Abstract

Substance use disorders are highly prevalent among forensic patients. They are associated with many challenges for patients with these problems, including their ability to rehabilitate and successfully move through secure forensic mental health services, as well as increasing risk for recidivism. Traditionally, forensic services have been more adept at focusing on and treating the primary mental health diagnosis alone and have been less likely to prioritise this co-occurring patient need. Opportunities exist to foster effective treatment strategies for substance use disorders, and past research has produced positive outcomes among forensic patients in studies in both Australia and the UK to navigate a new course for patients with these problems. By providing empirically validated, co-produced and culturally competent treatment responses, forensic patients living with substance use disorders will have the opportunity to significantly improve their wellbeing and progress through the system. They will also be more prepared and equipped to face challenges upon discharge into the community, including increased availability of alcohol and other drugs, social stigma and barriers to employment. Moreover, by prioritising effective substance use treatment programs during inpatient rehabilitation, services can reduce the levels of post-discharge recidivism.

Highlights

  • Substance use disorders are highly prevalent among forensic patients

  • There is a range of challenges faced by forensic patients with substance use histories in the UK and Australia; both during their treatment in forensic services and upon their release into the community

  • It has been argued that the stigmatisation of people with mental disorders fuels the societal belief that mental disorders and violence are strongly connected, for instance, a community-based survey found that respondents were more likely to predict someone would commit a crime in the future if they had a mental illness than if they did not have one [17]

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Summary

Introduction

Substance use disorders are highly prevalent among forensic patients (i.e. individuals who have committed a crime and been found not guilty by reason of mental illness). The link between substance use and offending is acknowledged [5,6], it has not always been accompanied by adequate changes to forensic mental health service delivery [7].

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