Seena Fazel

Senior Clinical Research Fellow, University of Oxford, Department of Psychiatry, Warneford Hospital, Oxford OX3 7JX

Honorary Consultant Forensic Psychiatrist, Oxford Health NHS Foundation Trust

Research Interests

Epidemiology of mental illness and violent crime, risk factors for violent crime in mental illness, violence risk assessment, mental disorders in homicide and sexual offenders, risk factors for repeat offending.
Funded by the Wellcome Trust

Mental health of prisoners, mental health of older prisoners, suicidal behaviour in prisoners, risk factors for self-harm and suicide in prisoners, adverse outcomes in recently released prisoners.
Funded by the Wellcome Trust and NIHR

Capacity and competence including fitness to plead and stand trial, capacity to complete advance directives, capacity/competence to consent to treatment.
Funded by NIHR

Recent media interest in research

"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

Latest Publications

Violence and mental illness

1. Fazel S, Wolf A, Chang Z, Larson H, Goodwin G, Lichtenstein P. (2015) Depression and violent crime: Swedish population study. Lancet Psychiatry

2. Fazel S, Wolf A, Palm C, Lichtenstein P. (2014) Violent crime, suicide, and premature mortality in patients with schizophrenia and related disorders: a 38-year total population study in Sweden. Lancet Psychiatry 1(1): 44-54.

3. Webb RT, Lichtenstein P, Larsson H, Geddes JR, Fazel S. (2014) Suicide, hospital-presenting suicide attempts, and criminality in bipolar disorder: examination of risk for multiple adverse outcomes. J Clin Psychiatry 75(8): e809-16.

4. Swanson JW, McGinty EE, Fazel S, Mays VM. (2014) Mental illness and reduction of gun violence and suicide: bringing epidemiologic research to policy. Ann Epidemiol Apr 29. pii: S1047-2797(14)00147-1.

5. Witt K, van Dorn R, Fazel S. (2013) Risk factors for violence in psychosis: systematic review and meta-regression analysis of 110 studies. PLoS One 8(2):e55942. doi:10.1371/journal.pone.0055942.

6. Lichtenstein P, Halldner L, Zetterqvist J, Sjölander A, Serlachius E, Fazel S, Långström N, Larsson H. (2012) Medication for Attention Deficit–Hyperactivity Disorder and Criminality. N Engl J Med, 367: 2006-14.

7. Yu R, Geddes JR, Fazel S. (2012) Personality Disorders, Violence, and Antisocial Behavior: A Systematic Review and Meta-Regression Analysis. J Pers Disord, 26: 775-92.

8. Fazel S, Lichtenstein P, Grann M, Långström N. (2011) Risk of violent crime in individuals with epilepsy and traumatic brain injury: a 35-year Swedish population study. PLoS Med, 8:e1001150

9. Fazel S, Yu R. (2011) Psychotic disorders and repeat offending: systematic review and meta-analysis. Schizophr Bull, 37: 800-810.

10. Webb RT, Långström N, Runeson B, Lichtenstein P, Fazel S (2011). Violent offending and IQ level as predictors of suicide in schizophrenia: National cohort study. Schizophr Res. 130: 143-7.

11. Anwar S, Langstrom N, Grann M, Fazel S. (2011) Is Arson the Crime Most Strongly Associated With Psychosis?—A National Case-Control Study of Arson Risk in Schizophrenia and Other Psychoses. Schizophr Bull, 37: 580-586.

12. Topiwala A, Fazel S. (2011) The pharmacological management of violence in schizophrenia: a structured review. Expert Rev Neurother, 11: 53-63(11).

Prisoner mental health

13. Hawton K, Linsell L, Adeniji T, Sariaslan A, Fazel S (2014) Self-harm in prisons in England and Wales: an epidemiological study of prevalence, risk factors, clustering, and subsequent suicide. Lancet 383(9923): 1147-54.

14. Rivlin A, Hawton K, Marzano L, Fazel S (2013) Psychosocial characteristics and social networks of suicidal prisoners: towards a model of suicidal behaviour in detention. PLoS ONE 8(7): e68944.

15. Fazel S, Wolf A, Geddes JR. (2013) Suicide in prisoners with bipolar disorder and other psychiatric disorders: a systematic review. Bipolar Disord 15(5): 491-5.

16. Zlodre J, Fazel S. (2012) All-Cause and External Mortality in Released Prisoners: Systematic Review and Meta-Analysis. Am J Public Health, 102: e67-e75.

17. Fazel S, Seewald K. (2012) Severe mental illness in 33 588 prisoners worldwide: systematic review and meta-regression analysis. Br J Psychiatry, 200: 364-73.

18. Zhou J, Chen C, Wang X, Cai W, Zhang S, Qiu C, Wang H, Luo Y, Fazel S. (2012) Psychiatric disorders in adolescent boys in detention: a preliminary prevalence and case–control study in two Chinese provinces. Journal of Forensic Psychiatry & Psychology, 23: 664-75.

19. Rivlin A, Fazel S, Marzano L, Hawton K. (2012) Studying survivors of near-lethal suicide attempts as a proxy for completed suicide in prisons. Forensic Sci Int, 220(1-3): 19-26.

20. Rivlin A, Marzano L, Hawton K, Fazel S. (2012) Impact on prisoners of participating in research interviews related to near-lethal suicide attempts. J Affect Disord, 136: 54-62.

21. Fazel S, Baillargeon J. (2011) The health of prisoners. Lancet, 377: 956-965.

22. Fazel S, Grann M, Kling B, Hawton K. (2011) Prison suicide in 12 countries: an ecological study of 861 suicides during 2003-2007. Soc Psychiatry Psychiatr Epidemiol, 46: 191-195.

23. Rivlin A, Fazel S, Marzano L, Hawton K. (2011) The suicidal process in male prisoners making near-lethal suicide attempts. Psychology, Crime & Law. doi: 10.1080/1068316X.2011.631540

24. Marzano L, Fazel S, Rivlin A, Hawton K. (2011) Near-lethal self-harm in women prisoners: contributing factors and psychological processes. Journal of Forensic Psychiatry & Psychology, 22, 863-884.

25. Marzano L, Hawton K, Rivlin A, Fazel S. (2011) Psychosocial influences on prisoner suicide: A case-control study of near-lethal self-harm in women prisoners. Soc Sci Med, 72: 874-883.

Violence risk assessment

26. Witt K, Lichtenstein P, Fazel S. (2015) Improving risk assessment in schizophrenia: epidemiological investigation of criminal history factors. Br J Psychiatry. pii: bjp.bp.114.144485.

27. Singh JP, Fazel S, Gueorguieva R, Buchanan A. (2014) Rates of violence in patients classified as high risk by structured risk assessment instruments. Br J Psychiatry 204(3): 180-7.

28. Singh J, Grann M, Fazel S (2013) Authorship bias in violence risk assessment? A systematic review and meta-analysis. PLoS One 8(9): e72484.

29. Fazel S, Singh JP, Doll H, Grann M. (2012) Use of risk assessment instruments to predict violence and antisocial behaviour in 73 samples involving 24 827 people: systematic review and meta-analysis. BMJ, 345:e4692.

30. Singh JP, Fazel S, Gueorguieva R, Buchanan A. (2012) Rates of Sexual Recidivism in High Risk Sex Offenders: A Meta-analysis of 10,422 Participants. Sexual Offender Treatment, 7.

31. Singh JP, Grann M, Lichtenstein P., Långström N, Fazel S. (2012) A novel approach to determining violence risk in schizophrenia: developing a stepped strategy in 13,806 discharged patients. PLoS One, 7e31727.

32. Singh JP, Serper M, Reinharth J, Fazel S. (2011) Structured assessment of violence risk in schizophrenia and other psychiatric disorders: A systematic review of the validity, reliability, and item content of 10 available instruments. Schizophr Bull, 37: 899-912.

33. Singh J, Grann M, Fazel S. (2011) A comparative study of violence risk assessment tools: A systematic review and metaregression analysis of 68 studies involving 25,980 participants. Clin Psychol Rev, 31: 499-513.

Other topics

34. Beijer U, Wolf A, Fazel S. (2012) Prevalence of tuberculosis, hepatitis C virus, and HIV in homeless people: a systematic review and meta-analysis. Lancet Infect Dis, 12(11): 859-70.

35. Goldacre MJ, Fazel S, Smith F, Lambert T. (2012) Choice and rejection of psychiatry as a career: surveys of UK medical graduates from 1974 to 2009. Br J Psychiatry. doi:10.1192/bjp.bp.112.111153


Selected Publications

Fazel S, Lichtenstein P, Grann M, Goodwin G, Långström N. (2010) Bipolar disorder and violent crime: new evidence from population-based longitudinal studies and systematic review. Archives of General Psychiatry, 67: 931-938.

Fazel S, Långström N, Hjern A, Grann M, Lichtenstein P (2009). Schizophrenia, substance abuse, and violent crime. JAMA, 301:2016-2023.

Fazel S, Gulati G, Linsell L, Geddes JR, Grann M (2009). Schizophrenia and violence: systematic review and meta-analysis. PLoS Med, 6(8).

Fazel S, Grann M, Carlström E, Lichtenstein P, Långström N (2009). Risk factors for violent crime in schizophrenia: a national cohort study of 13,806 patients. J Clin Psychiatry 70:362-9

Fazel S, Benning R (2009). Suicides in female prisoners in England and Wales, 1978-2004. Br J Psychiatry 194:183-4.

Fazel S, Khosla V, Doll H, Geddes J (2008). The prevalence of mental disorders among the homeless in western countries: systematic review and meta-regression analysis. PLoS Med. Dec 2;5(12):e225.

Grann M, Danesh J, Fazel S (2008). The association between psychiatric diagnosis and violent re-offending in adult offenders in the community. BMC Psychiatry. Nov 25;8:92.

Fazel S, Cartwright J, Nott-Norman A, Hawton K (2008). Suicide in prisoners: a systematic review of risk factors. Journal of Clinical Psychiatry 69: 1721-1731

Fazel S, Doll H, Långström N (2008). Mental disorders among adolescents in juvenile detention and correctional facilities: a systematic review and metaregression analysis of 25 surveys. J Am Acad Child Adolesc Psychiatry 47(9):1010-9.

Fazel S, Sjosdedt G, Langstrom N, Grann M (2007). Sexual offending and the risk of severe mental illness. Journal of Clinical Psychiatry 68:588-594

Assadi M, Noroozian M, Pakravannejad M, Aghayan S, Shariat S, Yahyazadeh O, Fazel S. Psychiatric morbidity among sentenced prisoners: prevalence study in Iran.British Journal of Psychiatry 2006; 188:159-64.

Fazel S, Grann M. The population impact of psychiatric patients on violent crime in Sweden, 1988-2000. American Journal of Psychiatry 2006; 163:1397-403.

Fazel S, Benning R, Danesh J. Suicides in male prisoners in England and Wales, 1978-2003. Lancet 2005; 366:1301-2.

Fazel S, Xenitidis K, Powell J.
The prevalence of intellectual disabilities among 12,000 prisoners - a systematic review.
Int J Law Psychiatry. 2008 Aug-Sep;31(4):369-73. View or Download PDF

Lambert T, Turner G, Fazel S, Goldacre M. Reasons why some UK medical graduates who initially choose psychiatry do not pursue it as a long-term career. Psychological Medicine 2006; 36:679-84. View or Download PDF

Fazel S, Bains P, Doll H. Systematic review of substance abuse and dependence in prisoners. Addiction 2006; 101:181-91. View or Download PDF


Fazel S. Mental health assessment. In: Cambridge Handbook of Forensic Psychology (Cambridge University Press, 2010)

Fazel S, Chhabra P. Elderly prisoners. In: Psychiatry in Prisons: a comprehensive handbook. Ed. S Wilson, I Cumming (London: Jessica Kingsley Publications, 2010)

Fazel S. Psychiatric aspects of crime and the elderly. In: Oxford Textbook of Old Age Psychiatry, ed. R. Jacoby, C. Oppenheimer et al. (Oxford University Press) 2008

Fazel S. Competence. In: Oxford Textbook of Old Age Psychiatry, ed. R. Jacoby, C. Oppenheimer et al. (Oxford: OUP) 2008

Hayes A, Fazel S. Elderly prisoners. In: Good practice in safeguarding adults: working effectively in adult protection. (Jessica Kingsley Publications, 2008)

Other activities:

Associate editor, Journal of Forensic Psychiatry and Psychology

Editorial board, BMC International Health and Human Rights

Editorial board, The Lancet Psychiatry

Committee Member, Law and Ethics Section, World Psychiatric Association

Co-author of Continuing Professional Education module on Suicides in Prison hosted by the Royal College of Psychiatrists, UK (2010):

Contact Seena Fazel