The image used in this report is a detail from The Victorian Train, by a patient at Camlet Lodge, Chase Farm Hospital, which won a Gold Award for Drawing at the 2014 Koestler Awards. 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