The rehabilitation of offenders diagnosed with severe mental illness

Section A: This paper reviews the existing theoretical and empirical literature of relevance to offenders with severe mental illness (SMI) in the UK. Due to the lack of theory accounting for progress through forensic mental health services (FMHS) as currently constituted, the adjacent areas of mental health recovery and forensic rehabilitation are the major focus. Relevant empirical literature is synthesised and critically evaluated and this paper concludes by (a) summarising research challenges that remain pertinent to this area of enquiry and (b) outlining recommendations as to how research can usefully proceed. Section B: The UK’s increasing recognition of offenders with SMI and the lack of a theoretical account specific to this group provided the rationale for this study. The aim was to develop a preliminary model of the ways offenders with SMI progress through FMHS towards reintegration with the community. Semi-structured interviews were conducted with seven FMHS-users and three FMHS staff members. Grounded theory was used to build a preliminary model, which contained six main categories: learning about and managing mental health, establishing facilitative relationships with staff, moving on from prison and early experiences of FMHS, developing self-direction, doing work in therapy, and managing wider support networks. Findings extend existing literature by providing a preliminary theoretical account of the multiple domains that influence progression of offenders with SMI towards reintegration with the community. Results are discussed with regard to the existing literature and clinical implications are outlined. Recommendations for future research are made. Section C: In order to reflect upon the process of conducting this project, the author considers four questions: (1) what research skills have been developed and what skills continue to require development?, (2) what would be done differently were this project to be repeated?, (3) what changes in clinical practice will occur as a consequence of this research?, and (4) what areas would future research focus on and how would this be approached