When the psychiatrist David Goldberg, who has died aged 90 after developing Alzheimer’s dementia, received his knighthood in 1997, Queen Elizabeth II asked why she was giving it to him. He replied that it was because he had taught a generation of doctors how to talk to people.
His psychiatric training (1962-69) took place at the Maudsley hospital, in south-east London, which works with the Institute of Psychiatry, now IoPPN, the Institute of Psychiatry, Psychology & Neuroscience. David had been drawn there while a trainee doctor after coming across a paper, Between Guesswork and Certainty in Psychiatry, by Aubrey Lewis, one of the institute’s leading lights.
When starting out, David was happy to take off the straitjackets of patients brought to him so that they could have a cup of tea – provided they promised not to hit him. His approach chimed with the change of approach of the 1959 Mental Health Act, marking the beginnings of a move from asylums to community care.
In the institute’s general practice unit, run by Michael Shepherd, David became a senior lecturer in 1969 and developed the standardised Clinical Interview Schedule (1970) and General Health Questionnaire (1972).
The GHQ went on to be used around the world to screen for psychological distress and psychiatric disorders, and helped shape policy in low- and middle-income countries, with their varying cultural and socioeconomic conditions, often using non-clinical settings for interviews.
Appointed a professor at Manchester University in 1972, David went to the US as a visiting professor in 1978-79, and found challenges in primary care and mental disorders in patients being missed in both Charleston, South Carolina, and Philadelphia.
This led him to develop interview techniques that he introduced to trainees at Manchester, and with Peter Huxley he arrived at what is now called the “filter model” of psychiatric services. Rather than just dividing people into those receiving psychiatric treatment and those who are not, it outlines the stages that people go through in seeking mental health care.
David took account of people’s growing awareness and acceptance of psychiatric conditions, and the pressure that general practitioners are always under. Self-evidently, a vast majority of patients with psychiatric disorders are seen in primary care, but only a small proportion make it to hospitals where most of the resources are allocated, and so he wanted to help patients navigate the paths involved. He went on to focus on training not only primary care physicians but also psychiatry students, and developed a system for the diagnosis of psychiatric disorders in primary care.
When he returned to the Maudsley and the institute in 1993, he introduced training by using videos, developed the Maudsley Discussion Documents series, revived the more substantial reports of the Maudsley Monographs and established public lectures.
Up to his retirement in 1999 and beyond he advised the Department of Health on psychiatric services developments and the World Health Organization as a mental health consultant. He addressed the future of mental health research and psychological assessment as chair of the Psychiatry Research Trust (1999-2016).
Born in London, David was the son of Ruby (nee Brandes), a secretary, and Paul Goldberg, a civil servant. Their parents had been Jewish immigrants from Germany in the 19th century. Growing up under the shadow of the second world war, David, who was non-observant, recognised that several incidents at that time may have subconsciously pushed him towards psychiatry – even when he was not entirely clear what it was.
In an interview with me in 2019 for the book Psychiatrists on Psychiatry, published last year, he recalled that if Hitler had invaded Britain, his father intended to kill his whole family, and for several years kept a bottle of barbiturates in his desk for the purpose. David went on in turn to keep the bottle as a memento in his desk.
The family moved to Oxfordshire for a short while during the early years of the war, but the children, especially David, had a rough time and were bullied for being outsiders from London. This may have contributed to his interest in understanding behaviours and their outcomes. He said that he could not understand at that age why people whom he had not met before – whether from Germany or Oxfordshire – should wish him physical harm.
From William Ellis school in north London, in 1952 he went to Hertford College, Oxford. For the first two terms he studied botany, and in order to switch to medicine had to retake Latin exams. He had an enjoyable time at the university, making friends, and appreciated the club atmosphere that he found during his clinical training at St Thomas’ hospital in London (1957-59).
As throughout his career, David emphasised the value of people feeling respected and comfortable: “At times I was working more than 100 hours a week but we were treated very well. There was a waiter to serve dinner and you felt you were special. Nowadays, junior doctors are treated extremely badly and don’t have the accommodation perks I had. No one seems to give a damn where they sleep and eat.”
In 1966 he married Ilfra Pink. Their first meeting came while they were training and she was presenting a case at a ward round. They had four children, Paul, Charlotte, Kate and Emma.
Ilfra died in 2017, and in recent years he enjoyed the companionship of Anne Geller, a doctor who had been his girlfriend at Oxford in the 1950s. She provided him with immeasurable support as his Alzheimer’s advanced.
I visited David on a weekly basis over the past few years to join him for a constitutional glass of champagne and to enjoy his infectious humour, which lasted to the end.
He is survived by his children and nine grandchildren.
