The image used in this report is a detail from Loneliness, a painting by a patient at the Bracton Centre, a secure mental health unit (copyright © 2016 The Koestler Trust, all rights reserved). The Koestler Trust is a prison arts charity, inspiring offenders, secure patients and detainees to take part in the arts, work for achievement and transform their lives. For more information visit: www.koestlertrust.org.uk Produced by Design102, Communications and Information Directorate, Ministry of Justice