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1. Purpose of WEMWBS

How can I use WEMWBS?

WEMWBS can be used to:

1.1 Assess change in mental wellbeing in individuals: WEMWBS was designed as a research tool to be used in populations. The WEMWBS responsiveness to change has been evaluated both at the population and the individual level which shows that a change of about 3 or more points can be considered significant.

1.2 Measure depression: The scale is not designed to measure depression, but low scores do relate to depression. Recent studies show that you can define a cut-off point in a WEMWBS score which has optimum sensitivity and specificity for depression (as measured by other scales). Wherever you put the cut-off point you will either miss some people with depression or include people who do not have depression. You would expect this from a scale that is normally distributed and designed to measure wellbeing in the general population.

1.3 Screen mental illness: The scales were not designed for this purpose. Cut points corresponding to probable or possible mental illness have been defined from studies of WEMWBS performance vis-à-vis mental illness measures with validated cut points. These are valid for categorising the scales in epidemiological studies.

1.4 Cover spiritual wellbeing: No, although aspects of spiritual wellbeing such as connectedness, growth and development, and purpose in life (which may be regarded as part of psychological functioning) are covered.

1.5 Monitor change at the individual level: Although the scales were not designed to monitor change at the individual level, they have been used in such a way because they enable conversations about mental wellbeing. Studies have now indicated that the scales could be valid for this purpose and suggest a level of change in scores that can be regarded as important.

Which groups of people can WEMWBS be used with?

WEMWBS be used with the following:

1.6 Validation studies of the English version of WEMWBS in different populations can be found here. This includes studies with children aged 11 years to adulthood, cross-cultural populations, populations living with learning difficulties, clinical populations and various occupational groups.

1.7 Children and Adults: The scale is validated for use with individuals aged 13 to 74 according to a 2011 study amongst others and for children from 11 years in a 2019 study. There is no evidence for the use of WEMWBS with children below the age of 11. It is therefore not recommended that WEMWBS be used with children aged under 11. We recommend the Stirling Children’s Wellbeing Scale for children aged 8-13. The Strengths and Difficulties Questionnaire is also designed for use in children.

1.8 Ethnic minority groups in the UK: Use of this scale in all population groups is encouraged. It has been validated among people with a Chinese and a Pakistani family background living in a city in England.

1.9 I understand the 14 point scale has been well validated but can you advise if the 7 point scale has also been validated as its own individual tool Yes, the SWEMWBS (7 point scale) is also very well validated now. Validations are available from our website here

2. Eligibility for a Commercial or a Non-Commercial Licence

2.1 Which organisations can obtain a Non-Commercial Licence? A non-commercial licence is made available for organisations whose main purpose is not directed towards commercial advantage or monetary compensation (“Non-Commercial Organisations”), including Public Sector Organisations (e.g. Universities, Schools, Public Health, Social Services, NGOs), Registered Charities, Registered Community Interest Companies and Registered Social Enterprises only.

2.2 I am self-employed but I’m not charging for my services, can I have a Non-Commercial Licence? Unfortunately not, the licence depends on the status of the organisation applying regardless of whether you are charging for services.

2.3 We are part of the NHS but are working with a consultant to develop an application to host the scale, we are still eligible for a Non-Commercial licence as part of the NHS aren’t we? Unfortunately not, as per the terms and conditions. If you are working with a third party (consultant or private organisation) and they are developing a system or application to host the scale, then they need to have a commercial licence in place.

3. Obtaining a Licence

3.1 How long does the licence last for? The licence is valid for 12 months. When you complete the application form, it asks you to confirm the start date for your licence so you can apply for a licence now for a project which starts in the future.

3.2 What does participant mean, does it mean the number of people who complete the scale? In this context participant relates to the number of individuals you offer the scale to for completion not the number of respondents. So if you are offering the scale to 1,000 people you need a licence for 1,000 participants regardless of how many respond.

3.3 How many times can I use the scale during my 12 month licence There is no limit to the number of times you can use the scale during the term of your licence if you are using it with the same participants. If you offer the scale to additional participants you will need to apply for a further licence to cover the difference. Example: You are running a training course with 90 people and want to measure their wellbeing at the beginning, mid-point and end, you would need a licence for 100 participants. If however you are running the same course during the same year with a new cohort of 80 people you would need to apply for a further licence for 100 participants, the second licence could have a later start date and again be used at start, mid-point and end.

3.4 I have registered, but I haven’t received my login details, when will I receive them? When you register you need to make sure you request an email receipt on the second page (this page appears when you have clicked the submit form button) when you receive the email receipt it will contain a link to the resources area where you can find the scale and associated resources. If you didn’t request a receipt we suggest you re-register. There are no login details associated with your access to the scale, please just save the link to the resources area and please do not share this link outside of the registered organisation.

3.5 Can I have a digital version of the scale? At the current time we do not have digital versions of either of the scales available although the terms and conditions of both the Non-Commercial and Commercial licence allow you to reproduce the scale providing you meet certain conditions including sending a copy to us for approval before using. Please read the terms and conditions (section 2.1 applies here) for further detail.

3.6 Do you have WEMWBS version in other languages? Once registered you have access to the resources page where you will find all of the translations we currently have access to. You may not be able to access the full list of translated version which is shown on the "WEMWBS in other languages" page, we can only provide translations with signed agreement of the translator which is not available in all cases.

3.7 What resources do I get?

Resources provided includes:

  • User Guides to help you implement the scale and interpret the results
  • Practice based User Guide and workbook to use WEMWBS to evaluate a service or other intervention
  • Data analysis calculation templates (Excel workbooks)
  • Translations of the scale and associated validations
  • Other relevant guides and references

4. Including WEMWBS in your Questionnaire

4.1 Can I change the layout of the scale? You should not alter the layout of the scale, if you are replicating it, it should be reproduced as faithfully as possible. Please read the terms and conditions (section 2.1 applies here) for further detail.

4.2 Do the following infringe copyright?

4.3 Adding other questions, for example, demographic description such as age and gender:No, this does not infringe copyright and is acceptable. It is envisaged that WEMWBS will frequently be included in the context of a questionnaire containing other questions so that other information about respondents can also be captured. As well as providing general information about the respondents, such data can be used in cross-tabulations with the WEMWBS data for wider analysis purposes.

4.4 Changing the text size of WEMWBS:No, this does not infringe copyright and is acceptable as long as no changes to the wording, response categories or layout of WEMWBS are made.

4.5 Using the questions in a different format:The scales are validated in their original format, and any significant change will compromise the validity and may infringe copyright. Changing the size of the text is acceptable as long as no changes to the wording, response categories or layout of WEMWBS are made. It is fine to add questions to WEMWBS as part of your study, however removing questions will mean the scale is no longer valid. If you do still wish to use any part of the scale in an altered format we request that you discuss with us first and ensure to acknowledge the source of the questions.

4.6 Do the numbers (1-5) in the boxes for WEMWBS response influence how people answer the questions? We have not seen any evidence that the numbers in the boxes affect response. If you decide to delete these numbers, then you should mention it in your report because it may affect its comparison with other studies. On a website, the numbers will not normally be seen, because the option will be to select buttons rather than boxes.

4.7 How do I reference WEMWBS scales in my questionnaire? If you are referencing the questionnaire on a website, app or elsewhere, it should have the below copyright statement underneath it:

Warwick-Edinburgh Mental Well-Being Scale (WEMWBS) © University of Warwick 2006, all rights reserved.

5. Using the WEMWBS Scale

5.1 The statements used in the WEMWBS questionnaire asks the individual to relate to their previous two week period when considering their response, can I change that? All the validation studies of the scales relate to this previous two week period, and so, any modification is not recommended.

5.2 How do I interpret the scores? When you have registered you will have access to a User Guide which will help you implement the scale and interpret the results.

5.3 Is it appropriate to provide information such as support contacts for people with low WEMWBS scores? Providing a supplementary page with information on support contacts is perfectly acceptable, but if such information is provided, then it should be available to all those who complete the questionnaire, not just to those with scores deemed to be ‘low’.

5.4 What is the average score for WEMWBS? Mean scores for the general population are reported in population surveys and are generally around 51 in the UK

5.5 Are there cut-off points for interpretation of WEMWBS scores? The scale was not developed with a view to categorising the population according to level of mental wellbeing. While this approach is attractive to researchers and policy makers, it goes against the grain of whole population approaches that need to focus on changes in the average of whole population groups. As interest in mental wellbeing is so comparatively recent a phenomenon, we do not yet know what ‘optimum’ mental wellbeing looks like and any cut-off points we define on the basis of WEMWBS scores would, of necessity, be arbitrary. Those wanting to assess the proportion of a population that suffers from mental health problems should use a scale validated for that purpose, e.g. the GHQ 12 identifies those with a possible psychiatric disorder.

5.6 If it is essential to present data in a categorical way, for example, for analytical purposes, the best approach to date is that used in the analysis of WEMWBS data from the Scottish Government’s ‘Well, What do you think? 2006’ survey. Scores were categorised according to the extent of their standard deviation from the mean.

  • A categorical variable was derived for the purposes of the report by dividing the survey population into three groups:
  • Those with relatively "good mental wellbeing" (a WEMWBS score of over one standard deviation above the mean),
  • Those with "average mental wellbeing" (a WEMWBS score of within one standard deviation of the mean) and,
  • Those with relatively "poor mental wellbeing" (a WEMWBS score of more than one standard deviation below the mean).

    5.7 This three-fold classification was used as a key analysis variable throughout the report.

    5.8 An alternative approach, published in a 2015 research paper by Stewart-Brown et al., has also been used successfully, is to divide the populations into quintiles based on WEMWBS scores.

    5.9 Could the scale be validated for use with individuals before and after interventions? WEMWBS was designed as a research tool to be used in populations however, its responsiveness to change has been evaluated both at the population and the individual level, and at the individual level a change of about three or more points can be considered significant. There are currently no plans to validate the scale as a screening tool for use with individuals to categorise their individual level of mental wellbeing.

    5.10 Can the questions in WEMWBS be used as triggers for conversations? Individual questions from WEMWBS can be used as triggers for conversations in the context of qualitative research and to guide focus groups, etc. They have also been used in the context of ‘health promoting projects’. This approach is well received but has not been formally evaluated. It should be noted that this should not be carried out if the research then includes completion of the scale by the same individuals for evaluation of an intervention. Discussing the individual items and asking for opinions from a group is likely to bias results if individuals are subsequently asked to complete the questionnaire to obtain the mean score for the group.

    5.11 Can the WEMWBS scales be reproduced on a website or be published in a report, book etc.?

    If you are publishing the questionnaire on a website, app, in a report, book etc., it should have the below copyright statement underneath it:

    Warwick-Edinburgh Mental Well-Being Scale (WEMWBS) © University of Warwick 2006, all rights reserved