The baseline risk is 22% for a repeat ACCT within 3 months of ACCT closure.
There may be individual factors that are not listed, some of which are modifiable, that will inform and contribute to an assessment of repeat self-harm risk. These individual factors could be noted in the records.
The content of the OxRisk website (including the risk calculators) is accurate according to the opinions of the authors of the calculators. The information and directions may or may not apply to specific individuals considered for assessment. The calculators provide a ‘best guess’ of likely outcomes based on current knowledge, but cannot provide an accurate prediction for each individual. Determination of appropriate application and scoring of the OxRisk calculators to specific cases and in specific jurisdictions requires the judgement of a clinician or criminal justice professional. OxRisk calculators are intended to be an adjunct to clinical decision-making.
Materials on this website are protected by copyright law. Access to the information on this website should be for the sole purpose of personal, educational and research use only. Where appropriate a single print out of a reasonable proportion of these materials may be made for personal education, research and private study. Materials should not be further copied, photocopied or reproduced, or distributed in electronic form. Any unauthorised use or distribution for commercial purposes is expressly forbidden.
Publications
Development and validation
- 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). - Fazel S, Heathcote L, Farouki L, Senior J, Perry A, Fanshawe T, Shaw J. A novel approach to the assessment of repeat self-harm in prisoners: development and validation of a tool to bridge assessment and treatment (RAPSS). Health Technol Assess 2026;30(30):1–38.
Other
- Fazel S, Gunnarsson L, Ryland H., 2025. Justice Trends Magazine. Reducing self-harm to improve rehabilitation outcomes.
- Heathcote L, Perry AE, Thompson E, et al. Understanding barriers and facilitators of implementing a new assessment and bridging tool to support those at risk of repeat self-harm in prison: the qualitative RAPPS study. Southampton (UK): National Institute for Health and Care Research; 2026 Mar.


