Joan Marsh is Deputy Editor of The Lancet Psychiatry
Professor Fred Hickling’s lively presentation, including Usain Bolt’s famous lightning gesture, had both style and substance. Smiling schoolchildren guarantee an impact, but these were children living in impoverished, disadvantaged, inner-city communities, selected for severe disruptive disorders and academic underachievement. In the 3-week Dream-A-World Cultural Therapy programme that took place during the summer of 2006, the 8-year-olds were asked to imagine (dream) a new world on another planet, name it and conceive its inhabitants, decide what to take or eliminate from their known world to this new one, how they would look, and what role they would play in governing the new world. They then worked with artists in bi-weekly sessions for 2½ years, learning how to play musical instruments and compose songs, poems, and dances about their new world. Literacy and numeracy sessions were included, as were field trips. The programme proved so popular that other children were asking whether they had to behave badly in order to be able to join. All 30 children from the proof-of-concept pilot project passed the grade 6 achievement test and have entered accredited high schools in Jamaica. The project is now being scaled up to a further 100 children in four more schools across Kingston.
The aim of Turning the World Upside Down is to celebrate projects, practices and ideas from low-income and middle-income countries, which could be effectively applied to the major health challenges faced by high-income countries. Organized in collaboration with Mind, the Centre for Global Mental Health, New York University’s Program in Global Mental Health, the Institute for Health Improvement, the London School of Hygiene and Tropical Medicine, and Maudsley International, the Mental Health Challenge attracted 34 entries. The top four presented to a panel of "Dragons’ Den"-style judges, although these judges were very supportive and praise heavily outweighed any criticism.
The real winner should be the mental health community, with an influx of new ideas, successful models of innovative care, and an emphasis throughout on engaging service users, their families, carers and communities from the start. We now all have the inspiration to Dream-a-World in which children and adults with mental health problems contribute to both the management of their own lives and to society.