everyone
• Giving a generic teamwork answer with no CMHT detail
• Missing out social and practical factors
• Focusing on your own contribution only

 

NHS values and standards

Working together for patients; Respect and dignity; Improving lives; GMC Good Medical Practice: working collaboratively with colleagues

 

Further reading

• NHS England Community Mental Health Framework for Adults and Older Adults
• GMC Good Medical Practice
• Royal College of Psychiatrists guidance on the role of the psychiatrist in community services

 

 

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