As head of empowerment and social inclusion at the Mental Health Foundation, David Crepaz-Keay is in a good position to talk about 'living with schizophrenia', the focus of this year's World Mental Health Day on October 10.

Perhaps what qualifies him most though, is that he himself has been "living with the diagnosis of schizophrenia" for 35 years, since his teens.

When that label was first slapped on him, he admits he thought his life was over. "My experience of living with that diagnosis has changed a lot over the years, but there's still a long way to go," David notes.

Despite being one of the most common serious mental illnesses, schizophrenia remains one of the least understood; lots of people still associate it with the very damaging - and inaccurate - notion of a 'split personality'.

Schizophrenia does involve a range of difficult and distressing symptoms, though, including hallucinations (visual and auditory), delusions and paranoia, confusion and behaviour changes. The illness tends to present in episodes - a person might withdraw from usual activities, seem unable to communicate 'normally' and feel emotionally 'flat', with varying degrees of psychosis. Symptoms can also be ongoing and constant. However, more than 50% of people diagnosed cannot access adequate treatment; something David, among many others, would like to see change.

Here, he outlines three other key areas to improve life for schizophrenics...

:: Public awareness and understanding has a long way to go

"Society has moved a long way in attitudes towards all kinds of things over recent decades, but the way people tend to respond to schizophrenia hasn't changed much. We've seen enormous shifts in the way bipolar disorder is perceived, with high profile people like Catherine Zeta Jones and Stephen Fry talking about their experiences of it, and attitudes have moved on significantly in a positive direction. We just haven't seen this happen with schizophrenia."

Understanding of depression has also improved; it's now regularly discussed in mainstream media and, generally, more openly talked about - but the same can't be said for schizophrenia.

"If you ask people what the characteristics of schizophrenia are, people will associate it with things like violence. If we only hear about schizophrenics [in the context of] going around with machetes, then you are going to be worried. But around one person in every 100 is diagnosed with schizophrenia, so that's about 600,000 in the UK alone. If they were all going around committing homicides, you'd notice - it isn't happening.

"Being more aware of the people with schizophrenia, who are leading successful or even ordinary lives - having families, holding down jobs - that sort of thing, would be very useful for increasing awareness, reducing isolation after diagnosis and helping move us away from that stigma."

:: Being diagnosed with schizophrenia is not a life sentence

"Typically, people are diagnosed when they're in their teens and twenties, and there isn't really anything that prepares you for it. It has a devastating impact. Part of what we're trying to achieve is to avoid this notion that the diagnosis of schizophrenia is a life sentence, or a death sentence, because when I was young, it was all about what you can't do. World Mental Health Day is a really good opportunity to try and encourage people to think positively."

David was studying to become an economist when he was diagnosed. He recalls how suddenly, expectations of what he would achieve dropped significantly, particularly among medical staff. The label of schizophrenia had overridden everything else about him; his intelligence, his interests, his potential... This is still an issue for a significant majority of people affected by schizophrenia today, and while awareness has a big role to play in helping move forward from this, so too does continuing to improve approaches and access to treatment and services.

David, of course, has defied the expectations of that label, both personally and professionally. He did qualify and work as an economist, including a long stint working for the treasury, before eventually focusing on the mental health field, now with a key role within a leading organisation. He isn't the only person diagnosed with schizophrenia who has accomplished a fulfilling work and family life - but a belief that this is even possible is still often lacking, and the ingredients necessary to facilitate it - including effective approaches to treatment, support networks and motivation - also too often fall short.

"One of the things that made a big difference for me," David recalls, "was a woman who worked for a local charity, who came to the hospital where I was, and told me to get off my backside and stop being a mental patient! I'm not going to prescribe that for everyone, of course, but it was what I needed."

:: Focusing on managing, rather than 'curing', means we can be more ambitious

It's difficult not to get hung up on the idea of a cure, or being able to 'switch off' chronic illness. Often though, this isn't possible, and while continuing to fund research into understanding and treatments for a range of illnesses is crucial, so too is making the most of methods that are within reach. Shifting the emphasis to 'managing' symptoms, and finding effective ways of living with them, is one of the most vital elements of treatment for a wide range of illnesses, both mental and physical - including schizophrenia.

Drugs are important, but even when they're effective, they don't 'solve' the challenges of schizophrenia, or necessarily do much to help somebody achieve a decent quality of life. "In the UK, we've come a long way in terms of making talking therapies [like CBT, counselling-based therapies and workshops] much more accessible, particularly for people with depression and anxiety. We haven't really followed that pathway so much with schizophrenia, but that could make a big difference," says David.

At present, he notes, only about a third of people diagnosed are considered as being effectively treated. Self-management and peer support models, however, can have very positive outcomes, and David believes this should be the way forwards. "The ideal approach to treatment is a highly individual thing," he explains. "With self-management and peer support, a big focus is goal-setting and problem solving - you come up with your own goals, and then collectively, as part of the peer group, work towards achieving them."

What those goals are is highly subjective, but two of the most common ones, David notes, are giving up smoking and losing weight - the same as for much of the general population. Somebody's goal might be finding a job, while another person's might be coping with social situations that presently cause distress. "The goals aren't just about 'treating schizophrenia', they're about having a better life, despite the fact you've got the diagnosis."

Lots of people - and very often, doctors - are concerned about managing expectations after a diagnosis. The bigger problem though, David notes, is not being ambitious enough. "People tend to drop out of the habit of thinking they can do stuff," he explains. The same can apply to families and parents who, very understandably, may have a tendency to be over-protective.

"I imagine I was a nightmare [for my parents], and if you throw in the diagnosis of schizophrenia, regularly ending up in hospital, then you can see why parents would want to be protective and risk-averse.

"It takes quite a lot of work to get people to reframe their attitude and encourage people to develop and move on, and there are some great organisations out there that support families. There's always a risk, and letting go of that protectiveness is something every parent has to work through. It's even more difficult to work through [if your child has schizophrenia], but it is important."

:: For more information, visit www.mentalhealth.org.uk

:: For mental health support, visit www.mind.org.uk