Forensic Psychiatry

+ 44 (0) 1865 613165
fazel.pa@psych.ox.ac.uk

4 NIHR grants since 2016

Publications on broad range of topics in psychiatric epidemiology, population mental health and evidence synthesis: violence prevention, victimisation, risk factors for suicide, homelessness, prediction modelling, prisoner health, suicide and self-harm in prisoners, community sentences, outcome measurement in forensic psychiatry, real world effectiveness of medication, psychological interventions for criminal behaviour.

Our research includes projects in the epidemiology of mental illness and violent crime, violence risk assessment, prison health, pharmacoepidemiology studies, forensic services, and suicide and self-harm in prisoners and offenders. More recent work has focused on suicide prevention, particularly in people with severe mental illness.

Our main focus in Forensic Psychiatry and Psychology is to investigate associations and mechanisms for violent crime in severe mental illness, and develop scalable approaches to violence risk assessment. This work is funded by the Wellcome Trust.

We have worked alongside our colleagues at the Karolinska Institute to begin a definitive examination of the relationship between violent crime and both schizophrenia and bipolar disorder, and increased risk attributable to comorbid substance misuse. We have estimated that the proportion of violent crimes attributable to patients with these diagnoses is less than 5%, a finding which has been used by mental health charities to address patient stigma. Our investigations on the association of mental illness with specific violent crimes suggests the need for much closer collaboration of criminal justice and mental health services.

Although some research has focused on risk factors, the underlying causal mechanisms are still poorly understood. Our current and future programme of work addresses this, and will continue to translate these findings into more effective violence risk assessment for patients with severe mental illness and treatment focused on modifiable risk factors.

We are also working on outcome measures in forensic mental health (NIHR-funded, led by Howard Ryland), and a mixed-methods investigation of risk assessment for violence in early intervention services (NIHR-funded, led by Daniel Whiting). Other work with Manchester University is examining modifiable risk factors and risk prediction for repeat self harm in high risk prisoners (HTA-funded). We are also researching, as part of the Oxford ARC, risk factors and prediction models for self harm using information from electronic health records.

Recent Media Activity

"Experts call to include prisoners in COVID-19 vaccine health plans". Lancet World Report: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)32663-5/fulltext

"Jabs for Jailbirds". The Spectator: https://www.spectator.co.uk/article/we-should-let-prisoners-jump-the-vaccine-queue

"Common nerve pain drug linked to suicidal behavior, overdose". Reuters: https://www.reuters.com/article/us-health-lyrica-side-effects-idUSKCN1TI2Q7

"No overcrowding link to prison suicide, study suggests"

BBC News

"Drug and alcohol abuse medications shown to improve patients' lives"
University of Oxford News

"Giving ex-prisoners psychiatric drugs leads to huge cut in reoffending rates, study finds"
The Independent

"Childhood traumatic brain injury and long term outcomes"
BBC World Service [mp3] & PLOS paper

"How To Interpret That Study Linking Violence And Antidepressants"
Huffington Post

"Is there a link between taking antidepressants and increased risk of committing violent crime?"
BBC World Service (from 8:39)

"Ex-prisoners with mental health problems 'more likely to reoffend'"
The Guardian

"Risk of sex offending linked to genetic factors, study finds"
The Guardian

"Clinically depressed three times more likely to commit violent crime"
Reuters

"Schizophrenia associated with increased rates of violence and suicide"
BMJ News

"Mental Illness Can Shorten Lives More Than Chain-Smoking"
National Public Radio

"Medications Cut Violence Among Mentally Ill in Study"
Wall Street Journal

Coin-toss justice, Seena Fazel
New Scientist

Book Review: The Drugs Don't Work?, Seena Fazel
PLoS Medicine Community Blog

"Brain injury survivors three times more likely to die prematurely"
The Guardian; Reuters

"Self-harm 'four times more likely' in female prisoners"
BBC News

Our team

Seena Fazel

Wellcome Trust Senior Research Fellow
Rongqin Yu

Researcher
Tapio Paljarvi

Epidemiologist
Daniel Whiting

NIHR Doctoral Research Fellow
Howard Ryland

NIHR Doctoral Research Fellow
Denis Yukhnenko

DPhil student
Gabrielle Beaudry

DPhil Candidate
Achim Wolf

Honorary Researcher
Jelle Lamsma

MSc (Res) candidate

Podcasts

“Can computers predict crime”?

Oxford Sparks (February 2019)

"Mental illness and violence"
Oxford Sparks, Feb 2016

"Seena Fazel discusses how research into the health of prison populations might benefit both prisoners and society as a whole."
The Lancet Psychiatry, Apr 2015 [mp3]

"Seena Fazel discusses his research into prison populations; their mental health problems and suicide risks."
University of Oxford, Feb 2015

"Seena Fazel discusses a two-part Series on homelessness with Richard Lane."
The Lancet, Oct 2014 [mp3]

"Niall Boyce discusses the concept and management of risk in mental health care with Robin Murray, Seena Fazel, and Stefan Leucht."
The Lancet Psychiatry, Jun 2014 [mp3]

"Seena Fazel discusses a population study to assess the effects of antipsychotics on violent behavior and crime."
The Lancet, May 2014 [mp3]

"Seena Fazel discusses new research about epilepsy and psychiatric comorbidity."
The Lancet, Jul 2013 [mp3]

"Seena Fazel discusses the predictive ability of violence risk assessment instruments."
BMJ, Jul 2012

Links

OxRisk.com - Web-Based Risk Calculators

Department of Medical Epidemiology and Biostatistics, Karolinska Institute

Google Hangout: Beyond the Impact Factor

Measuring an Individual Researcher's Impact (Evidence Based Mental Health 2019) - supplementary files

Group Members

Karolinska Institute, Stockholm

Paul Lichtenstein
Niklas Långström
Henrik Larsson
Zheng Chang

Yasmina Molero

Primary Care Health Sciences, Oxford
Thomas Fanshawe
Maria Vazquez Montes

Centre for Medical Imaging, University College London
Susan Mallett

Ongoing joint projects in the UK with Manchester University, Edinburgh University, IOPPN.

pREVIOUS MEMBERS

Previous Postdocs

- Zheng Chang who is now assistant professor at Karolinska Institute. In Oxford, Dr Chang worked on projects that led to 5 papers, 4 in Lancet Psychiatry and one in JAMA.

- Amir Sariaslan who is now senior researcher at University of Helsinki. In Oxford, Dr Sariaslan worked on projects that were published in Molecular Psychiatry, PLoS Medicine, JAMA Psychiatry and Schizophrenia Bulletin.

- Yasmina Molero is a research affiliate with the Karolinska Institute. In Oxford, Dr Molero worked on a series of pharmaco-epidemiological studies, including on medications for drug use disorders (published in Am J Psychiatry), gabapentinoids (BMJ) and statins (Lancet Psychiatry).

- Previous DPhil Students - Achim Wolf worked on clinical prediction rules and evidence synthesis. Published 12 articles, including the Lancet, Lancet Psychiatry, JAMA Psychiatry and now works as a senior researcher at Clinical Practice Research Datalink (CPRD) group at the MHRA in London. Katrina Witt works at Melbourne University as a senior research fellow on suicide prevention.

- Previous MRes Students - Taanvi Ramesh worked on a systematic review and an epidemiological study, and published two papers as a Masters student, including one in Lancet Psychiatry. Isabel Yoon worked on two systematic reviews, which were published in Addiction and J Consult Clin Psychol. E Naomi Smith worked on an umbrella review, which was published in Br J Psychiatry. Heidi Hailes worked on an umbrella review that on outcomes following childhood sexual abuse that was published in the Lancet Psychiatry.