This article examines how the Offender Personality Disorder Pathway has been tailored to deliver services to a relatively wide population of women prisoners, despite the fact that few of them meet the dangerousness criteria that determine access for men. Although women in custody have a well-established claim to resources that address their mental health needs, there are legitimate concerns about programmes that foster individualised and ‘pathologised’ understandings of female offenders. These are particularly problematic in the contemporary rehabilitative climate which functions in a state of legal and ethical uncertainty about the duty of care owed to those who participate in the programmes. The article calls for a broader understanding of the political and cultural circumstances in which the Offender Personality Disorder Pathway for Women operates and an awareness of the consequences that derive from the coercive environment of the prison, the ideological dominance of risk management and the minority status of women in the criminal justice system.