There are many kinds of adult adversities that can provoke severe psychological distress, including debt and unemployment, dysfunctional marital relationships and occupational stress. The reality is that the social causes of mental ill-health are all around us.

Countries with the best-resourced medical services have the best outcomes for physical illness (it is better to have a heart attack in Washington or London than in rural Africa) whereas precisely the opposite is the case for mental illness (developing nations with limited psychiatric resources have better outcomes and lower suicide rates).

Childhood trauma is not necessarily a prophecy of doom, because some children are resilient or because later experiences help to restore mental health.

Conventional psychiatry has emphasized the genetic roots of psychosis based on the claim that twin and other studies show that schizophrenia is 80% heritable, which means that 80% of the cause is genetic.

At the individual level, if we can identify the psychological mechanisms linking adverse environments to psychosis (and there has been a lot of progress with this despite minimal funding) we should be able to devise more effective interventions for those who are already ill.

Since the Second World War, rates of common mental illness (depression and anxiety) have been increasing in the industrialized nations, whereas rates of recovery from severe mental illness have not improved despite the availability of apparently effective therapies such as antipsychotic drugs.

The only way you can estimate environmental influences is by measuring them.