Interview with John Sawkins: A Critical Voice in Psychiatry

John Sawkins gained an interest in thinking through the issues of mental health when he had a break down at the age of 52. He worked full time as a lecturer and taught for thirty years. Subsequently he made up his mind that he was going to recover from the break down and returned to work full time again in teaching for nine years.


Since then he always kept an interest in psychiatry and psychology. Through getting involved in various voluntary organisations such as VOX (Voice of Experience:, and See Me (, he tried to find some way of changing things. He didnt feel that being part of membership of committees and things was going to change anything, and so he started getting involved in various subgroups.
One of these subgroups was working with the Royal College of Psychiatrists. Initially he thought it was like walking into the lions den where the situation was him and 24 psychiatrists. At first it was very daunting but gradually they accepted him, and rather than be antagonistic all the time he felt it was important to find common ground.

He has been doing that for about seven years now, and for the last five years he has been involved in the ethics committee of the Royal College of Psychiatrists down in London. There he gives a service user perspective on various issues, where he does feel that the ideas have been taken on board and listened to.
Ethical issues he explores include the way that older people are treated and marginalised. The idea that older people are not expected to have something to contribute is a recurrent issue, but whereas because someone might have far more time on their hands older people are in a good position to contribute – and he says, they should be doing so.
With dementia in Scotland, at the age of 65, and if you end up in hospital, the doctors will automatically administer a test to see if you have got dementia or not. The issue lies in the fact that it is a very very short A4 sheet of paper and asks things like ‘can you recite the months of the year off backwards?’. And these are the kind of things are are used to determine what your mental state is.
Originally they would use an American test, however they stopped that because it cost them money every time they used it so they devised their own. The American one had things like, ‘starting at 100 I want you to keep subtracting seven from that’… but for some, that is not an easy thing to do as they have not got mathematical minds.

In England, the age is 75 when people get referred. He also discovered that in England, doctors and medics get paid for referring people who they think have got dementia. So they get a bonus – a carrot to incentivise testing people. In Scotland he says it is the stick; if you as a medic are not reaching your targets you get your fingers rapped…

These are some of the issues which he has been raising through the ethics committee, and in the interview he talks about many of the aspects which he thinks should be examined and questioned. Along with the interview he shared a reading list that he thinks is good to inform people around the nuances of analysing mental health.

Recommended Reading List: