Focus: Life inside for Janet and the 400

Janet Cresswell is having yet another clear-out of clothes, packing them up for her daughter Jane to collect. Like all the other inmates in England's three high-security mental hospitals, Mrs Cresswell has to cope with strict limits on the numbers of personal items and clothes she can have.

She has been living this way for 25 years, and it was her plight which was the catalyst for The Independent on Sunday's campaign.

The limit on personal items is just another of the routine, petty humiliations of life in Broadmoor – but for her and more than 400 men and women in high-security hospitals the regime should be markedly more relaxed. An official inquiry three years ago admitted that this large minority of the patients in Broadmoor, Ashworth and Rampton should be living in lower-security conditions, or even be released.

Mrs Cresswell, an award-winning playwright and poet whose crime was to go for her psychiatrist's buttocks with a vegetable knife a quarter of a century ago, will also be banned from eating home-cooked Christmas cake this year. Food and drink apparently pose an unacceptable risk to security.

"With Christmas coming, it's very difficult," said Jane, her daughter. "I used to send her a slice of cake but you're not allowed to do that now. Only toiletries are allowed in. To me, perfume and talcum powder can have the same stuff in as a cake. It's ludicrous. You can't even send in food from M&S."

The ban on "outside" food and drink was introduced after an independent review of security at the three hospitals by Sir Richard Tilt, the former head of the prison service, in 1999. That review also ended Mrs Cresswell's access to a computer, because inmates at Ashworth had downloaded pornography. She, however, had used her word processor to write a play performed at London's Bush Theatre and won the Arthur Koestler prize for an essay on Bedlam, the infamous asylum.

Mrs Cresswell also used to enjoy playing bowls, until the authorities banned men and women inmates from mixing. Naturally, the food ban is unevenly applied. Families of Ashworth inmates can buy approved foods by mail order from a local supermarket. But not so at Broadmoor.

Sir Richard identified 436 inmates who could be moved out of high-security confinement. He also admitted in his report that scores of them, 61 by his count, had already been officially approved for a transfer but were still incarcerated, awaiting places in medium- or low-security institutions which had not then been built. Other experts said there were nearer 100 deserving immediate transfer.

Jane Johnson counts her mother as one of those unfortunates. She has refused to agree that she is mad, and refused to see a Home Office psychiatrist. As a result, her family believes, Mrs Cresswell may well languish in Broadmoor until she dies.

Promises of a move to a medium-secure unit have been made, and then withdrawn, leading to a weary cynicism. "She's been told that loads of times before, but her attitude is to believe it when it happens and I think the same. Every time, something has changed and our hopes are got up and then they're smashed," Ms Johnson said.

The hospitals insist the situation is improving, if slowly. Ashworth is closing its 50-bed women's unit in 18 months, moving most of its patients to smaller, locally based medium-security ones. "There are very few women deemed to need high-security treatment," said an Ashworth spokeswoman. Some, however, may end up being moved to Broadmoor or Rampton if, as many suspect, sufficient medium-secure places are not ready in time.

"It was identified as part of the Tilt procedure that there is a number of patients, men and women, inappropriately placed in high-secure hospitals," said a spokesman for Broadmoor. "Some of those people have been moved through the system. But there has, for some time, been a shortage of low- and medium-secure accommodation. There aren't enough beds, but there are initiatives around to address this." Broadmoor, for example, is opening a 20-bed medium-secure unit in Ealing, west London.

Yet even the British Medical Association shares Mrs Cresswell's suspicions. Dr Robin Arnold, the BMA's psychiatry spokesman, has studied proposals for a major improvement in medium- and low-security places. "There are clear intentions," he said, "but they are far from actual development."