Background Schizophrenia isknown to be associatedwith a range of adverse outcomes, whichhave animpact atthe

Declaration of interest None. The asylum movement of the 19th century could be regarded as part of a state-guided sanitary movement to cleanse society of the harmful impact of those with mental illness. Although stigmatisation and fear were instrumental in this process, there is now strong evidence for genuine adverse outcomes of schizophrenia on society. Deinstitutionalisation and community care, which have become widespread since the 1970s, have re-exposed the general public to such outcomes, accompanied by a fear of violence, and particularly homicide perpetrated by people with schizophrenia, fuelled by media attention. Suicide and self-harm are much more prevalent outcomes in this group, however, and victimisation of people with schizophrenia is especially neglected. Substance misuse, unemployment and homelessness are also prevalent outcomes of public concern. The prevalence and risk factors for each of these six adverse outcomes in schizophrenia will be reviewed, with an examination of the contribution to society as a whole. There are few validated instruments for measuring these ‘societal outcomes’, but their assessment at both the individual and population level will be considered.