The provision of psycho‐educational groups for people diagnosed with schizophrenia is an important part of successful treatment. The value of such interventions is less clearly established in secure settings with no reports on women. Gender differences in the manifestation of schizophrenia highlight the importance of a gender‐specific intervention. A ‘Living with Mental Illness’ group programme for women in a secure psychiatric setting is described and evaluated. Those who completed group treatments (n = 20; 63%) showed improved knowledge of schizophrenia, decreased fear of schizophrenia, greater insight and increased optimism and perceived control of the illness. They also showed increased hope and greater self‐compassion. Pre–post group findings reflected improved ratings of compliance with drug treatments, appropriate behaviour and insight into risk. This was reflected in a decrease in risk behaviours, improved attendance at treatment sessions and a reduction in symptomatology. Group members also reported a positive group therapeutic alliance. Findings are discussed in the context of gender‐specific treatment, research, methodological issues characteristic of a real‐world evaluations and the need to assess the long‐term benefits of such treatment. Copyright © 2015 John Wiley & Sons, Ltd. Key Practitioner Message Psycho‐educational groups for secure inpatients with schizophrenia need to address gender‐specific differences in the manifestation of the condition. Such interventions as part of a broader treatment initiative can be associated with clinical improvement that is both illness specific and leads to improved engagement with care initiatives. The needs of patients who do not complete treatments needs to be regularly reassessed.