Prof of Forensic Psychiatry, Oxford University; researching adverse outcomes in mental illness, prisoner health, risk assessment for suicide and violence/crime.
16M people self-harm/year - and suicide risk is 20x increased in the next yr (or 1 in 50-100 people). Current guidelines recommend intensive psychol treatments for all - not realistic for most health systems. Hence the need for possible risk stratification. See recent reviews👇. 
Despite community *sentences* being widely used, reoffending rates are not low. Recidivism rates in UK >25% over 1 yr. In many countries, >20% over 1-2 yrs. Figure 👇from 2019 review (and note higher rates in Norway than Ireland/Holland): journals.plos.org/plosone/articl… 2/ 
Primary analysis was to use a within-individual design to test associations between those dispensed antipsychotics and adverse outcomes. This design examines outcome rates when someone is dispensed (i.e. prescribed and collected) meds compared to when they are not dispensed meds
We compared reoffending rates in people who were in different prisons at the same security level (between-individual), adjusting for measured confounds, and also examined repeat offending in the same person released from different prisons (within-individual). Two approaches. 2/ 
First, the overall pattern emerges that antipsychotics are associated with clear reductions in all crime outcomes. Shown in between-individual models (crime rates in people dispensed meds vs those not dispensed meds) - among the persons who were prescribed antipsychotics 2/ 