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This paper describes two different services within the UK, both of which aim to better address the needs of offenders with personality disorder. Both services have been developed in the light of recent policy and practice guidance, which recognises the need to develop new ways of working with this hard‐to‐reach population.The importance of developing boundaries and optimistic therapeutic relationships in order to foster motivation and engagement is emphasised. It is within these that assessment and interventions to address risk, mental health and social integration issues can be undertaken. In addition, the need for different agencies to work together in partnership to better address these needs is also emphasised.Resettle is a stand‐alone service in the pilot stage whilst the probation link‐work role is a resource within an established community personality disorder service.

One of the main features of the reform of the Mental Health Act 2007 was the introduction of community treatment orders (CTOs). CTOs represent a fundamental shift in the rights of people with severe mental health problems, who have been detained in hospital under section 3 of the Mental Health Act and subsequently discharged. The call for the introduction of CTOs or similar legislation has been a feature of mental health policy over the past 20 years. Despite the detailed discussion of the relationship between ethnicity and psychiatry, there has been very little attention paid to the way that race was a factor in the community care scandals of the 1990s. This article, through the consideration of two very high profile cases ‐ Christopher Clunis and Ben Silcock, explores the media's influence on the construction of the debate in this area. In particular, it explores the way that the media reporting of the two cases had a role in not only perpetuating racial stereotyping, but also the stigmatising of those experiencing acute mental health problems. In addition, with the use of government papers obtained under the Freedom of Information Act, it considers the response to and the attempts to influence the media debate at that time.

This paper provides a clinical practice overview of the challenges that can arise when working with dangerous and severe personality‐disordered patients in a high secure hospital. Poor engagement and treatment readiness, mistrust, paranoia and dominant interpersonal styles are all clinical features that affect treatment delivery. The paper discusses the impact of these features, and suggests how clinicians can engage effectively with individuals who have personality disorders in regard to therapy in general.