Julian Leff's parents, both committed Marxists and instrumental in the setting up of the British National Health Service, initially tried to dissuade him from studying medicine. They believed that environmental improvements would soon eliminate the causes of disease and so make doctors redundant. This incredible optimism of socially oriented thinkers of the 1950s and 1960s has given way to pessimism about the ability of society to prevent mental illness. This shift was partly due to the increasing encroachment of biological perspectives during the 1980s and 1990s.

Leff's purpose in writing this book is to temper the Orwellian view of the future apparently promised by the supposed increased control over behaviour made available to us by the unravelling of the human genome and the new insights into brain structure and function provided by medical imaging.

The book builds an argument in favour of the importance of social causes of mental illness and in the final chapter uses the tools assembled to tackle the contentious issue of whether the higher rates of schizophrenia found in African—Caribbeans in Britain are due to social or biological factors.

This is an even-handed antidote to biological psychiatry, with Leff content to present data and accept that definitive explanations await further research. For example, the intriguing Dutch National Psychiatric Case Register study, which found that being born and brought up in a densely populated city doubles the risk of developing schizophrenia in adult life, is used, as are all the studies quoted, to illustrate both biological and social theories.

Ultimately, Leff's vision of the future of psychiatry is one that depends not on technical advances in making images of the brain or replacing bad genes with good ones, but on increasing our understanding of relationships between people. He presents a simple formula for calculating the number of relationships generated by the people who are close to us. It isn(n — 1). Using this equation, we find that a couple with three children and their partners have 56 relationships between them. Leff argues that no simple one-to-one correspondence between genes and behaviour could encompass the interactions in even a small network of people.

Leff is also influenced by psychoanalytic thinking and he points out that Donald Winnicott once made the challenging statement that there is no such thing as a baby. He meant, of course, that a baby cannot survive on its own but needs the nurture and care provided by other people. So, to look for the causes of mental illness in one brain or gene ignores the social network in which these phenomena exist and is ultimately misguided.

This easy-to-read, erudite and entertaining guide to where social psychiatry is at the moment is essential for anyone involved in psychiatric research or clinical work. Its arguments, ranging from Shakespeare to serotonin, left me with the insight that, in fact, there is probably also no such thing as a social or a biological psychiatrist. Psychiatry is too complex to be categorised in this way and this book, unusually wide-ranging for a product from a specialist, explodes the attempts to divide and pigeonhole the subject.