Mental health clinicians’ beliefs about the causes of psychosis: Differences between professions and relationship to treatment preferences

The ontology of mental health problems is an area of long standing debate. This has been
fuelled by strong claims of a genetic basis to mental health problems, particularly in
relation to the more serious difficulties such as schizophrenia and psychosis (John,
Thirunavukkarasu, Halahalli, Purushottam, & Jain, 2015). The result of this biological
framework has influenced practice at a service-level, with medication the primary
treatment offered to this client group. Although neurobiological and genomic research
has substantially progressed over the past decade, findings have also provided strong
evidence for the role of environmental factors. Deprivation, trauma, social isolation,
urbanicity and adverse childhood experiences have all been associated with the onset of
psychosis (Cohen, 1993; Read, Van Os, Morrison, & Ross, 2005; Van Os, 2004). Given
the evidence-base, psychosis is now considered by many experts in the field to be the
result of a complex interaction of biological and environmental factors, for which the
relevance of these differs for each individual. As a result, an integrative approach to
treating psychosis is now endorsed by some clinical guidelines, with a recommendation
that everyone be given a comprehensive, multidisciplinary assessment and be offered
both antipsychotic medication and psychosocial interventions (NICE, 2014).