Five levels and four filters: a personal reflection on the Pathways to Psychiatric Care

In this personal reflection on Goldberg and Huxley’s seminal Pathways to Care model, the author considers how it has provided a framework for research she has carried out during her career in primary care mental health. The levels described in the model are not only of epidemiological significance, but also represent the, quite different, ‘worlds’ encountered within mental health care. The filters are the sites at which negotiation is required to pass through (in either direction) and where quality of communication becomes paramount.