This attitude, to which family members of sufferers and even sufferers themselves may also succumb, diminishes their chances of finding employment, marrying, owning a home or getting help from neighbours. In our country, despite efforts to reform psychiatric care, the standard of care for mental illnesses is at a lower level than for somatic illnesses.

The lack of acceptance of people with schizophrenia is due to many misleading and hurtful stereotypes e.g.:

• Schizophrenia is always an "incurable" illness and always runs a negative course
• Schizophrenic patients are usually aggressive and dangerous.
• Schizophrenic patients can infect others with their madness.
• Schizophrenic patients are lazy and cannot be relied upon.
• Schizophrenia is the result of a conscious weakness of will and character ("The patient could shake it off if he only wanted to").
• Schizophrenic patients always talk 'out of turn'.
• Schizophrenic patients are completely incapable of making rational decisions about their own lives (e.g. where to live).
• Schizophrenic patients are always unpredictable.
• Patients with schizophrenia are unable to work effectively.
• The condition of schizophrenic patients is constantly deteriorating.
• Parents are blamed for schizophrenia.

It was in opposition to these opinions that psychiatrists launched the 'Schizophrenia - Open the Door' programme in 1996 at the World Psychiatric Congress in Madrid . The first pilot project was initiated in Alberta, Canada. Following the first positive results of the Canadian programme, similar actions were developed in Austria, China, Egypt, Germany, Greece, India, Italy and Spain. In each country, the programme is coordinated by a committee made up of psychiatrists, patients, family members of sufferers, journalists, politicians, teachers and social activists.

The campaign 'Schizophrenia - Open the Door' has been running in Poland since September 2000. Its aim is to improve the social perception of schizophrenia and to deepen tolerance in our country for mentally ill people. The programme "Schizophrenia - Open Doors" is run in cooperation with the World Health Organisation (WHO) and in Poland by the Board of the Polish Psychiatric Association. The programme has received the patronage of the Ministry of Health, the Ministry of Labour and Social Policy and the Ministry of Education. It was developed with the support of a research grant from the Lilly Company.

For years, a number of teams in Poland have been conducting training, research and organising symposia on schizophrenia. The programme "Schizophrenia - open the door" aims in the first stage to integrate our communities and to create an "intellectual community", a broadly connected opinion-forming environment so that our common message will have a strong resonance in public opinion and truly lead to a breakthrough in attitudes and prejudices towards mentally ill people. The immediate aim of the programme is to challenge the stigma and discrimination against people with schizophrenia by educating many sections of society - schoolchildren, clergy, patients and their families, psychiatrists and GPs - and working closely with the media on a new, closer to the truth image of the mentally ill person in society.

Programme structure

In order to guarantee the long-term development of the programme and its nationwide coordination and cooperation with the WPA, it was decided to implement the project according to the schedule required by the World Psychiatric Association.

In January 2000, the PTP Board appointed a programme coordinator who organised a 'planning group' for the programme (according to WHO terminology, the 'Initial Planning Group'). This group formed the Association for the Advancement of Psychiatry and Community Care, one of whose statutory objectives is to implement the programme "Schizophrenia - open the door". In the first phase of the project, we invited individuals, associations and institutions involved in schizophrenia from four regions: Silesia, Lesser Poland, Mazovia and Podlasie.

In the next step, the group of regional coordinators of the 'Schizophrenia - Open the door' programme was expanded in successively included regions:

• Silesia region - Krzysztof Czuma
• Małopolska Region - Anna Bielańska
• Mazovia Region - Joanna Meder
• Podlasie Region - Leszek Sagadyn
• Lubuskie Region - Władysław Stern
• Kujawsko-Pomorskie Region - Aleksander Araszkiewicz
• Wielkopolskie Region - Barbara Trafarska
• Opole Region - Krzysztof Nazimek
• Łódzkie Region - Edward Patura-Szost
• Lublin Region - Tadeusz Młynarczyk
• Pomerania Region - Roman Ludkiewicz
• Lower Silesia Region - Ewa Bartecka-Piłasiewicz
• Świętokrzyskie Region - Renata Mirosławska-Masternak
• Subcarpathian Region - Joanna Górecka
• West Pomerania Region - Agata Lisiecka
• Warmia and Mazury Region - Tadeusz Ciborski

In addition to the regional coordinators, the coordinators of projects and tasks resulting from the substantive objectives of the programme were also asked to cooperate.

• Anna Bielanska - cooperation with the media
• Jacek Wciórka - research into attitudes towards the mentally ill
• Maria Pałuba - 'Together in Life and Art' programme in the regions
• Józefa Grodecka - coordination of cooperation with Social Welfare Centres in the regions - "To heal, live and work in the municipality" programme
• Hubert Kaszyński - communal and regional work programmes for mentally ill people
• Agnieszka Lewonowska - cooperation with NGOs
• Zofia Puchelak/Andrzej Warot - cooperation with Family Associations
• Małgorzata Kawula - cooperation with the Patients Association "Open the door"
• Bogdan de Barbaro - coordination of training for family doctors
• Jarosław Naliwajko SJ - coordination of cooperation with the "Church" and training for seminarians
• Irena Namysłowska/Ewa Domagalska - coordination of cooperation with "School" and training for teachers
• Joanna Meder - cooperation with the chairs of the PTP sections with the aim of introducing "psychotherapeutic standards for the treatment of schizophrenia"
• Andrzej Cechnicki/Maria Rostworowska - coordination of the "early treatment and relapse prevention in schizophrenia" programme

The "National Coordinators' Group" (according to WHO terminology "Local Action Group") is responsible for the substantive implementation of the Programme, which consists of regional coordinators, persons leading the coordination of individual tasks and the chairs of the PTP Sections cooperating with the Programme.

Substantive programme

The substantive aim of the Programme is to challenge stigma and discrimination against people with schizophrenia; it includes four areas of action:

1. Cooperation with the media
2. Educational programme
3. Practical actions
4. Attitude survey

Cooperation with the media

Cooperation with the media implemented in both national and local programmes, based on the experience gathered so far by the institutions and individuals invited to cooperate within the "National Coordinators Group". One of the objectives is to establish a common language accessible to the non-professional listener - with which, we professionals will talk about the disease - its causes, course and treatment. We are disseminating 10 generally accepted theses about schizophrenia across the country. This also means regular radio and television programmes, publications in the local and national press. Articles in the local press or radio should be presented from the perspective of the patient, family and professional. It becomes an important task to work with patients who will be willing to 'give their voice' or present 'their face' in the media. It is planned to prepare a short, informative film for television "Schizophrenia - open the door" and a poster campaign throughout Poland. The slogan for 2001 was: "Schizophrenia is not an incurable disease".

An important task is to prepare and publish an information booklet on schizophrenia, which would be easily accessible throughout Poland and contain basic information about the illness in order to overcome existing stereotypes and myths. There are also plans to put the most relevant information about schizophrenia and its treatment on the Internet.