A historical overview
11.6 Framing the future
ensuring that the available housing for people with mental illnesses will be mainly located in neighbour- hoods that do not have the clout to exclude this feared group from their midst.
Should these considerations change our viewpoint about policies to reduce violence among individuals with mental illness? Perhaps the most effective intervention of all would be to make adequate care available including supported housing in safe neighbourhoods. This policy would, at the same time, tend to reduce substance abuse and psychotic symptoms, which are among the important risk factors for violence that have been identified among mentally ill individuals. In addition, it might behoove us to address the antecedents of current policy, and advocate for change societal attitudes towards mental illness.
studies. Causation is rarely immediate; identifying the relevant causal factors will require a deeper understanding of how we develop liability to mental disorders, and mindfulness of a pathogenic trajectory over the life course, and perhaps over the life course of parent, children and grandchildren.
Classical epidemiology before the primacy of mul- tivariate methods is replete with examples of strategic inquiry focused on evaluating explanations for dis- ease causation. Clever tests help us decide whether a causal explanation is consistent with observed facts or inconsistent with those facts. These examples from classical epidemiology tell us we need two things together: causal explanations and informative tests of those causal explanations. We need to bring this aspect of classical epidemiology to the new focus on multiple levels of inquiry.
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12 Studying the natural history of psychopathology
William W. Eaton
Department of Mental Health, Bloomberg School of Public Health, John Hopkins University, Baltimore, MD, USA