I agree that the term ‘salience’ may appear obscure at first glance but let us analyse the issue in more detail. The term ‘schizophrenia’ is stigma-inducing because it confusingly and mystifyingly refers to a disease that is characterised by a ‘split mind’ – a psychological state that the public cannot personally relate to. This is different from, for example, depression, as virtually every member of the public knows that depression is about a negative emotional state that they themselves may also experience on a daily basis, albeit to a lesser degree. Say we were to call schizophrenia ‘reality distortion syndrome’ or ‘integration dysregulation syndrome’. Although the meaning of the words would certainly be clear to the general public, the problem is that these names may paradoxically also result in stigma because the people cannot relate to a universal psychological function of ‘reality’ or ‘integration’. How long will people talk to somebody at a party who ‘cannot see reality’ or is ‘not integrated’? In other words, I do not think that it is the degree of immediate and easy recognition that is important for a new name for schizophrenia, but (a) the potential of the new name to teach the general public about the experiences we call psychotic, based on (b) a scientifically valid model and (c) an aspect of psychological experience that everybody can relate to. The reality is that this is never going to be easy and cannot be solved by an appealing name alone. Salience is about how internal or external stimuli can become attention-grabbing and how this, if it is not willed, can lead to perplexing experiences that result in a search for an explanation that we subsequently call delusions. There may be some explaining to do, but maybe not an impossible message to convey.

In conclusion, I feel it is not so much important whether or not a new name is immediately clear to everybody, but whether it has got potential to make people recognise it as relating to an aspect of psychological experience that is universal. Salience may be a vehicle to teach the general public about the experiences we call psychotic. The second issue is that it may be important to move on from criticising the term schizophrenia to systematically proposing alternatives. The reason that the cogent scientific reasoning by people such as Herman van Praag, ^{Reference van Praag1} Mary Boyle, ^{Reference Boyle2} Richard Bentall ^{Reference Bentall, Jackson and Pilgrim3} and Ian Brockington, ^{Reference Brockington4} and many others did not have an impact on DSM–IV and ICD–10 may be because an alternative was never proposed. This is why I started with an alternative, not just a criticism of the term schizophrenia.