ABSTRACT
Current legislation and policy frameworks directing the detention and treatment of mentally disordered offenders are predicated on the assumption that these patients have enduring violent tendencies and pose a substantial risk to the safety of others and themselves. This chapter seeks to explore the extent to which notions of risk and the imperative to contain and minimise the potential for harm dominate the care and treatment of patients in secure settings impacting negatively on their self-concept, epistemic agency, and self-representation and contributing to diverse forms of marginalisation. Such settings are characterised by risk aversion and significant levels of restriction which may act in opposition to the development of therapeutic alliances and the implementation of effective care and treatment plans. To be specific, we will examine the concept of the individual inpatient as a marginalised entity within such settings in England and Wales with a especial focus on those individuals whose index offence is acknowledged to be an isolated event and uncharacteristic of their behaviour. Within this, we will challenge the notion of risk posed by mentally disordered offenders as a long-term phenomenon and reify the human rights issues and associated concerns.
