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BSc (Hons), MBChB, MD, FRCPsych
Wellcome Trust Senior Research Fellow
- Professor of Forensic Psychiatry
- Honorary Consultant Forensic Psychiatrist
My research focuses on the relationship between mental illness and violent crime, the mental health of prisoners, and violence risk assessment. This is funded by the Wellcome Trust as part of a Senior Research Fellowship in Clinical Science.
By applying epidemiological methods, our team has tried to address a number of key questions in forensic psychiatry. Using population-based datasets and family-based designs, this work has clarified the contribution of the main neuropsychiatric conditions to violent crime. These studies, supported by systematic reviews, have challenged some widely held beliefs (e.g. that epilepsy causes violence), addressed areas of considerable uncertainty (whether schizophrenia increases risk) and highlighted neglected areas of risk (bipolar disorder, depression, and head injury). In addition, we have clarified modifiable risk factors for violence risk. This work has benefited from novel methods to account for confounding, and collaborations with disease experts and biostatisticians. The research on schizophrenia, bipolar disorder, attention-deficit hyperactivity disorder and epilepsy has contributed to national clinical guidelines, and work on risk assessment to an Institute of Medicine working party and US Congressional Research Service report.
In prison health, our research has focused on the prevalence of mental disorders, and suicide risk. The work in suicide risk has applied new methods (e.g. interviewing near-lethal suicide attempts), and population-based datasets to study secular trends and risk factors. I have given evidence on older prisoners’ health to the UK Justice Select Committee and the Prisons Minister. This work has contributed to the recent WHO Handbook on Prison Health and WHO report on Preventing Suicide, and assisted in formulating English and Welsh prison policy.
My principal collaborations are with the Medical Epidemiology and Biostatistics Department at the Karolinska Institute, Department of Primary Care Health Sciences at Oxford University, the Centre for Suicide Research in the department, and more recently Birmingham, Manchester and Edinburgh Universities.
I am an external examiner for the MSc in Forensic Mental Health at the Institute of Psychiatry, Section Editor for Forensic Psychiatry for BMC Psychiatry and Evidence-Based Mental Health, sit on the advisory committee of the South Central Region for the Research for Patient Benefit Programme of the NIHR, and the international advisory board of The Lancet Psychiatry.
I was the expert forensic psychiatrist appointed by the UN-sponsored Khmer Rouge Tribunal to assess the fitness to plead and stand trial of the defendants in Case 002.
Clinical work includes sessions for Oxford Health NHS Foundation Trust as a visiting psychiatrist at a local prison. Previously I worked in low and medium secure hospital settings. I was appointed consultant forensic psychiatrist in 2003.
More broadly, I have tried to communicate our group's research findings with the general public and clinical colleagues. For media work and podcasts, see: http://www.psych.ox.ac.uk/research/forensic-psychiatry
Our recent paper on deriving and validating a scalable risk assessment tool in prisoners can be found at: http://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(16)00103-6/fulltext (open access)