b.23 December 1916 d.9 December 2003
BA Cantab(1938) MB BChir(1942) DPM(1949) MD(1950) MRCP(1965) FRCPsych(1971) FRCP(1976)
Peter Sainsbury's research career began when Sir Aubrey Lewis [Munk's Roll, Vol.VI, p.284] discovered his interests were suicide and psychosomatic disorder. Sainsbury was then a senior registrar at the St Francis Hospital observation ward in East Dulwich and Lewis visited each week to select patients for the Maudsley Hospital in nearby Camberwell for postgraduate teaching. Lewis drew Sainsbury's attention to the research potential of combining coroners' inquest notes and H L Smith's Survey of London life and labour to investigate the social relations of suicide. Appointment as a registrar at the Maudsley Hospital and subsequently as a clinical research assistant at the Institute of Psychiatry (from 1949 to 1954) resulted in clinical and research training and allowed Sainsbury to complete his MD and write Suicide in London (London, Maudsley Monographs, 1955), a minor classic, still cited.
In 1957, while on a shared lecture platform, Lewis leant across to Sainsbury and asked if he would like to become director of the Medical Research Council's clinical psychiatry research unit at Graylingwell Hospital, Chichester. Amazed, he accepted. The unit, started by Joshua Carse, the medical superintendent of Graylingwell, just before the inception of the National Health Service in 1947, when mental hospitals were a local authority responsibility, was continued by the Ministry of Health. Erwin Stengel [Munk's Roll, Vol.VI, p.415] and Martin Roth were directors. The Graylingwell unit survived the Ministry's 1950s cull, becoming part of the Medical Research Council. Sainsbury succeeded Roth in 1957 and remained director until he retired at 65 in 1982.
When Sainsbury was appointed, the mental hospital was the setting for psychiatric research in Britain. There were few academic departments of psychiatry, the clinical arena was the mental hospital, where there was optimism because of service reform and novel drugs. The MRC increased its support for mental disorder research and the Graylingwell unit benefited. The unit director was given independence to decide the research programme within a budget. With this freedom from the tyranny of grant application, Sainsbury undertook research using clinical observation, epidemiology and electrophysiology. Much of this resulted from the hospital setting. For instance, Sainsbury saw that the avoidance of admission with 'care in the community', an approach pioneered at Graylingwell, needed evaluation. This was achieved with an elaborate, prospective comparison of the services at Chichester with those at the more traditional Salisbury, a nearby cathedral city with a similar population. The study became famous, resulting in many international visitors.
The high suicide rate of patients maintained Sainsbury's interest in suicide. There were inquiries on the ill health of suicides, their social setting, the aftermath, predictive scales, accuracy of suicide statistics and preventive measures. This continued throughout Sainsbury's directorship and he became an internationally recognised authority, advising the World Health Organization (WHO). His interest in physiology spawned studies of movement, the persistence of high blood pressure after the stress of mental illness and spectral analysis of the EEG.
Sainsbury had an original mind. An example is his disposal of the criticism that suicide rates were useless because of ascertainment error. He used a method conceived in anger on a return flight from Geneva, where suicide statistics had been rubbished at a WHO seminar. He showed the rank order of the suicide rates of immigrants to the United States was the same as the rank order of the rates of their country of origin. The different ascertainment procedures had had no effect. Suicide rates took on a new validity after Nature published this result in 1968.
Sainsbury, born in Horsham, West Sussex, was the second of the three children of Arthur Pomroy Sainsbury and Isobel Gertrude née Thompson. His father, a fashionable West End dentist, was fond of drama and theatre people were frequent visitors to their Horsham home. In 1931, after preparatory school, Sainsbury entered Stowe School for four years. The glorious house and grounds of Stowe instilled in him a lifelong love of architecture and landscape, which found a small expression in his own house and garden. The educational atmosphere created by J F Roxburgh, Stowe's founding headmaster, suited Sainsbury and he flourished. In particular an appreciation of language induced by his English master T H White, author of Arthurian novels, resulted in Sainsbury's own lucid and stylish prose.
In 1935, he went up to Trinity College, Cambridge, to read medicine and in 1938 took a BA, before going on to the Middlesex Hospital Medical School for clinical studies, graduating in 1942. The anti-fascist and left wing politics of pre-war Cambridge attracted him and he remained, to the end, committed to the National Health Service. He did not forget The Times' pre-war appeasement policy and still refused to read it 20 years on.
After junior posts at Addenbrooke's and Bury St Edmund's Hospitals in 1941 and 1942, Sainsbury joined the RAMC. He was commissioned as a lieutenant in 1942 and left for Burma. A stop at Sierra Leone resulted in malaria and he stayed at Freetown for 18 months as a recruiting officer. There followed periods in Belgium and France, before he left the army as a captain in 1945.
Opting for psychiatry, Sainsbury became an assistant medical officer at Bexley and Guy's Hospitals (from 1946 to 1947), before moving to St Francis Hospital as a senior registrar. In 1949, he joined the Maudsley Hospital as a registrar on the professorial unit and then moved on to the Institute of Psychiatry as a clinical research assistant investigating movement with cinematography. In 1954, he went to the Westminster Hospital as a clinical assistant, resigning in 1957 for the MRC post. He now had the clinical experience and research training for his new position.
As a unit director, Sainsbury served on MRC advisory committees. These were the clinical psychiatry committee, of which he was secretary and which conducted the famous trial of anti-depressant treatments (1958 to 1967), the epidemiology of mental disorders committee (1958 to 1967), the working party on the epidemiology of drug dependence (from 1967 to 1969), which arose from the heroin epidemic at Crawley, the clinical research board (grants committee) (1970 to 1971) and the working party on parasuicide (1980 to 1982).
Sainsbury was a strong supporter of the Royal College of Psychiatrists and its precursor, the Royal Medico-Psychological Association, seeing them as vehicles to promote research and a scientific approach to treatment. He was secretary of the research and clinical section (1963 to 1965) and its chairman (from 1965 to 1971). He became a foundation fellow of the College in 1971, was vice-president from 1975 to 1977 and was made an honorary fellow in 1983. The misuse of psychiatric treatment to silence dissidents resulted in the College having a special committee on the political abuse of psychiatry. Sainsbury was its chairman from 1978 to 1987 and interviewed exiled dissidents.
Other distinctions included being made president of the Royal Society of Medicine section of psychiatry (1972), Mayne Guest professor, University of Queensland (1972), and consultant to WHO, World Health Assembly (1974).
Sainsbury married in 1942 Ruth, daughter of Edmund Ahrend and Juliana née Tödter. Ruth was born in 1919 on Nordeney, an East Friesian island, where her father was an electrical engineer. The Ahrends left Germany for Australia via England in 1939 because of German racial persecution.
In 1963, Sainsbury purchased Pondfield, several acres of farmland at Cutmill, an unmarked hamlet at the head of Bosham Channel, part of Chichester Harbour. Here he lived for the rest of his life in "the smallest great house in England", as he referred ironically to the home he built there to his own highly original design. From the upstairs lounge the spire of Bosham Church, where Canute's daughter is buried, is visible through a gap in shelter pines. Around the house he planted a fine garden of English and exotic trees and shrubs. The Sussex landscape, Weald and Down, gave him much pleasure as he sped forward on foot or drove in his Austin-Healey.
Charm was Sainsbury's most striking personal characteristic. With his alert, attractive face and welcoming smile, he made everyone feel he was pleased to see them and intensely interested in what they had to say. This made him a graceful host at the many parties he and Ruth held at Pondfield for staff and international visitors to his unit.
Brian Barraclough[References:Brit.med.J.,2004,328,1442; The Guardian 24 Feb 2004]