Oliver James was right about one thing: his lengthy essay on new research into the cause of schizophrenia has indeed proved "deeply upsetting" and "infuriating" (Think again, October 22). This is not because childhood abuse and subsequent trauma aren't important psychiatric topics to bring to the fore, but because of the way in which he presented his critique.

Essentially his argument, despite his "caveat" that it is not about blame, is that parents - mothers who deliver "early infantile deprivation and erratic or unresponsive care", and fathers who "account for much of the abuse" - cause schizophrenia. James draws on "tectonic plate-shifting evidence" published in November's edition of Acta Psychiatrica Scandinavica by John Read and others. Read's paper is an important meta-review of more than 50 articles, exploring the role of childhood trauma in the development of schizophrenia and psychosis. James's own position on this subject is reflected in the title of his book, They F*** You Up - How to Survive Family Life.

The mental health field has been here before. The anti-psychiatry movement of RD Laing in the 1960s rejected the concept of schizophrenia as an illness and set out to blame the parents. It was an approach that was discredited when it didn't explain people's experiences or help in recovery. Far more effective were practical techniques exploring the dynamics of family relationships such as psycho-social family therapy. Unfortunately, the stigma generated by Laing's assertions is still being felt by carers and service users, although these experiences are being addressed. A near decade of increased health and people-centred social care spending, and advances in drug and talking therapies, offer hope of recovery for those being diagnosed today. The risk for families of people with schizophrenia is that articles such as James's will breed new stereotypes. His caveats will be lost as the public grasp his central, but erroneous, message: childhood trauma causes schizophrenia.

The question of what causes "schizophrenia" remains open. Schizophrenia is a collection of severe and disabling symptoms; be identified with enough of them and you have it.

There is no single identifiable cause - most people recognise that genetic make-up, foetal development and socio-environmental factors such as poverty can produce a predisposition or increased risk of developing the symptoms - but it takes something else to trigger its emergence. Bereavement, stressful life events, cannabis use, and abuse (emotional and physical) can all be that "something else".

So let's have a real debate about how the care and treatment of some of the most disadvantaged can be improved, rather than creating new stereotypes. Let's ensure that people with mental health problems who have been abused in the past receive the help and support that they need. It is important for mental health services to continue developing holistic packages of care with the person at the centre of treatment decisions, rather than resurrect a sterile 40-year-old debate that searches for a single cause where none is likely to exist.

· Dr Vanessa Pinfold is head of research and policy for the mental health charity Rethink. Email: info@rethink.org

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