I am a clinician scientist with a background in forensic psychiatry, which has shaped my research at the intersection of health and justice. My work focuses on the mental health and suicide risk of individuals within the criminal justice system, as well as the broader links between mental illness and violence. Over the past decade, I have expanded my research to examine other adverse outcomes—particularly suicide and premature mortality—across high-risk populations and a range of neuropsychiatric disorders.   

My research primarily applies epidemiological methods to assess risk factors for adverse outcomes and develop prognostic models for risk stratification. I have also employed innovative pharmacoepidemiological approaches to explore preventative strategies. My work leverages national register data from Sweden, Finland, and Denmark, and more recently from Wales, Norway, and the Netherlands.  

Clinically, I have worked as a consultant forensic psychiatrist in medium- and low-secure hospitals and spent over a decade as a visiting psychiatrist in a prison. Since 2024, I have been part of community teams in Oxfordshire and West Berkshire, providing liaison services to general psychiatric teams.  

Beyond clinical and research work, I have experience in public and policy engagement. I have worked with the media to improve public understanding of psychiatry and have advised government bodies. I have provided evidence to Parliamentary Select Committees, advised the UK’s Chief Medical Officer and Chief Scientific Officer, and currently serve as an expert panel member for the Independent Advisory Panel on Deaths in Custody, a public advisory body co-sponsored by three government departments.

Profiled in 2015 in the Lancet Psychiatry.

Participated in 10 press briefings hosted by the UK Science Media Centre. These have included: violence in mental illness; impacts of head injury; prison mental health; rise in antidepressant medication. These have led to more than 100 newspaper articles.

Conducted interviews with different media outlets on research on suicide, violence, trauma, and prison health, including with all national newspapers in the UK (incl. Guardian, Times, Telegraph, Mail), some magazines (e.g. Economist, Spectator, Newsweek, Big Issue), national radio (e.g. Radio 4’s Today programme, BBC World Service, Woman’s Hour) and TV (Channel 4, Sky, ITV). Also interviewed by international media (including The New Yorker, Atlantic Monthly, New York Times, Washington Post, LA Times, Reuters).

2024/25 activity

BBC Radio 4’s World At One. Interviewed on lessons for mental health services from Valdo Calocane case

BBC World Service. Interviewed for Documentary Podcast. Prison of the mind. https://www.bbc.co.uk/programmes/p0kjmrbp

Times Radio lunchtime news: Interviewed on sentencing of Axel Rudakubani.

BBC News: Advice about Netflix’s ‘Adolescence’ mini-series.

BBC Panorama: Advice about documentary on the Calocane case.

Mail on Sunday: Advice about risks of varenicline.

Channel 4 News: Interviewed about increase in UK prescriptions for gabapentinoids.

Previously

Mortality rates in people in detained in hospital and in prison settings: Independent

Cited in Guardian analysis on recent homicides in the UK perpetrated by peolple with severe mental illness

Article in the Conversation on new research on beta-blockers and associations with crime

Violence and mental illness: five minutes with Seena Fazel (in the BMJ).

Common nerve pain drug linked to suicidal behavior, overdose. Reuters.

Prison suicide: BBC website

Violence risk assessment tool in severe mental illness – ‘a tremendous step forward’: American Council on Science and Health

‘A single concussion’: New York Times

Head injury in children and adolescents: PLoS Science AMA

Risk of violent reoffending in prisoners with mental illness: Guardian

Antidepressants and risk of violent crimes: Guardian

“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

Sexual offending – familial risks. BBC Radio 4 Today.

‘Coin-toss justice’: New Scientist

 

Podcasts:

“Evidence-based strategies for suicide and self-harm prevention”, Department of Psychiatry, University of Oxford (2023)

“Can computers predict crime”? Oxford Sparks (2019)

“Prediction models in psychiatry”, Department of Psychiatry, University of Oxford (2019)

“Perpetration of violence”, The Mental Elf, (2018)

 

Blogs

Covid-19 in prisons: why prioritizing staff and prison populations for vaccination matters. 2021. Penal Reform International https://www.penalreform.org/blog/covid-19-in-prisons-why-prioritising-staff-and/

The drugs don’t work? Antipsychotics, big pharma, and psychiatry. 2013. PLoS Blogs https://speakingofmedicine.plos.org/2013/12/18/book-review-the-drugs-dont-work-antipsychotics-big-pharma-and-psychiatry/

Adverse outcomes in neuropsychiatric disorders

High risk and marginalised populations

Nilsson SF, Laursen TM, Andersen LH, Nordentoft M, Fazel S. Homelessness, psychiatric disorders, and violence: a population-based cohort study. Lancet Public Health 2024; 9(6): e376-e385.

 

Nilsson SF, Nordentoft M, Fazel S, Laursen TM. Homelessness and police-recorded crime victimization: a nationwide, register-based cohort study. Lancet Public Health 2020; 5(6): e333-e341.

 

Gutwinski S, Schreiter S, Deutscher K, Fazel S. The prevalence of mental disorders among homeless people in high-income countries: an updated systematic review and meta-regression analysis. PLoS Medicine 2021; 18(8): e1003750.

 

Sariaslan A, Pitkänen J Forsman J, Kuja-Halkola R, Brikell I, D’Onofrio BM, Aaltonen M, Larsson H, Martikainen P, Lichtenstein P, Fazel S. Risk of common psychiatric disorders, suicidal behaviours and premature mortality following violent victimisation: a matched cohort and sibling-comparison study of 127,628 people who experienced violence in Finland and Sweden. PLoS Medicine 2024; 21(10): e1004410.

 

Sariaslan A, Kääriälä A, Pitkänen J, Remes H,  Aaltonen M, Hiilamo H, Martikainen P, Fazel S. Long-term health and social outcomes in children and adolescents placed in out-of-home care. JAMA Pediatrics 2021; 176(1): e214324-e214324.

 

Hailes HP, Yu R, Danese A, Fazel S. Long-term outcomes of childhood sexual abuse: an umbrella review. Lancet Psychiatry 2019; 6(10): 830-839.

 

Sariaslan A, Sharpe M, Larsson H, Wolf A, Lichtenstein P, Fazel S. Psychiatric comorbidity and risk of premature mortality and suicide among those with chronic respiratory diseases, cardiovascular diseases, and diabetes in Sweden: a nationwide matched cohort study of over 1 million patients and their unaffected siblings. PLoS Medicine 2022; 19(1): e1003864.

 

Chang Z, Lichtenstein P, Larsson H, Fazel S. Substance use disorders, psychiatric disorders, and mortality after release from prison: a nationwide longitudinal cohort study. Lancet Psychiatry 2015; 2(5): 422-430.

 

Yukhnenko D, Blackwood N, Lichtenstein P, Fazel S. Psychiatric disorders and reoffending risk a national cohort study of individuals given community sentences in Sweden. Lancet Public Health 2023; 8(2): e119-e129.

 

Hawton K, Linsell L, Adeniji T, Sariaslan A, Fazel S. Self-harm in prisons in England and Wales: an epidemiological study of prevalence, risk factors, clustering, and subsequent suicide. Lancet 2014; 383(3): 1147-1154.

 

Fazel S, Benning R, Danesh J. Suicides in male prisoners in England and Wales, 1978-2003. Lancet 2005; 366: 1301-1302.

 

Järvinen A, Lichtenstein P, D’Onofrio BM, Fazel S, Kuja-Halkola R, Latvala A. Health, behavior, and social outcomes among offspring of parents with criminal convictions: a register-based study from Sweden. Journal of Child Psychology and Psychiatry 2024; 65(12): 1590-1600.

 

By major disorder:  

Transdiagnostic

Sariaslan A, Arseneault L, Larsson H, Lichtenstein P, Fazel S. Risk of subjection to violence and perpetration of violence in persons with psychiatric disorders in Sweden. JAMA Psychiatry 2020; 77(4): 359-367.

 

Chesney E, Goodwin GM, Fazel S. Risks of all-cause and suicide mortality in mental disorders: a meta-review. World Psychiatry 2014; 13(2): 153-160.

 

Schizophrenia

Whiting D, Gulati G, Geddes JR, Fazel S. Association of schizophrenia spectrum disorders and violence perpetration in adults and adolescents from 15 countries: a systematic review and meta-analysis. JAMA Psychiatry 2022; 79(2): 120-132.

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

 

Bipolar disorder

Webb RT, Lichtenstein P, Larsson H, Geddes JR, Fazel S. Suicide, hospital-presenting suicide attempts, and criminality in bipolar disorder: examination of risk for multiple adverse outcomes. Journal of Clinical Psychiatry 2014; 75(8): e809-e816.

Paljärvi T, Herttua K, Taipale H, Lähteenvuo M, Tanskanen A, Fazel S, Tiihonen J. Cause-specific excess mortality after first diagnosis of bipolar disorder: population-based cohort study. BMJ Mental Health 2023; 26(1): e300700.

 

Depression

Fazel S, Wolf A, Chang Z, Larsson H, Goodwin GM, Lichtenstein P. Depression, and violence: a Swedish population study. Lancet Psychiatry 2015; 2(3): 224-232.

Paljärvi T, Tiihonen J, Lähteenvuo M, Tanskanen A, Fazel S, Taipale H. Mortality and psychotic depression: 18-year follow-up study. British Journal of Psychiatry 2023; 222(1): 37-43.

 

Traumatic brain injury

Ogonah M, Botchway S, Yu R, Schofield PW, Fazel S. Health outcomes following traumatic brain injury: an umbrella review. Nature Mental Health 2024; 3(1): 83-91.

Sariaslan A, Sharp D, D’Onofrio B, Larsson H, Fazel S. Long-term outcomes associated with traumatic brain injury in childhood and adolescence: a nationwide Swedish cohort study of a wide range of medical and social outcomes. PLoS Medicine 2016; 13(8): e1002103.

Fazel S, Pillas D, Wolf A, Lichtenstein P, Långström N. Suicide, fatal accidents, and other causes of premature mortality in traumatic brain injury: a 40-year Swedish population study. JAMA Psychiatry 2014; 71(3): 326-333.

 

Epilepsy

Fazel S, Wolf A, Långström N, Newton CR, Lichtenstein P. Premature mortality in epilepsy and the role of psychiatric comorbidity: a total population study. Lancet 2013; 382(11): 1646-1654.

 

Substance use disorders

Zhong S, Yu R, Fazel S. Drug use disorders and violence: associations with individual drug categories. Epidemiologic Reviews 2020; 42(1): 103-116.

 

 

Prognostic models in mental health

 

Whiting D, Glogowska M, Mallett S, Maughan D, Lennox B, Fazel S. Use of a violence risk prediction tool (OxMIV) in Early Intervention in Psychosis services: a mixed methods study of acceptability, feasibility, and clinical role. British Journal of Psychiatry 2025; 1-10.

 

Fazel S, Vazquez-Montes MDLA, Molero Y, Runeson B, D’Onofrio BM, Larsson H, Lichtenstein P, Walker J, Sharpe M, Fanshawe TR. Risk of death by suicide following self-harm presentations to healthcare: development and validation of a multivariable clinical prediction rule (OxSATS). BMJ Mental Health 2023; 26(1): e300673-e300673.

 

Whiting D, Mallett S, Lennox B, Fazel S. Assessing violence risk in first-episode psychosis: external validation, updating and net benefit of a prediction tool (OxMIV). BMJ Mental Health 2023; 26(1): e300634.

 

Yu R, Molero Y, Lichtenstein P, Larsson H, Prescott-Mayling L, Howard LM, Fazel S. Development and validation of a prediction tool for reoffending risk in domestic violence. JAMA Network Open. 2023; 6(7): e2325494.

 

Fazel S, Heathcote L, Farouki L, Senior J, Perry A, Fanshawe TR, Shaw J. Bridging assessment and treatment for repeat suicidality in prisons: development and validation of a risk model. BMJ Mental Health 2025; 28(1): e301280

 

Fazel S, Wolf A, Larsson H, Lichtenstein P, Mallett S, Fanshawe TR. Identification of low-risk violent crime in severe mental illness with a clinical prediction tool (Oxford Mental Illness and Violence tool [OxMIV]): a derivation and validation study. Lancet Psychiatry 2017; 4(6): 461-68.

 

Sariaslan A, Fanshawe T, Pitkänen J, Cipriani A, Martikainen P, Fazel S. Predicting suicide risk in 137 112 people with severe mental illness in Finland: external validation of the Oxford Mental Illness and Suicide tool (OxMIS). Translational Psychiatry 2023; 13(1): 126-126.

 

Fazel S, Vazquez-Montes MDLA, Lagerberg T, Molero Y, Walker J, Sharpe M, Larsson H, Runeson B, Lichtenstein P, Fanshawe TR. Risk of repeat self-harm among individuals presenting to healthcare services: development and validation of a clinical risk assessment model (OxSET). BMJ Mental Health 2024; 27(1): e301180.

 

Wolf A, Fanshawe TR, Sariaslan A, Cornish R, Larsson H, Fazel S. Prediction of violent crime on discharge from secure psychiatric hospitals: a clinical prediction rule (FoVOx). European Psychiatry 2018; 47: 88-93.

 

 

Pharmaco-epidemiology studies of common medications

 

Molero Y, Kaddoura S, Kuja-Halkola R, Larsson H, Lichtenstein P, D’Onofrio BM, Fazel S. Associations between β-blockers and psychiatric and behavioural outcomes: A population-based cohort study of 1.4 million individuals in Sweden. PLoS Medicine 2023; 20(1): e1004164.

 

Sariaslan A, Zetterqvist J, Lichtenstein P, Leucht S, Fazel S. Associations between individual antipsychotics and the risk of arrests and convictions of violent and other crime: a nationwide within-individual study of 74,925 persons. Psychological Medicine 2022; 52(16): 3792-3800.

 

Molero Y, Cipriani A, Larsson H, Lichtenstein P, D’Onofrio BM, Fazel S. Associations between statin use and suicidality, depression, anxiety, and seizures: a Swedish total-population cohort study. Lancet Psychiatry 2020; 7(11): 982-990.

 

Molero Y, Larsson H, D’Onofrio BM, Sharp DJ, Fazel S. Associations between gabapentinoids and suicidal behaviour, unintentional overdoses, injuries, road traffic incidents, and violent crime: population-based cohort study in Sweden. BMJ 2019; 365: 2147.

 

Chang Z, Lichtenstein P, Långström N, Larsson H, Fazel S. Association between prescription of major psychotropic medications and violent reoffending after prison release. JAMA 2016; 316(17): 1798-1807.

 

Fazel S, Zetterqvist J, Larsson H, Långström N, Lichtenstein P. Antipsychotics, mood stabilizers, and risk of violent crime. Lancet 2014; 384(9949): 1206-1214.

 

Molero Y, Lichtenstein P, Zetterqvist J, Gumpert CH, Fazel S. Varenicline and risk of psychiatric conditions, suicidal behavior, criminal offending, and transport accidents and offences: population-based cohort study. BMJ 2015; 350: h2388-h2388.

 

Molero Y, Zetterqvist J, Binswanger IA, Binswanger MD, Hellner C, Larsson H, Fazel S. Medications for alcohol and opioid use disorders and risk of suicidal behavior, accidental overdoses, and crime. American Journal of Psychiatry 2018; 175(10): 970-978.

 

Paljarvi T, Forton J, Luciano S, Herttua K, Fazel S. Analysis of neuropsychiatric diagnoses after montelukast initiation. JAMA Network Open 2022; 5(5): e2213643-e2213643.

 

Paljarvi T, McPherson T, Luciano S, Herttua K, Fazel S. Isotretinoin and adverse neuropsychiatric outcomes: retrospective cohort study using routine data. British Journal of Dermatology 2022; 187(1): 64-72.

 

Herttua K, Scola G, Paljarvi T, Fazel S. Associations between antidepressants and risk of suicidal behavior and violent crimes in personality disorder. European Psychiatry 2025; 68(1): e28

 

 

Forensic mental health

 

Tully J, Hafferty J, Whiting D, Dean K, Fazel S. Forensic mental health: envisioning a more empirical future. Lancet Psychiatry 2024; 11(11): 934-942.

 

Ogonah MGT, Seyedsalehi A, Whiting D, Fazel S. Violence risk assessment instruments in forensic psychiatric populations: a systematic review and meta-analysis. Lancet Psychiatry 2023; 10(10): 780-789.

 

Beaudry G, Yu R, Perry AE, Fazel S. Effectiveness of psychological interventions in prison to reduce recidivism: a systematic review and meta-analysis of randomized controlled trials. Lancet Psychiatry 2021; 8(9): 759-773.

 

Senior M, Fazel S [corresponding author], Tsiachristas A. The economic impact of violence perpetration in severe mental illness: a retrospective, prevalence-based analysis in England and Wales. Lancet Public Health 2020; 5(2): e99-e106.

 

Rongqin Y, Nevado-Holgado AJ, Molero Y, D’Onofrio BM, Larsson H, Howard LM, Fazel S. Mental disorders and intimate partner violence perpetrated by men towards women: A Swedish population-based longitudinal study. PLoS Medicine 2019; 16(12): e1002995.

 

Ryland H, Cook J, Ciobanasu O, Oluwabamise O, Cornish R, Al-Taiar H, Chris-Okoro E, Hoggart C, Vallakalil A, Fitzpatrick R, Fazel S. Reliability and validity of the FORUM-P and FORUM-C: two novel instruments for outcome measurement in forensic mental health. Psychology, Crime & Law 2024; 30 (2): 150-165.

 

Douglas T, Pugh J, Singh I, Savulescu J, Fazel S. Risk assessment tools in criminal justice and forensic psychiatry: the need for better data. European Psychiatry 2017; 42 (5): 134-137.

 

Fazel S, Fimińska Z, Cocks C, Coid J. Patient outcomes following discharge from secure psychiatric hospitals: systematic review and meta-analysis. British Journal of Psychiatry 2016; 208(1): 17-25.

 

 

Evidence syntheses

 

Fazel S, Runeson B. Suicide. New England Journal of Medicine 2020; 382(3): 266-274.

 

Fazel S, Hayes A, Bartellas K, Trestman R. Mental health of prisoners: prevalence, adverse outcomes, and interventions. Lancet Psychiatry 2016; 3(9): 871-881.

 

Fazel S, Geddes JR, Kushel M. The health of homeless people in high-income countries: descriptive epidemiology, health consequences, and clinical and policy recommendations. Lancet 2014; 384(10): 1529-1540.

 

Fazel S, Baillargeon J. The health of prisoners. Lancet 2011; 377(9769): 956-965. (citations >3500)

 

Other evidence syntheses

 

Fazel S, Burghart M, Wolf A, Whiting D, Yu R. Effectiveness of violence prevention interventions: umbrella review of research in the general population. Trauma, Violence and Abuse 2024; 25(2): 1709-1718.

 

Fazel S, Hurton C, Burghart M, DeLisi M, Yu R. An updated evidence synthesis on the Risk-Need-Responsivity (RNR) model: Umbrella review and commentary. Journal of Criminal Justice 2024; 92: 102197.

 

Swanson J, McGinty E, Fazel S, Mays V. Mental illness and reduction of gun violence and suicide: bringing epidemiologic research to policy. Annals of Epidemiology 2015; 25(5): 366-375.

 

Systematic and umbrella reviews

 

Mundt AP, Cifuentes-Gramajo PA, Baranyi G, Fazel S. Worldwide incidence of suicides in prison: a systematic review. Lancet Psychiatry 2024; 11(7): 536-544.

 

Favril L, Rich JD, Hard J, Fazel S. Mental and physical health morbidity among people in prisons: an umbrella review. Lancet Public Health 2024; 9(4): e250-e260.

 

Chow RTS, Yu R, Geddes JR, Fazel S. Personality disorders, violence, and antisocial behaviour: updated systematic review and meta-regression analysis. British Journal of Psychiatry 2024; 1-11.

 

Favril L, Yu R, Geddes JR, Fazel S. Individual-level risk factors for suicide mortality in the general population: an umbrella review. Lancet Public Health 2023; 8(11): e868-e877.

 

Favril L, Yu R, Hawton K, Fazel S. Risk factors for self-harm in prison: a systematic review and meta-analysis. Lancet Psychiatry 2020; 7(8): 682-691.

 

Mundt AP, Baranyi G, Gabrysch C, Fazel S. Substance use during imprisonment in low- and middle-income countries.  Epidemiologic Reviews 2018; 40: 70-81.

 

Vassos E, Collier DA, Fazel S. Systematic meta-analyses and field synopsis of genetic association studies of violence and aggression. Molecular Psychiatry 2013; 19(4): 471-477.

 

Fazel S, Danesh J. Serious mental disorders in 23,000 prisoners: a systematic review of 62 surveys. Lancet 2002; 359:545-50.

 

Edited books, chapters, and other publications (selected)

 

Singh JP, Bjørkly S, Fazel S (eds). International Perspectives on Violence Risk Assessment, Oxford: OUP, 2016.

 

Fazel S, Ryland H, Saunders L, Grubin D, Bicknell M, Leamann J, Bunn A. Mental health. In: Prison Medicine and Health. Oxford: OUP 2024; 175-202.

Mitchell A, Phipps E, Fazel S, Katona C, Hunt J, Dexter E. Foreign nationals in detention. In: Prison Medicine and Health. Oxford: OUP 2024; 293-313.

Topiwala A, Fazel S. Memory and trauma. In: Old Evidence and Core International Crimes. Brussel: Torkel Opsahl Academic EPublisher. Revised edition 2024; 73-83.

Fovet T, Mundt A, Fazel S. Psychiatry in prisons and corrections. In: Tasman’s Psychiatry. Cham: Springer 2023; 1–28.

Fazel S, Toynbee M. Associations between psychiatric disorder and offending. In: New Oxford Textbook of Psychiatry. Oxford: OUP 2020; 1415-22.

Whiting D, & Fazel S. Epidemiology and risk factors for violence in people with mental disorders. In: Violence and Mental Disorders. Cham: Springer 2020; 1: 49-62.

Whiting D, Ryland R, Fazel S. Forensic mental health treatment and recidivism. In: The Routledge Handbook of the Philosophy and Science of Punishment. New York: Routledge 2020; 303-14.

Fazel S. The scientific validity of current approaches to criminal and violence risk assessment. In: Predictive Sentencing: normative and empirical perspectives. London: Bloomsbury 2019; 197-212.

Fazel S, Bjørkly S. Methodological Considerations in Risk Assessment Research. In:  International Perspectives on Violence Risk Assessment. Oxford: OUP 2016; 16-25.

Fazel S. Martin Grann: a tribute. International Journal of Forensic Mental Health 2013; 12: 229-30.

 

Section editor, BMJ Mental Health

International advisory board, The Lancet Psychiatry

Editorial boards: BMC Psychiatry, Health & Justice, Forensic Science International: Mind and Law, Iranian Journal of Psychiatry 

Co-author of Continuing Professional Education module on Suicides in Prison hosted by the Royal College of Psychiatrists, UK (2020): http://www.psychiatrycpd.co.uk/learningmodules/suicidesinprison.aspx

Email

seena.fazel@psych.ox.ac.uk

You can follow me on Twitter: @seenafazel

Weblinks

University of Oxford Department of Psychiatry

Karolinska Institutet, Department of Medical Epidemiology and Biostatistics

The Wellcome Trust