Hostname: page-component-7c8c6479df-995ml Total loading time: 0 Render date: 2024-03-28T09:59:19.281Z Has data issue: false hasContentIssue false

Goldberg and Huxley's model 27 years on

Published online by Cambridge University Press:  02 January 2018

Treasa O'Sullivan
Affiliation:
Andrew Duncan Clinic, Royal Edinburgh Hospital, Morningside Terrace, Edinburgh EH10 5AF
Ravneet Batra
Affiliation:
Andrew Duncan Clinic, Royal Edinburgh Hospital, Morningside Terrace, Edinburgh EH10 5AF
Margot Nolan
Affiliation:
Andrew Duncan Clinic, Royal Edinburgh Hospital, Morningside Terrace, Edinburgh EH10 5AF
Allan Scott
Affiliation:
Andrew Duncan Clinic, Royal Edinburgh Hospital, Morningside Terrace, Edinburgh EH10 5AF
Rights & Permissions [Opens in a new window]

Abstract

Type
Columns
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
Copyright © Royal College of Psychiatrists, 2007

Over 25 years ago Goldberg & Huxley (Reference Goldberg and Huxley1980) proposed a widely recognised pathway to psychiatric care. This model, which has since been refined (Reference GoldbergGoldberg, 1995), predicts that 20.8 adults per 1000 population per year will be in contact with specialist mental health services. We have previously demonstrated that this model underestimated the utilisation of specialist psychiatric services in North East Edinburgh in 2003 (Reference O'Sullivan, Cotton and ScottO’Sullivan et al, 2005). We decided to resurvey referrals in the same area for 2005 to attempt to replicate our findings.

We recorded all new referrals from general practitioners (GPs) to mental health services among those aged 18–64 years in our sector. This included general and specialist psychiatric services, namely clinical psychology, psychotherapy, addictions and eating disorder services. Given the emphasis on social factors in the original model, we checked for a correlation between the levels of deprivation as measured locally by the Scottish Index of Multiple Deprivation (SIMD; http://www.scotland.gov.uk/Topics/Statistics/SIMD/Overview) and referral rates from individual GP practices.

There were 1541 new individual referrals of those aged 18–64 years, which is equivalent to 24.6 per 1000 catchment population per year (95% CI 24–26). New referrals alone exceeded the number predicted in the model. Spearman's rank correlation coefficient between the SIMD score of individual practices and referral rate was 0.44.

In an atmosphere of continual change in the National Health Service, we urge service planners to be mindful of the gross underestimation of current referral to psychiatric services by Goldberg and Huxley's model.

References

Goldberg, D. (1995) Epidemiology of mental disorders in primary care settings. Epidemiologic Reviews, 17, 182190.Google Scholar
Goldberg, D. & Huxley, P. (1980) Mental Illness in the Community: The Pathway to Psychiatric Care. Tavistock Publications.Google Scholar
O'Sullivan, T., Cotton, A. & Scott, A. (2005) Goldberg and Huxley's model revisited. Psychiatric Bulletin, 29, 116.CrossRefGoogle Scholar
Submit a response

eLetters

No eLetters have been published for this article.