TY - JOUR

T1 - The Goldberg-Huxley model of the pathway to psychiatric care

T2 - 21st-century systematic review

AU - Huxley, Peter

AU - Krayer, Anne

AU - Poole, Rob

AU - Gromadzka, Alicja

AU - Lai Jie, Daniel

AU - Nafees, Sadia

PY - 2023/7

Y1 - 2023/7

N2 - BACKGROUND: The classification of mental disorders used to be based only on people seen by hospital psychiatrists. In fact, most people with a mental disorder were, and are, not seen by psychiatrists because of decisions made prior to psychiatric consultation. The first description of this 'pathway' to care and its levels and filters was published by Goldberg and Huxley in 1980.AIMS: To conduct a review of papers relevant to the application of the Goldberg-Huxley model in the 21st century.METHOD: Systematic review (PROSPERO registration CRD42021270603) of the pathway to psychiatric care in the 21st century. The review concentrates on community surveys and passage through the first filter (consultation in primary care or its equivalent). Ten databases were searched for papers meeting the defined inclusion criteria published between 2000 and 2019 and completed on 15 February 2020.RESULTS: In total, 1824 papers were retrieved, 137 screened fully and 31 included in this review. The results are presented in a table comparing them with previous research. Despite major social, economic and health service changes since 1980, community prevalence and consultation rates remain remarkably consistent and in line with World Health Organization findings. Passage through the first filter is largely unchanged and there is evidence that the same factors operate internationally, especially gender and social parameters.CONCLUSIONS: The Goldberg-Huxley model remains applicable internationally, but this may change owing to an increasingly mixed mental health economy and reduced access to primary care services.

AB - BACKGROUND: The classification of mental disorders used to be based only on people seen by hospital psychiatrists. In fact, most people with a mental disorder were, and are, not seen by psychiatrists because of decisions made prior to psychiatric consultation. The first description of this 'pathway' to care and its levels and filters was published by Goldberg and Huxley in 1980.AIMS: To conduct a review of papers relevant to the application of the Goldberg-Huxley model in the 21st century.METHOD: Systematic review (PROSPERO registration CRD42021270603) of the pathway to psychiatric care in the 21st century. The review concentrates on community surveys and passage through the first filter (consultation in primary care or its equivalent). Ten databases were searched for papers meeting the defined inclusion criteria published between 2000 and 2019 and completed on 15 February 2020.RESULTS: In total, 1824 papers were retrieved, 137 screened fully and 31 included in this review. The results are presented in a table comparing them with previous research. Despite major social, economic and health service changes since 1980, community prevalence and consultation rates remain remarkably consistent and in line with World Health Organization findings. Passage through the first filter is largely unchanged and there is evidence that the same factors operate internationally, especially gender and social parameters.CONCLUSIONS: The Goldberg-Huxley model remains applicable internationally, but this may change owing to an increasingly mixed mental health economy and reduced access to primary care services.

KW - Goldberg–Huxley model

KW - Pathway to care

KW - common mental disorder

KW - community prevalence

KW - consultation rates

U2 - 10.1192/bjo.2023.505

DO - 10.1192/bjo.2023.505

M3 - Article

C2 - 37350326

VL - 9

JO - BJPsych open

JF - BJPsych open

SN - 2056-4724

IS - 4

M1 - e114

ER -