Mental illness in the community: The Goldberg-Huxley model of the pathway to psychiatric care

Abstract

A description is presented of the key features of the Goldberg-Huxley model of the pathway to psychiatric care. There are five levels (from the community to the hospital), and four filters, the most important of which are at the primary care level. Some of the intrinsic and extrinsic problems of the model are described and discussed and some of the major implications of the model explored. In spite of reservations about its use in other cultures, most recent evidence confirms the structure and the applicability of the model. The model is sometimes misinterpreted to suggest that all the resources for treatment of mental illness should be redirected into primary care. The authors of the model do not agree with this interpretation, and this article suggests that, in mental health policy formulation and in service planning more thought needs to be given to the implications of the model, especially in respect of people with severe forms of mental illness. People with severe illnesses pass more easily through the filters to secondary professional care than do people with common mental disorders.

Key Words:

• Filters
• Goldberg-Huxley model
• Levels
• Primary care
• Severe mental illness