Sailing uncharted seas without a compass: A review of interventions in forensic mental health

Mentally disordered offenders (MDOs) represent a complex and diverse population who are often regarded as difficult to treat. Accordingly, the practitioners who are tasked with their reintegration face many challenges which are compounded by a paucity of published research on interventions with MDOs and a lack of comprehensive rehabilitation models to orient their practice. This article provides an overview of published literature on interventions used in inpatient forensic mental health services over the past 15 years. The literature is categorized according to its broad theoretical orientation and three approaches are identified: (1) Treatments targeting mental illness and other psychological issues; (2) Interventions based on the principles of the Risk–Need–Responsivity (RNR) model that aim to reduce recidivism; and (3) Strength-based models. The literature review highlights a practice of blending divergent models in an attempt to cater to the wide-ranging needs of forensic patients. It is asserted that this practice, which is problematic for a number of reasons, is underpinned by an absence of overarching rehabilitation frameworks to integrate the multiple elements of forensic practice. It is proposed that the Good Lives Model of offender rehabilitation, when adapted for use in a forensic context, may provide a promising way forward.