IntroductionPrevious evidence has demonstrated that the rate of Substance Misuse (SMU) within the psychiatric population is considerably higher than within a general population (D'Silva and Ferriter, 2003; Farrell et al., 1998). For forensic psychiatric patients, statistics are often even higher, with rates among patients admitted to forensic units typically between 50% and 90% (Derry, 2008). There is no clear agreement with regards to the link between mental disorder and violence; the link between a particular diagnosis and violence has been defined as "controversial and emotive" by some authors (Fazel et al., 2009). A variety of studies indicate that there is an association between serious violence and Schizophrenia, and that this link could be explained simply on the basis of either comorbid substance abuse, or prior criminal offending (Bennett et al., 2011; Fazel et al., 2009). In addition, many studies have attested an association between violence and psychopathic traits (Serin, 1991). Thus, the relationship between violence, mental disorders and substance misuse has been widely documented (Johnson et al., 2014;Steadman et al., 1998).In contrast, some studies have suggested that rather than clinical factors, criminogenic risk factors appear to contribute more to risk (Bonta et al., 1998;Phillips et al., 2005). In this respect, there is an increasing amount of evidence to demonstrate that the risk of offending is enhanced by comorbidity with substance misuse (Short et al., 2013), and that "dual diagnosis" patients are significantly more violent than patients who suffer from either condition exclusively (Swanson et al., 1990). Comorbid patients have been found to use a greater frequency of violent behaviour; involving more victims and with the use of weapons (Phillips, 2000).Comorbid patients spent less time in the community in comparison with those without a history of substance misuse (Derry and Batson, 2008). Substance misuse is also indicated to be related to an increased risk of criminal recidivism; hence many authors underlining the need for specific interventions, in both the health service and prison settings and in adolescent populations (Flynn et al., 2012).Several authors indicate the lack of services, or current consensus on appropriate treatment interventions for patients whose mental illness is made more complex by substance misuse, both in and outside of secure hospital settings (McMahon et al., 2003;Lindqvist, 2007). Morris and Moore, (2009) put forward that identifying and meeting patients' needs in those with comorbid diagnoses should be addressed whilst in secure settings in order to minimise potential relapse once the patient has been discharged. Research into the needs of patients detained in high secure hospital settings in England reported that unmet needs for male patients were related to drug use in 23% of the sample