[Fight against schizophrenia stigma]

Stigma, discrimination and prejudice against mental diseases, those who suffer from them and their families are common everywhere. To reduce stigma in schizophrenia is essential for a better outcome of the disease in each patient. Stigma interferes with the detection of the illness, with adherence to treatment, with rehabilitation and with social reinsertion. Stigma is everywhere in schizophrenia, from within the family itself to the health care system and into society at large. The WPA has developed a Program to fight the stigma of schizophrenia consisting on several modules: 1) Instructions on how to implement a campaign. 2) A monograph in schizophrenia. 3) A summary of the experiences in the sites where the program has been tested. 4) Further modules which include information on similar campaigns and material such as leaflets, books and videos and concrete examples of discrimination. A pilot study of the WPA Program was carried out in Madrid in 1999. A survey was undertaken to identify target population and specific messages, showing little knowledge about the disease and a small stigma amount. It was decided not to carry out an awareness campaign in the population, which has the risk of increasing stigma in parallel to being increased in awareness but to explore the amount of stigma in the environment closer to the patient such as patients themselves, relatives, neighbours and health services staff. The stigma degree was much more significant. Activities related to this group of people were undertaken specially by training psychiatrists to identify stigma and discrimination and to fight it. The outcome showed a great satisfaction among patients, relatives and physicians. A pilot media campaign was also undertaken. In previous years there was no information about schizophrenia in mass media only news on incidental problems of patients with schizophrenia. After the campaign news on the disease itself appeared in mass media. The Madrid experience shows that the WPA Program strategies, based on doing population research and adapting the campaign to local needs, are most appropriate and that an anti-stigma campaign can be carried out with succes. The same experience has been repeated in the year 2000 and part of 2001 in the whole of Spain. Health authorities of the Autonomous Community of Madrid, the City Council, the Department of Health and Consumption and the Department of Social Affairs and the INSALUD (National Institute of Health) were very helpful with the campaign. The program is supported by an unrestricted grant by Eli Lilly and various institutions and foundations have also collaborated.