Psychiatric & Behavioral Health End of Rotation ™ Exam Blueprint & Topic List

The Psychiatric & Behavioral Health End of Rotation™ (EOR) exam is one of the PA Education Association’s objective, standardized evaluations and is intended to serve as one measure of the medical knowledge PA students gain during their supervised clinical practice experience. This article outlines the updated PAEA Psychiatric & Behavioral Health EOR Exam Blueprint, including its content areas and task areas, and presents the Exam Topic List. The specifications presented here reflect the updated Psychiatric & Behavioral Health Blueprint and Topic List published by PAEA as of July 2026. Updated Psychiatric & Behavioral Health exam versions based on these specifications were published July 2026; legacy Psychiatry & Behavioral Health examinations remain available through July 2027, so students should confirm which version their program is administering. Questions on an examination represent only a sample of the content that may be assessed and may not reflect every topic identified in the Topic List. Exam candidates and clinical coordinators are encouraged to review the original Blueprint, Topic List, and Core Tasks and Objectives through PAEA’s End of Rotation™ Blueprints and Topic Lists resource page at https://paeaonline.org/assessment/end-of-rotation/blueprints-and-topic-lists. ^[1]

AMBOSS is an independent entity with no affiliation to or endorsement by the PA Education Association (PAEA) or the PAEA End of Rotation™ examinations. The PAEA-derived portions of this article are based on the PAEA Psychiatric & Behavioral Health End of Rotation™ Exam Blueprint, Topic List, and Core Tasks and Objectives, which are created and owned by PAEA®. The psychiatric and behavioral health-specific "Knowledge of" and "Skill in" descriptions, general study guidance, and organization of certain Professional Practice concepts were developed by AMBOSS and are not taken verbatim from the PAEA Core Tasks and Learning Objectives or from another source. AMBOSS does not claim ownership of material originating from PAEA. This article is provided at no cost to the public as an informational resource for PA students, educators, clinicians, and other healthcare professionals. It is not an official PAEA publication and does not contain actual PAEA examination questions. Use or reproduction of PAEA materials is subject to PAEA’s applicable terms and any required permissions. ^[2]

Content Categories

Task Categories

Each End of Rotation™ exam contains 120 multiple-choice questions, including 100 scored questions and 20 unscored pretest questions. The Blueprint percentages apply to the 100 scored questions. The updated Psychiatric & Behavioral Health Blueprint is organized by both content area and task area, and Professional Practice is one of its seven task areas.

General study approach

• Use the Blueprint percentages to set relative study priorities rather than to exclude lower-percentage categories.
  • Depressive and bipolar disorders, substance-related and addictive disorders, and trauma- and stress-related disorders together account for 45% of the scored questions; the five largest content categories account for 67%.
  • Diagnosis, Clinical Intervention, and Clinical Therapeutics together account for 60% of the scored questions, emphasizing the need to move beyond recognition of diagnostic criteria and practice selecting the most likely diagnosis, the most appropriate immediate or longitudinal intervention, and appropriate pharmacologic management.
• Psychiatric & Behavioral Health End of Rotation™ questions cover the full lifespan and may be set in ambulatory, emergency department, and inpatient care. Preparation should therefore include pediatric, adolescent, adult, pregnant, geriatric, medically complex, and substance-using patient populations.
• End of Rotation™ questions use a one-best-answer clinical-vignette format intended to assess higher-order thinking. Study each condition through its diagnostic features, important differential diagnoses and medical mimics, suicide or violence risk when applicable, appropriate diagnostic evaluation, immediate safety needs, psychotherapy and other nonpharmacologic interventions, pharmacologic treatment, adverse effects and monitoring, disposition, and follow-up.

Content Categories

• Bipolar I disorder
• Bipolar II disorder
• Cyclothymic disorder
• Major depressive disorder
• Persistent depressive disorder (dysthymia)
• Premenstrual dysphoric disorder
• Suicidal behaviors

• Alcohol-related disorders
• Caffeine-related disorders
• Cannabis-related disorders
• Hallucinogen-related disorders
• Inhalant-related disorders
• Nonsubstance-related disorders
• Opioid-related disorders
• Sedative-, hypnotic-, or anxiolytic-related disorders
• Stimulant-related disorders
• Tobacco-related disorders

• Acute stress disorder
• Adjustment disorder
• Bereavement
• Child abuse and neglect
• Elder abuse and neglect
• Intimate partner violence
• Physical abuse
• Posttraumatic stress disorder
• Prolonged grief disorder
• Psychosocial abuse
• Reactive attachment disorder
• Sexual abuse

• Factitious disorder
• Functional neurological symptom disorder
• Generalized anxiety disorder
• Illness anxiety disorder
• Panic disorder
• Separation anxiety disorder
• Social anxiety disorder
• Somatic symptom disorder

• Brief psychotic disorder
• Catatonia
• Delusional disorder
• Schizoaffective disorder
• Schizophrenia
• Schizophreniform disorder

• Anorexia nervosa
• Avoidant/Restrictive food intake disorder
• Binge eating disorders
• Bulimia nervosa

• Attention-deficit/hyperactivity disorder
• Autism spectrum disorder
• Depersonalization-derealization disorder
• Dissociative amnesia
• Dissociative identity disorder
• Intellectual disabilities
• Stereotypic movement disorder
• Tic disorder

• Circadian rhythms sleep-wake disorders
• Hypersomnolence
• Insomnia
• Narcolepsy
• Parasomnias

• Gender dysphoria
• Gender identity
• Psychosexual disorders

• Antisocial personality disorder
• Avoidant personality disorder
• Body dysmorphic disorder
• Borderline personality disorder
• Dependent personality disorder
• Histrionic personality disorder
• Narcissistic personality disorder
• Obsessive-compulsive disorder
• Obsessive-compulsive personality disorder
• Paranoid personality disorder
• Schizoid personality disorder
• Schizotypal personality disorder

Task Categories

*AMBOSS editorial study guidance: The following psychiatric and behavioral health-specific "Knowledge of" and "Skill in" descriptions were developed by AMBOSS and are not taken verbatim from the PAEA Core Tasks and Learning Objectives or from another source.

• Knowledge of:
  • Components and techniques of comprehensive, focused, and problem-based psychiatric histories and mental status examinations across the lifespan
  • Psychiatric history, including symptom onset and course, prior diagnoses, hospitalizations, psychotherapy, medication trials, treatment response, adherence, and previous suicide or self-harm behaviors
  • Medical, neurologic, medication, substance-use, family, developmental, social, occupational, trauma, abuse, and legal histories relevant to psychiatric presentations
  • Assessment of suicidal ideation, self-harm, homicidal ideation, violence risk, access to lethal means, protective factors, and other immediate safety concerns
  • Components of the mental status examination, including appearance, behavior, psychomotor activity, speech, mood, affect, thought process, thought content, perception, cognition, insight, and judgment
  • Developmental, behavioral, educational, family, and caregiver history relevant to children and adolescents
  • Cognitive, functional, sensory, medication, substance-use, and caregiver considerations relevant to older adults
  • Features suggesting delirium, intoxication, withdrawal, medication effects, neurologic disease, endocrine disease, infection, or other medical causes of psychiatric symptoms
• Skill in:
  • Conducting comprehensive and focused psychiatric interviews using a patient-centered, trauma-informed, and culturally responsive approach
  • Performing and interpreting a mental status examination
  • Obtaining collateral information from family members, caregivers, emergency personnel, prior records, pharmacies, and other clinicians when appropriate
  • Assessing suicide, self-harm, homicide, violence, abuse, neglect, exploitation, and vulnerability risk
  • Evaluating substance use, intoxication, withdrawal, and substance-related impairment
  • Assessing cognition, attention, memory, insight, judgment, functional status, and decision-making capacity when clinically relevant
  • Recognizing abnormal vital signs, neurologic findings, altered consciousness, autonomic instability, catatonia, severe agitation, or other findings requiring urgent medical evaluation
  • Integrating history, physical examination, and mental status findings to distinguish psychiatric disorders from medical, neurologic, developmental, and substance-induced conditions

• Knowledge of:
  • Patient-centered education related to laboratory and diagnostic studies used in psychiatric and behavioral health care
  • Role and limitations of diagnostic testing in psychiatric disorders, which are primarily diagnosed through clinical assessment
  • Indications for targeted laboratory studies to evaluate medical, metabolic, endocrine, infectious, neurologic, toxicologic, or substance-related causes of psychiatric symptoms
  • Indications for toxicology testing, pregnancy testing, electrocardiography, medication concentrations, metabolic monitoring, and other studies relevant to psychopharmacologic treatment
  • Indications for neuroimaging, electroencephalography, sleep studies, or other specialized testing when the presentation suggests an alternative or comorbid medical disorder
  • Selection of laboratory and diagnostic studies based on clinical presentation, patient risk, cost, probable yield, invasiveness, contraindications, and potential effect on management
  • Monitoring requirements associated with medications that may affect metabolic, hematologic, renal, hepatic, endocrine, or cardiac function
• Skill in:
  • Selecting appropriate initial and subsequent laboratory and diagnostic studies based on the psychiatric presentation and differential diagnosis
  • Reviewing and interpreting laboratory studies, toxicology results, electrocardiograms, medication concentrations, and other diagnostic findings in clinical context
  • Recognizing findings consistent with intoxication, withdrawal, medication toxicity, metabolic disturbance, endocrine disease, infection, or other medical mimics of psychiatric illness
  • Determining when neuroimaging, electroencephalography, sleep testing, or specialty medical evaluation is indicated
  • Monitoring laboratory, metabolic, cardiovascular, and other treatment-related parameters during psychopharmacologic therapy
  • Recognizing results that require emergency medical evaluation, medication modification, additional testing, or specialty consultation
  • Avoiding unnecessary testing when the diagnosis is adequately established clinically and additional studies are unlikely to alter management
  • Communicating the purpose, limitations, results, and follow-up implications of diagnostic testing to patients and caregivers

• Knowledge of:
  • Diagnostic criteria, epidemiology, risk factors, typical presentation, course, prognosis, and common comorbidities of psychiatric and behavioral health disorders
  • Significance of psychiatric history, mental status examination findings, physical examination findings, collateral information, laboratory studies, and diagnostic data as they relate to the differential diagnosis
  • Distinguishing features among depressive, bipolar, anxiety, trauma-related, psychotic, substance-related, eating, neurodevelopmental, dissociative, sleep-wake, personality, obsessive-compulsive, and related disorders
  • Medical, neurologic, medication-induced, substance-induced, developmental, and cognitive conditions that may mimic or contribute to psychiatric symptoms
  • Differences among delirium, dementia, primary psychiatric illness, intoxication, and withdrawal
  • Age-specific and developmental differences in psychiatric presentation across children, adolescents, adults, and older adults
  • Effects of trauma, substance use, pregnancy, medical comorbidity, culture, social determinants, and psychosocial stressors on psychiatric presentations
• Skill in:
  • Formulating an appropriately prioritized differential diagnosis based on the available clinical information
  • Selecting the most likely psychiatric or behavioral health diagnosis while considering serious medical and substance-related alternatives
  • Recognizing manic, depressive, psychotic, anxious, trauma-related, dissociative, substance-related, eating-disorder, neurodevelopmental, and personality-disorder presentations
  • Distinguishing primary psychiatric disorders from substance-induced, medication-induced, neurologic, endocrine, infectious, metabolic, and other medical conditions
  • Identifying psychiatric comorbidity and recognizing when more than one diagnosis contributes to the clinical presentation
  • Recognizing psychiatric emergencies, including acute suicidality, severe self-harm risk, homicidal or violent behavior, severe agitation, catatonia, psychosis with impaired safety, and medically unstable eating or substance-related disorders
  • Revising the differential diagnosis as collateral information, diagnostic results, treatment response, or the clinical course provides additional information
  • Recognizing when diagnostic uncertainty requires observation, medical evaluation, specialty consultation, or longitudinal reassessment

• Knowledge of:
  • Indications, contraindications, risks, benefits, and principles of psychotherapy, behavioral interventions, crisis intervention, and other nonpharmacologic psychiatric treatments
  • Principles of supportive psychotherapy, cognitive behavioral approaches, motivational interviewing, behavioral modification, exposure-based approaches, family interventions, and other commonly used therapeutic modalities
  • Immediate management priorities for suicidal behavior, self-harm, homicidal ideation, severe agitation, acute psychosis, catatonia, intoxication, withdrawal, and other psychiatric emergencies
  • Principles of verbal de-escalation, environmental modification, safety planning, lethal-means counseling, observation, and crisis stabilization
  • Indications for outpatient treatment, intensive outpatient or partial hospitalization, inpatient psychiatric hospitalization, emergency psychiatric evaluation, and higher levels of substance-use treatment
  • General indications and safety principles for involuntary psychiatric evaluation or treatment under applicable law
  • Indications, risks, monitoring requirements, and appropriate use of seclusion or physical restraints when less restrictive interventions are insufficient
  • Indications for electroconvulsive therapy and other specialized nonpharmacologic psychiatric treatments
  • Roles of psychiatry, psychology, social work, nursing, substance-use specialists, occupational therapy, primary care, emergency clinicians, and other interprofessional team members
  • Discharge planning, safety planning, continuity of care, relapse prevention, and appropriate psychiatric or substance-use follow-up
• Skill in:
  • Prioritizing immediate patient and staff safety before completing nonurgent diagnostic or therapeutic interventions
  • Developing and implementing individualized safety plans for patients at risk of suicide or self-harm
  • Using verbal de-escalation and the least restrictive effective intervention for agitation or behavioral dysregulation
  • Selecting appropriate psychotherapy, behavioral therapy, psychosocial intervention, or substance-use treatment based on the working diagnosis and patient needs
  • Determining the appropriate level of psychiatric care based on acuity, safety risk, medical stability, social support, treatment adherence, and ability to follow up
  • Initiating emergency evaluation, hospitalization, consultation, or protective intervention when a patient poses an imminent safety risk
  • Recognizing and responding appropriately to suspected abuse, neglect, exploitation, or interpersonal violence
  • Coordinating care with family members, caregivers, schools, community services, substance-use programs, and other clinicians while respecting confidentiality requirements
  • Evaluating response to psychotherapy, behavioral intervention, crisis intervention, and other nonpharmacologic treatment
  • Providing clear discharge instructions, crisis resources, return precautions, and follow-up plans

• Knowledge of:
  • Indications for use
  • Contraindications and precautions
  • Mechanisms of action
  • Dosing and routes of administration
  • Pharmacokinetics and pharmacodynamics
  • First-line and alternative pharmacologic treatment of depressive, bipolar, anxiety, psychotic, neurodevelopmental, sleep-wake, and other psychiatric disorders
  • Pharmacologic treatment of alcohol-, opioid-, nicotine-, and other substance-related disorders, including intoxication, withdrawal, relapse prevention, and maintenance treatment when applicable
  • Use and monitoring of antidepressants, mood stabilizers, antipsychotics, anxiolytics, stimulants, nonstimulant attention-deficit/hyperactivity disorder medications, and medications used for sleep disorders
  • Age-, pregnancy-, lactation-, renal-, hepatic-, and geriatric-specific medication considerations
  • Adverse effects and serious toxicities associated with psychotropic medications, including extrapyramidal symptoms, tardive dyskinesia, metabolic effects, serotonin toxicity, neuroleptic malignant syndrome, cardiac conduction abnormalities, hematologic toxicity, and organ-specific toxicity
  • Drug interactions, polypharmacy, withdrawal syndromes, overdose, and medication-induced psychiatric symptoms
  • Monitoring requirements associated with lithium, anticonvulsant mood stabilizers, antipsychotics, clozapine, stimulants, and other psychotropic medications
  • Principles of medication adherence, gradual titration, cross-tapering, discontinuation, and relapse prevention
• Skill in:
  • Selecting appropriate psychopharmacologic therapy based on diagnosis, symptom severity, comorbidities, prior response, adverse-effect profile, patient preference, reproductive considerations, and safety
  • Initiating, titrating, monitoring, switching, tapering, or discontinuing psychotropic medications appropriately
  • Selecting pharmacologic treatment for acute agitation, severe anxiety, mania, psychosis, insomnia, intoxication, withdrawal, and other acute psychiatric presentations when indicated
  • Selecting appropriate medication treatment for substance-use disorders and withdrawal syndromes
  • Monitoring therapeutic response through symptoms, mental status findings, validated scales, laboratory studies, metabolic parameters, electrocardiography, and medication concentrations when appropriate
  • Recognizing and managing adverse effects, toxicity, drug interactions, withdrawal phenomena, and treatment-emergent mood or behavioral changes
  • Recognizing medications that require urgent discontinuation, antidotal treatment, medical evaluation, or hospitalization because of serious toxicity
  • Reconciling medications and identifying nonadherence, duplication, inappropriate combinations, interactions, and medications that may contribute to psychiatric symptoms
  • Counseling patients and caregivers regarding medication purpose, expected benefits, onset of effect, administration, adverse effects, interactions, monitoring, adherence, and safe discontinuation
  • Developing longitudinal medication-management and relapse-prevention plans

• Knowledge of:
  • Associations among psychiatric conditions and complications identified through the application of scientific concepts
  • Genetic, developmental, neurobiologic, psychological, environmental, and social influences on psychiatric and behavioral health disorders
  • Neuroanatomy and neural circuits involved in mood, reward, cognition, fear, memory, sleep, impulse control, and behavior
  • Neurotransmitter systems relevant to mood, anxiety, psychosis, attention, sleep, and substance use
  • Neuroendocrine and physiologic responses to stress and trauma
  • Neurobiology of addiction, reward, tolerance, dependence, withdrawal, and relapse
  • Normal psychological, cognitive, emotional, and behavioral development across the lifespan
  • Sleep physiology, circadian rhythms, and mechanisms underlying common sleep-wake disorders
  • Learning, conditioning, reinforcement, cognition, attachment, and other behavioral principles relevant to psychotherapy and behavioral disorders
  • Pharmacologic principles underlying the therapeutic and adverse effects of psychotropic medications
  • Public-health principles relevant to suicide, substance use, trauma, abuse, violence, stigma, and access to behavioral health care
• Skill in:
  • Applying neuroanatomy, neurophysiology, genetics, and developmental principles to psychiatric diagnosis and treatment
  • Relating neurotransmitter and neural-circuit function to psychiatric symptoms and psychopharmacologic treatment
  • Applying principles of learning, conditioning, cognition, attachment, and behavioral reinforcement to patient assessment and treatment
  • Relating stress physiology and trauma responses to acute and chronic psychiatric symptoms
  • Applying addiction neurobiology to intoxication, withdrawal, craving, relapse, and treatment
  • Applying sleep physiology and circadian principles to evaluation and management of sleep-wake disorders
  • Applying pharmacokinetic and pharmacodynamic principles to psychotropic medication selection, dosing, interactions, adverse effects, and monitoring
  • Incorporating evidence-based medicine and current psychiatric literature into clinical decision-making

Legal/medical ethics

• Knowledge of:
  • Informed consent and refusal for psychiatric evaluation, medications, hospitalization, psychotherapy, and other interventions
  • Decision-making capacity and identification of an appropriate surrogate decision-maker
  • Confidentiality and privacy considerations involving psychiatric diagnoses, psychotherapy, substance use, reproductive care, adolescents, families, and electronic communication
  • General legal and ethical principles related to voluntary and involuntary psychiatric evaluation, hospitalization, and treatment
  • Ethical and legal considerations involving suicidal behavior, homicidal or violent threats, duty to protect or warn as applicable, abuse, neglect, exploitation, and mandated reporting
  • Advance directives, code status, including do-not-resuscitate and do-not-intubate orders, medical power of attorney, organ donation, and goals-of-care decisions
  • Ethical principles governing seclusion, physical restraints, treatment refusal, emergency treatment, autonomy, beneficence, and use of the least restrictive intervention
  • Patient rights, responsibilities, cultural and religious beliefs, stigma, health disparities, and legal or policy issues affecting access to psychiatric and substance-use care
• Skill in:
  • Assessing and documenting decision-making capacity when psychiatric illness, intoxication, cognitive impairment, or other conditions may affect health care decisions
  • Obtaining informed consent and supporting informed, voluntary, and patient-centered treatment decisions
  • Maintaining confidentiality while recognizing situations requiring disclosure, mandated reporting, or protective intervention
  • Communicating appropriately with legally authorized representatives when a patient lacks decision-making capacity
  • Balancing patient autonomy with immediate safety concerns and the need for emergency psychiatric intervention
  • Recognizing and escalating complex ethical or legal concerns to the supervising physician, psychiatry team, ethics service, risk management, legal counsel, or other appropriate resource

Medical informatics

• Knowledge of:
  • Accurate and complete documentation of psychiatric history, mental status examination, risk assessment, capacity, diagnosis, treatment, reassessment, and disposition
  • Documentation requirements related to suicidal or homicidal risk, involuntary evaluation, restraints or seclusion, abuse or neglect, medication monitoring, and transitions of care
  • Electronic health records, prescription-monitoring programs, clinical decision-support systems, telepsychiatry, and evidence-based behavioral health resources
  • Privacy risks associated with psychiatric records, substance-use information, patient portals, electronic communication, and information sharing
• Skill in:
  • Documenting psychiatric symptoms, mental status findings, clinical reasoning, risk assessment, safety planning, treatment response, and disposition clearly and promptly
  • Documenting collateral information, consultations, capacity assessments, informed refusal, and critical safety communications
  • Using health information systems to review prior psychiatric diagnoses, medication trials, hospitalizations, controlled-substance prescriptions, and treatment response
  • Protecting sensitive psychiatric and substance-use information when using electronic health information systems and communication tools

Patient care and communication (individual patients)

• Knowledge of:
  • Affordable, effective, and patient-specific psychiatric and behavioral health care across the lifespan
  • Communication and treatment preferences of diverse patients, families, caregivers, and communities
  • Effects of stigma, health literacy, language, disability, culture, trauma, family structure, finances, housing, transportation, social isolation, and access to care on psychiatric outcomes
  • Trauma-informed, developmentally appropriate, culturally responsive, and recovery-oriented communication principles
  • Communication strategies for psychosis, mania, severe depression, anxiety, cognitive impairment, intoxication, agitation, suicidal crisis, and diagnostic uncertainty
• Skill in:
  • Establishing rapport and therapeutic alliance while maintaining professional boundaries
  • Communicating with empathy, respect, cultural humility, and awareness of stigma
  • Using qualified interpreters and accessible communication methods when appropriate
  • Using verbal de-escalation and nonconfrontational communication with agitated, paranoid, intoxicated, psychotic, or behaviorally dysregulated patients
  • Explaining diagnoses, treatment options, medication risks and benefits, safety plans, disposition, and follow-up in understandable language
  • Engaging patients, families, and caregivers in shared decision-making while respecting confidentiality and patient autonomy
  • Delivering difficult information and discussing suicide risk, substance use, trauma, serious mental illness, prognosis, and goals of care sensitively
  • Identifying barriers to adherence and coordinating realistic behavioral health, social, and community resources

PA role in professional practice

• Knowledge of:
  • Professional and clinical limitations, scope of practice, credentialing, privileging, supervision, and collaboration requirements
  • Responsibilities of the PA in outpatient psychiatry, emergency psychiatric assessment, inpatient care, consultation, medication management, crisis intervention, and transitions of care
  • Roles and responsibilities of psychiatrists, psychologists, nurses, social workers, therapists, pharmacists, substance-use specialists, primary care clinicians, emergency clinicians, and other members of the interprofessional team
  • Professional boundaries, conflicts of interest, clinician impairment, ethical conduct, and effects of implicit bias and stigma on psychiatric care
• Skill in:
  • Recognizing personal limitations and seeking supervision, consultation, or transfer of care appropriately
  • Communicating effectively during psychiatric consultations, handoffs, emergency evaluations, multidisciplinary rounds, and transitions of care
  • Collaborating with medical, psychiatric, behavioral, substance-use, and social-service professionals
  • Maintaining professional behavior and appropriate boundaries during emotionally intense, adversarial, or high-risk encounters

Professional development

• Knowledge of:
  • Continuing medical education resources relevant to psychiatric diagnosis, psychotherapy, psychopharmacology, addiction medicine, and crisis care
  • Evidence-based guidelines, quality standards, validated assessment tools, and evolving psychiatric and behavioral health treatments
  • Effects of clinician stress, burnout, secondary traumatic stress, and repeated exposure to suicide, violence, trauma, and severe mental illness
• Skill in:
  • Critically evaluating psychiatric and behavioral health literature and applying evidence-based recommendations appropriately
  • Identifying and interpreting information from reliable psychiatric and behavioral health resources
  • Recognizing personal knowledge or skill gaps and pursuing appropriate education, supervision, feedback, or additional training
  • Participating in quality-improvement, morbidity review, patient-safety, and suicide-prevention activities
  • Using strategies that support clinician well-being and safe professional performance

Public health (population/society)

• Knowledge of:
  • Population-level burden and prevention of suicide, substance use, overdose, interpersonal violence, abuse, trauma, and serious mental illness
  • Health disparities and barriers to psychiatric and substance-use treatment affecting vulnerable and underserved populations
  • Community resources for crisis care, suicide prevention, substance-use treatment, domestic violence, child and elder protection, housing, and social support
  • Public-health principles related to stigma reduction, harm reduction, overdose prevention, firearm safety, and access to behavioral health services
  • Mandated-reporting requirements and public-safety considerations involving abuse, neglect, exploitation, and credible threats of harm
• Skill in:
  • Identifying patients and populations at increased risk for suicide, overdose, violence, abuse, neglect, and inadequate access to behavioral health care
  • Providing suicide-prevention, overdose-prevention, substance-use, and other harm-reduction counseling
  • Connecting patients and caregivers with crisis services, community behavioral health programs, substance-use treatment, social services, and other appropriate resources
  • Recognizing health disparities and incorporating social and structural barriers into treatment and disposition planning
  • Following applicable reporting and protective-intervention requirements

Risk management

• Knowledge of:
  • Accountability, standards of care, and appropriate resource utilization in psychiatric and behavioral health practice
  • Common causes of preventable harm involving suicide, self-injury, violence, elopement, medication errors, inadequate monitoring, communication failures, and unsafe transitions of care
  • Patient-safety measures involving suicide precautions, environmental safety, observation levels, medication reconciliation, fall prevention, restraints or seclusion, and procedural safety when applicable
  • Importance of reassessment when suicide risk, agitation, intoxication, psychosis, capacity, or clinical stability may change over time
  • Requirements for reporting adverse events, near misses, safety concerns, occupational exposures, and other reportable incidents
• Skill in:
  • Performing and documenting appropriate suicide, self-harm, violence, elopement, and vulnerability risk assessments
  • Implementing appropriate observation, environmental safety, lethal-means restriction, and other risk-reduction measures
  • Using medication reconciliation, allergy review, interaction screening, laboratory monitoring, and treatment-response assessment to reduce medication-related harm
  • Reassessing patients after medication, de-escalation, intoxication resolution, restraint use, or other changes in clinical status before disposition
  • Providing safe handoffs that communicate diagnosis, risk assessment, treatment, response, medication changes, pending studies, safety concerns, and follow-up needs
  • Recognizing, documenting, reporting, and responding appropriately to adverse events and near misses
  • Escalating concerns when patient safety, clinician impairment, staffing, environmental conditions, or standards of care are compromised

AMBOSS is an independent entity with no affiliation to or endorsement by the PA Education Association (PAEA) or the PAEA End of Rotation™ examinations. The PAEA-derived portions of this article are based on the publicly available PAEA Psychiatric & Behavioral Health End of Rotation™ Exam Blueprint, Topic List, and Core Tasks and Objectives, which are solely created and owned by PAEA®. The psychiatric and behavioral health-specific "Knowledge of" and "Skill in" descriptions, general study guidance, and organization of certain Professional Practice concepts were developed by AMBOSS and are not taken verbatim from the PAEA Core Tasks and Learning Objectives or from another source. AMBOSS does not claim ownership of material originating from PAEA. This article is provided at no cost to the public as an informational resource for PA students, educators, clinicians, and other healthcare professionals. It is not an official PAEA publication and does not contain actual PAEA examination questions. Questions on an examination represent only a sample of the content that may be assessed, and the Topic List is not a comprehensive list of all possible examination topics. Use or reproduction of PAEA materials is subject to PAEA’s applicable terms and any required permissions. ^[2]