How it works

Discover how WEMWBS can transform your understanding of mental wellbeing. From setting up assessments to analysing the results, our straightforward process help you accurately measure and track mental wellbeing over time. Whether you're using the 14 question scale, 7 question scale, or our pre-approved digital form, WEMWBS makes it easy to gain actionable insights that support wellbeing across diverse settings.

Learn how it works and start your journey toward a healthier, more informed approach to mental wellbeing.

APPLICATION PROCESS

WEMWBS is protected by copyright. Should you wish to use WEMWBS you will require a licence appropriate to your intended use.

Once you have obtained a licence you will be able to access more detailed information on the correct use of the scale including Practitioner Guidelines.

HOW TO USE WEMWBS EFFECTIVELY

Collecting:

The WEMWBS scales have been designed to be self-completed. Both digital and paper versions work well, if there is a need to help participants complete the scale by reading out items or filling in the questionnaire for them there is a risk that participants will respond more positively than if they were completing the questionnaire on their own. This could introduce bias into the study. As a rule of thumb studies need to include at least 30 people with data at two points in time or 30 people in each group to be compared. Some simple guidance on sample size calculation is available on page 38 of the user guide for researchers, user guides are available from the Resources pages of the website once you are registered to use the scale.

Scoring:

The 14-item scale WEMWBS is very simple to score. The total score is obtained by summing the score for each of the 14 items. The scoring range for each item is from 1 – 5 and the total score is from 14-70. For more help with scoring WEMWBS please refer to the user guides available on the Resources Page of the website which is available once your have registered to use the scale.

The 7-item scale SWEMWBS is more complicated to score and it must be scored correctly in order for comparisons to be made across different studies. SWEWMBS is a shortened version of WEMWBS which is Rasch compatible. This means the seven items have superior scaling properties to the 14 items, but in order to take advantage of this and to compare results with those of other studies using the 7-item scale SWEMWBS, raw scores need to be transformed.

Analysis:

(S)WEMWBS scores approximate to a normal distribution, permitting parametric analysis. So the most statistically efficient approach to analysing data is to calculate means and standard deviations and compare results using Students T-test. UK Population norms have been published and can be used as comparators for your scores(WEMWBS and SWEMBS population norms Health Survey for England 2011).Link opens in a new window

Some investigators prefer to analyse their data using categorical approaches. Scores can be divided into high, average and low mental wellbeing using cut points. Two different methods can be used.

Statistical approach:

This puts the cut points at plus or minus one standard deviation. This approach puts approximately 15% of the participants into high wellbeing and 15% into low wellbeing categories.

Using this approach, UK population samples put score ranges as follows:

WEMWBS: the top 15% of scores range from 60-70 and the bottom 15% 14-42

SWEMWBS: the top 15% of scores range from 27.5-35.0 and the bottom 15% from 7.0-19.5

As background information

WEMWBS has a mean score of 51.0 in general population samples in the UK with a standard deviation of 7 (Tennant R, Hiller L, Fishwick R, Platt P, Joseph S, Weich S, Parkinson J, Secker J, Stewart-Brown S. The Warwick-Edinburgh Mental Well-being Scale (WEMWBS): development and UK validation.Link opens in a new windowHealth and Quality of Life Outcome 2007;5(63)) This means that 15% of the population can be expected to have a score of less than 42.3, so we have set the cut point at 42. Equally 15% of the population can be expected to have a score greater than 59.7, so we have set 60 as the recommended cut point for high wellbeing.

SWEMWBS has a mean of 23.5 and a standard deviation of 3.9 in UK general population samples (Ng Fat L; Mindell J, Boniface, Stewart-BrownEvaluating and establishing national norms for the short Warwick-Edinburgh Mental Well-being Scale (SWEMWBS) using the Health Survey for England Quality of Life ResearchLink opens in a new window2016;26(5):1129-1144 ). This means 15% of the population can be expected to have a score >27.4 so we have set the cut point at 27.5 for high wellbeing. Equally 15% of the population can be expected to have a score <19.6, so we have set the cut point at 19.5.

Benchmarking approach:

Both WEMWBS and SWEMWBS have been benchmarked against well-validated measures of depression and it is possible to suggest scores that are equivalents to cut points for possible and probable clinical disease on both these scales.

WEMWBS has been bench marked on CES-D with which it is highly correlated (.84). For more information see (Donatella Bianca reportLink opens in a new window).

Using CES-D =26 and CES-D = 16 as cut points, this analysis suggests that : -

a score of 41-44 is indicative of possible/ mild depression

a score of <41 is indicative of probable clinical depression.

These cut points can be used for analysis if it is important to focus on likely mental illness

SWEMWBS has been benchmarked on PHQ-9 and GAD-7 with which is it highly correlated (Neha Shah, Mizaya Cader, William Andrews, Sarah L Stewart-Brown Short Warwick-Edinburgh Mental Well-being Scale (SWEMWBS): performance in a clinical sample in relation to PHQ-9 and GAD-7 BMC Health and Quality of Life Outcomes (2021) 19:260Link opens in a new windowand also seecut points on SWEMWBS analysis)Link opens in a new window

Using the cut points of PHQ-9 = 5 and PHQ-9 =10 this analysis suggests that

a score of >18-20 is indicative of possible mild depression

a score of 18 or less is indicative of probable clinical depression

These cut points can be used for analysis if it is important to focus on likely mental illness

As there is no gold standard for measuring high mental wellbeing all cut points are by definition arbitrary. A cut-point of 60 and above can be used to identify the top 15% of scores on WEMWBS and 28 and above for SWEMWBS

Interpretation

Parametric approach:If you have used a parametric approach to analysis you need to compare your scores with population norms. Ideally results should be adjusted for differences in age and sex distribution. You compare mean scores and standard deviations before and after programme or intervention using Student’s T test.Link to calculation template:Link opens in a new window

Categorical approach:If you are using a categorical approach you will have used one of the cut points recommended above and estimate the % of the population which falls into each category. You need to compare %s before and after your intervention or programme using a X2 test.Link to calculation template:Link opens in a new window

Individual-level differences:Neither of the measures was developed for monitoring change at the individual level or in clinical settings, but both the 14-item scale and 7-item scale WEMWBS have been shown to be responsive to change at the individual level and some practitioners are using the scales to help clients and patients think about ways in which their mental health is changing. Different statistical approaches give different results with regard to minimally important levels of change. For the 14-item scale WEMWBS the methods give a minimum of 3 points and a maximum of 8 points(Maheswaran H Weich S Powell J Stewart-Brown S Evaluating the responsiveness of the Warwick Edinburgh Mental Well-Being Scale (WEMWBS): Group and individual level analysis BMC Health and Quality of Life Outcomes 2012,Link opens in a new window10:156 (27 December 2012) for the 7-item scale SWEMWBS, a minimum of 1 point and a maximum of 3 points(Neha Shah, Mizaya Cader, William Andrews, Dilini Wikijsera, Sarah Stewart-Brown Responsiveness of the Short Warwick-Edinburgh Mental Well-being Scale (SWEMWBS) in a clinical sample Health and Quality of Life Outcomes Under Health Qual Life Outcomes. 2018Link opens in a new window; 16: 239

FAQs

Purpose of WEMWBS

1. How can I use WEMWBS?

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 levelwhich shows that a change of about 3 or more points can be considered significant.
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.
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.
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.
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.

2. Which groups of people can WEMWBS be used with?

Validation studies of the English version of WEMWBS in different populations can be found hereLink opens in a new window. This includes studies with children aged 11 years to adulthood, cross-cultural populations, populations living with learning difficulties, clinical populations and various occupational groups.
Children and Adults: The scale is validated for use with individuals aged 13 to 74 according to a 2011 studyLink opens in a new window amongst others and for children from 11 years in a 2019 study.Link opens in a new window 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 8-13Link opens in a new window. The Strengths and Difficulties QuestionnaireLink opens in a new window is also designed for use in children.
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 Link opens in a new windowliving in a city in England.

3. 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

Eligibility for a Commercial or a Non-Commercial Licence

4. 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, Social Services, NGOs), Registered Charities, Registered Community Interest Companies and Registered Social Enterprises only.

5. I am self-employed but I’m not charging for my services, can I have a Non-Commercial Licence? 6. 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?

From 1st December 2024 NHS organisations are no longer eligible for free of charge licences, further information can be found above, in addition, if you are working with a third party (consultant or private organisation), and they are developing a system or application including WEMWBS, they need to have a full commercial licence in place before including the scale in such systems.

Obtaining a Licence

7. How long does the licence last for? 8. What does participant mean, does it mean the number of people who complete the scale? 9. 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.

10. 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.

11. 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 for the relevant licence, these can be found and downloaded from within the application form.

12. 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.

13. What resources do I get?

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

Including WEMWBS in your Questionnaire

14. Can I change the layout of the scale? 15. Do the following infringe copyright?

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.
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.
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 contact us first to ensure your planned changes are acceptable.

16. Do the numbers (1-5) in the boxes for WEMWBS response influence how people answer the questions? 17. How do I reference WEMWBS scales in my questionnaire?

Using the WEMWBS Scale

18. 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? 19. How do I interpret the scores? 20. Is it appropriate to provide information such as support contacts for people with low WEMWBS scores? 21. What is the average score for WEMWBS? 22. 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.

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).

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

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.

23. 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.

24. 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.

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

You should not publish the questionnaire on a website, in a report, book etc., it should have the below copyright statement underneath it:

and should also contain a statement to confirm that users need to register with a link to our registration page.