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Goldberg and Huxley’s model revisited

Royal Edinburgh Hospital

Amanda Cotton, Senior House Officer

Royal Edinburgh Hospital

Allan Scott, Consultant Psychiatrist

Andrew Duncan Clinic, Royal Edinburgh Hospital, Morningside Terrace, Edinburgh EH10 5HF

We were interested that a recent editorial in The Lancet used a model of referral to specialist psychiatric services from 1980 (Peen & Dakker, 2004). The original model (Goldberg & Huxley, 1980) has been refined (Goldberg, 1995). One important prediction it makes is the number of adults who will be in contact with the totality of specialist mental health services. We decided to test the relevance of this model for north-east Edinburgh in 2003.

We received 1390 new referrals from the population aged 18-64 years inclusive. (Our records were hand-searched to ensure each individual was counted only once.) This is equivalent to 2.3% of the catchment population in 1 year, or 230 people per 10 000 population (95% confidence interval 220-240). The model predicts a figure of 208 adults in contact with the totality of specialist mental health services.

We conclude that the model substantially underestimated the utilisation of specialist psychiatric services. It would take a great deal more work to calculate the variance; we would have to add to the patients newly referred, patients already known to our own service, services for the elderly, NHS psychotherapy, and clinics for people with alcohol, drug and eating problems.

We do not know to what extent our findings can be generalised. We only hope that those who purchase general adult psychiatric services are not doing so on the basis of this model.

References

GOLDBERG, D. (1995) Epidemiology of mental disorders in primary care settings. Epidemiologic Reviews, 17, 182 -190.[Free Full Text]

GOLDBERG, D. & HUXLEY, P. (1980) Mental Illness in the Community: The Pathway to Psychiatric Care. London: Tavistock Publications.

PEEN, J. & DAKKER, J. (2004) Is urbanicity an environmental risk-factor for psychiatric disorders? The Lancet, 363, 2012 -2013.[CrossRef][Medline]

This article has been cited by other articles:

				T. O'Sullivan, R. Batra, M. Nolan, and A. Scott Goldberg and Huxley's model 27 years on Psychiatr. Bull., August 1, 2007; 31(8): 316 - 316. [Full Text] [PDF]

This Article Full Text (PDF) Submit an eLetter Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by O’Sullivan, T. Articles by Scott, A. Search for Related Content PubMed Articles by O’Sullivan, T. Articles by Scott, A.