Wellbeing Measures: Consultation
We had asked you for your opinions on two sets of wellbeing measures so that we can share the results with decision-makers in the NHS. The expectation is that NHS England will require mental health services to use these measures nationally, so we want to be able to tell them what people think. Thanks to the 59 people who responded. The original questions and examples of the two sets of wellbeing measures are below, and the results are in.
Results
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We asked:
Which of sets of wellbeing measures do you most prefer? It was hardly a landslide for either set but 53% preferred Set 1, 42% Set 2 and 5% had no preference. |
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We asked:
Which set feels most relevant to you in describing your wellbeing? Again, not a strongly decisive result: 48% felt Set 1 was most relevant, 42% Set 2 and 10% neither. |
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The survey asked people how they would describe each set in up to three words. For each set, those words have been presented in a word-cloud: the bigger the word, the more frequently it was used.
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Words used to describe Set 1
The most commonly-stated descriptions were "negative" and "easy", each included in 4% of total responses. |
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Words used to describe Set 2
"Positive" was the most commonly-stated description, included in 7% of responses. |
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Opinions were varied, as we might expect given how close the preference and relevance votes were. A very broad sense was that Set 1 uses negative phrasing compared to Set 2, but that the statements were clear and less open to interpretation.
Finally, people were invited to give any further comments. All comments received are shown below - they reflect the varied opinions from the survey. Overall, the results do not land strongly in favour of one set over the other - there was a slight preference for Set 1 - and this demonstrates the challenge of deciding on one set of measures that will suit everybody.
We will share these results with the people making these decisions and update this page with any developments.
We will share these results with the people making these decisions and update this page with any developments.
In Britain we have an embarrassed, post-empire mentality of feeling pressured to say that everything is fine when it is anything but, so the positive set of questions will twist the answers into a falsely positive bias because of our British etiquette.
Both surveys are good and everybody is different on what they prefer.
Feels like set 1 was created by a sufferer and set 2 by a clinician.
I am answering without the lives experience of mental illness but from the experience of working with those who do.
Set 1 is more connected to the person as a whole - set 2 is functional and has a similar feel but has no connection to suicidality and has a functional feel to the questions.
You can Cope and you have educated yourself on your illness - ergo you reached a point of recovery?
I think these are limited anyway as any one change can create a shift in thought and someone's idea of recovery is their own.
I object to having my quality of life reduced to a score for clinicians to judge how I am. Set 2 makes me think more about how I am doing and where I am going; Set 1 just refers to the past week - looking backwards, not forwards. Set 2 is more about recovery and reflection, not just producing a score. How can anyone's whole life be "scored"?
Would like to see some kind of indication of what each score should be - in 1 is it only occasionally if it is once a day for 5 min or is that all the time? For 2 I would find it difficult to put how things have changed since the previous time and would prefer to answer in the same way as the first time I completed the questionnaire
If physicians want people to have a quality score why not simply ask the individual to give themselves a score out of 10 (or 100) on a sliding scale?. You are reducing something very complex to a few simplistic tick boxes that negate complexity. I object to the notion you can judge that for me. Personally I also find such scales virtually impossible to complete
set 1 is more 'easy speak' plain English therefore easier to digest, think about, relate to
I understand there is a need for using docs measures in mental health settings (I use them myself in my role). Regardless of which set is used I feel it is the manner and tone in which the questions are presented that is key ie. if there is space within the time allocated for this exercise to expand on certain points for the client and use it as a real personal tool for discussion points rather than just to get "a number".
The questions in set2 assume the subject is more depressed/suffering than I am. Those in set1 are more apt for someone with PTSD (and a hypoxic brain injury) as I have.
When in distress not really in the know to decide how you really feel about your circumstance.
Set one I think easier as it's very much here and now.
Depending on where you are in your journey, either set applied to me.
Appropriate I 1 that it includes physical wellness.
I haven't used mental health services before; I'm a volunteer. I've been involved in creating evaluation methods in the past.
I found the first one more direct and personable, it made me feel more like there was genuine interest and understanding, The second one made me struggle as to whether i was explaining myself properly
Neither should be used as a single tool to gain understanding from us about our wellbeing but Set 2 feels more flexible in building it into a conversation.
Set 2 questions touch feelings and allows a scale of measuring these. Set 1 is cold and not feeling, does not allow for varying degrees of emotion/feeling to be recorded
The second set of questions are all couched in the positive which could be misleading for the respondent despite the option to rate them high or low. I prefer set one as there is a range of questions reflecting both a positive and negative mood range, and is more likely to identify severe low mood through the questions couched in the negative and, importantly, suicidal feelings, since the question is much more direct that just "I have a good feeling of self worth".
the problem with set 1 give the same questions 4 times a day and the answers will differ significantly, set 2 is more of an overall look. also set 1 feels like a PIP form
i like that set 1 has a time frame and asks about physical health, I feel jumping between negative and positive statements makes it prone to error perhaps or over thinking, I like set 2 more but it's more subject to how one feels in the moment, unless a time frame is given as with set 1, it would be good to ask about physical health
I felt as if set 2 were trying to get a certain representation from me, whereas set 1 felt more open or perhaps more likely to give a fair representation, one that I would be trying to get across
There are probably benefits and drawbacks with each set of questions but I feel set 2 are more relatable to overall wellbeing and resilience
Important to match in to other services both locally and nationally so you can benchmark.
Not sure about the word "goals" - when low in mood it can be hard to define and know. Sounds like forced recovery
Important to match in to other services both locally and nationally so you can benchmark.
Not sure about the words "goals & needs" - when low in mood it can be hard to define and know. Sounds like forced recovery
personally I find set 2 has too many words. It confuses my brain, it could possibly just the layout though.
I think the relevance of the questions depends on what they're being used for. Eg I think the second set of questions would be well suited for use before getting involved with Healthy Minds sessions, and the first one more suited to accessing medication and therapies via a medical professional etc.
I have very recently been diagnosed as autistic and I am aware now that I've always found these sorts of questionnaires don't correlate with my needs - whenever I've been extremely depressed and am asking for help from the NHS I would take the questions very literally and wouldn't always score very highly even though I was extremely distressed and desperate for help (eg there was a question about not enjoying things as much as I used to, and I didn't know how to answer it because I'd never really experienced enjoyment before...my literal thinking meant I wouldn't score highly on that because I was focused on the literal definitions ie the difference between then and now rather than how bad I currently feel). I believe very strongly that there should be an open-ended question at the end that asks if you found answering the questions difficult and if so why. I think some answers would flag up a huge amount of potential neurodiversity and get people the relevant diagnoses (and therefore help) quicker.
You might get substantially different answers from service users compared with service providers. It would be useful to know which category the respondent most associates with.
I liked how set 1 saw the person as a whole, asking questions about thoughts, actions, feelings and most importantly physicality which has a huge impact on mentality. The scale used was also based on frequency of events which is a more tangible marker than your opinion on your situation, which can shift from one moment to the next.
Set 2 feels like it was written to adhere to a pre given metric. It's quite clinical and doesn't get to the practicality of living with a mental illness. The scale also makes you feel negative; if you have mental health problems, you will be disagreeing or strongly disagreeing with everything! Not great for someone who already feels they are struggling to find the positive in life.
Set 2 reflects real and holistic areas of wellbeing. It is transparent, positive and informs that these are the key areas of wellbeing. Whereas set 1. is quite gloomy and focuses on deficits. In addition, set 1 gives an unrealistic impression of mental health and wellbeing; being happy/confident/able to cope all/most of the time is not a reflection of real life nor good wellbeing. This could mislead a service user into thinking they're unwell/abnormal for occasionally/sometimes lacking in confidence/enjoyment etc. When in fact, for most people, it's completely normal. Set 2. is a much better option gives the user a clear idea of areas of wellbeing and areas which could or need to be worked on.
I prefer the approach of a start point and then a not too frequent re-measuring, to a weekly review
I like set 1 because it produces a score and includes physical health. set 2 may encourage people to minimise how bad things are
You haven't asked questions about respondents so you wont know if you have had BAME representation, LGBTQ, carers etc.
In my opinion, the main problem with set 1 is that some of the statements are positive and some are negative - this gives potential for confusion. Set 2 are all positive, and the scoring system works in the same direction for all of them
Number 1 appears like a tick box quick exercise: "I've asked and they're ok"
It does not show empathy and it's set out to look like it needs completing quickly
When people are in a state of anxiety and depression they are less likely to agree/admit they way they feel so asking them to strongly agree/disagree is not a good way to ask someone to state how they are feeling. Set 1 enables the user to state how often they feel the way they do. This is more appropriate to find out how often someone feels the way they do to enable an appropriate response and treatment plan. As someone who has suffered with my own mental health, I feel that Set 1 would make more sense when in a state of panic and able to focus more on less words with each statement.
Both surveys are good and everybody is different on what they prefer.
Feels like set 1 was created by a sufferer and set 2 by a clinician.
I am answering without the lives experience of mental illness but from the experience of working with those who do.
Set 1 is more connected to the person as a whole - set 2 is functional and has a similar feel but has no connection to suicidality and has a functional feel to the questions.
You can Cope and you have educated yourself on your illness - ergo you reached a point of recovery?
I think these are limited anyway as any one change can create a shift in thought and someone's idea of recovery is their own.
I object to having my quality of life reduced to a score for clinicians to judge how I am. Set 2 makes me think more about how I am doing and where I am going; Set 1 just refers to the past week - looking backwards, not forwards. Set 2 is more about recovery and reflection, not just producing a score. How can anyone's whole life be "scored"?
Would like to see some kind of indication of what each score should be - in 1 is it only occasionally if it is once a day for 5 min or is that all the time? For 2 I would find it difficult to put how things have changed since the previous time and would prefer to answer in the same way as the first time I completed the questionnaire
If physicians want people to have a quality score why not simply ask the individual to give themselves a score out of 10 (or 100) on a sliding scale?. You are reducing something very complex to a few simplistic tick boxes that negate complexity. I object to the notion you can judge that for me. Personally I also find such scales virtually impossible to complete
set 1 is more 'easy speak' plain English therefore easier to digest, think about, relate to
I understand there is a need for using docs measures in mental health settings (I use them myself in my role). Regardless of which set is used I feel it is the manner and tone in which the questions are presented that is key ie. if there is space within the time allocated for this exercise to expand on certain points for the client and use it as a real personal tool for discussion points rather than just to get "a number".
The questions in set2 assume the subject is more depressed/suffering than I am. Those in set1 are more apt for someone with PTSD (and a hypoxic brain injury) as I have.
When in distress not really in the know to decide how you really feel about your circumstance.
Set one I think easier as it's very much here and now.
Depending on where you are in your journey, either set applied to me.
Appropriate I 1 that it includes physical wellness.
I haven't used mental health services before; I'm a volunteer. I've been involved in creating evaluation methods in the past.
I found the first one more direct and personable, it made me feel more like there was genuine interest and understanding, The second one made me struggle as to whether i was explaining myself properly
Neither should be used as a single tool to gain understanding from us about our wellbeing but Set 2 feels more flexible in building it into a conversation.
Set 2 questions touch feelings and allows a scale of measuring these. Set 1 is cold and not feeling, does not allow for varying degrees of emotion/feeling to be recorded
The second set of questions are all couched in the positive which could be misleading for the respondent despite the option to rate them high or low. I prefer set one as there is a range of questions reflecting both a positive and negative mood range, and is more likely to identify severe low mood through the questions couched in the negative and, importantly, suicidal feelings, since the question is much more direct that just "I have a good feeling of self worth".
the problem with set 1 give the same questions 4 times a day and the answers will differ significantly, set 2 is more of an overall look. also set 1 feels like a PIP form
i like that set 1 has a time frame and asks about physical health, I feel jumping between negative and positive statements makes it prone to error perhaps or over thinking, I like set 2 more but it's more subject to how one feels in the moment, unless a time frame is given as with set 1, it would be good to ask about physical health
I felt as if set 2 were trying to get a certain representation from me, whereas set 1 felt more open or perhaps more likely to give a fair representation, one that I would be trying to get across
There are probably benefits and drawbacks with each set of questions but I feel set 2 are more relatable to overall wellbeing and resilience
Important to match in to other services both locally and nationally so you can benchmark.
Not sure about the word "goals" - when low in mood it can be hard to define and know. Sounds like forced recovery
Important to match in to other services both locally and nationally so you can benchmark.
Not sure about the words "goals & needs" - when low in mood it can be hard to define and know. Sounds like forced recovery
personally I find set 2 has too many words. It confuses my brain, it could possibly just the layout though.
I think the relevance of the questions depends on what they're being used for. Eg I think the second set of questions would be well suited for use before getting involved with Healthy Minds sessions, and the first one more suited to accessing medication and therapies via a medical professional etc.
I have very recently been diagnosed as autistic and I am aware now that I've always found these sorts of questionnaires don't correlate with my needs - whenever I've been extremely depressed and am asking for help from the NHS I would take the questions very literally and wouldn't always score very highly even though I was extremely distressed and desperate for help (eg there was a question about not enjoying things as much as I used to, and I didn't know how to answer it because I'd never really experienced enjoyment before...my literal thinking meant I wouldn't score highly on that because I was focused on the literal definitions ie the difference between then and now rather than how bad I currently feel). I believe very strongly that there should be an open-ended question at the end that asks if you found answering the questions difficult and if so why. I think some answers would flag up a huge amount of potential neurodiversity and get people the relevant diagnoses (and therefore help) quicker.
You might get substantially different answers from service users compared with service providers. It would be useful to know which category the respondent most associates with.
I liked how set 1 saw the person as a whole, asking questions about thoughts, actions, feelings and most importantly physicality which has a huge impact on mentality. The scale used was also based on frequency of events which is a more tangible marker than your opinion on your situation, which can shift from one moment to the next.
Set 2 feels like it was written to adhere to a pre given metric. It's quite clinical and doesn't get to the practicality of living with a mental illness. The scale also makes you feel negative; if you have mental health problems, you will be disagreeing or strongly disagreeing with everything! Not great for someone who already feels they are struggling to find the positive in life.
Set 2 reflects real and holistic areas of wellbeing. It is transparent, positive and informs that these are the key areas of wellbeing. Whereas set 1. is quite gloomy and focuses on deficits. In addition, set 1 gives an unrealistic impression of mental health and wellbeing; being happy/confident/able to cope all/most of the time is not a reflection of real life nor good wellbeing. This could mislead a service user into thinking they're unwell/abnormal for occasionally/sometimes lacking in confidence/enjoyment etc. When in fact, for most people, it's completely normal. Set 2. is a much better option gives the user a clear idea of areas of wellbeing and areas which could or need to be worked on.
I prefer the approach of a start point and then a not too frequent re-measuring, to a weekly review
I like set 1 because it produces a score and includes physical health. set 2 may encourage people to minimise how bad things are
You haven't asked questions about respondents so you wont know if you have had BAME representation, LGBTQ, carers etc.
In my opinion, the main problem with set 1 is that some of the statements are positive and some are negative - this gives potential for confusion. Set 2 are all positive, and the scoring system works in the same direction for all of them
Number 1 appears like a tick box quick exercise: "I've asked and they're ok"
It does not show empathy and it's set out to look like it needs completing quickly
When people are in a state of anxiety and depression they are less likely to agree/admit they way they feel so asking them to strongly agree/disagree is not a good way to ask someone to state how they are feeling. Set 1 enables the user to state how often they feel the way they do. This is more appropriate to find out how often someone feels the way they do to enable an appropriate response and treatment plan. As someone who has suffered with my own mental health, I feel that Set 1 would make more sense when in a state of panic and able to focus more on less words with each statement.
The original consultation questions are below, for reference.
We are seeking views on how mental health services can record and measure what difference they make in people's wellbeing.
If you have had treatment or support from mental health services in the NHS or through organisations like Healthy Minds, you are likely to have been asked questions about your feelings and how well you're doing on different areas in your life.
Below are two examples of these "outcome measures" that are currently being considered for use in mental health services throughout West Yorkshire (and possibly further afield). We want to gather views so that we can tell NHS England what people think, and they can take this into account in deciding what measures to use.
Please take a look at the two example sets of wellbeing measures below and complete the survey questions further down the page. It should only take a few minutes to complete the survey. You won't be able to fill in the wellbeing measures - they're just shown to illustrate the questions they ask. We would like you to compare the two sets of measures and tell us what you think. You might want to consider how they look, how easy they are to fill in, and the language they use - but you can say as much as you want and all comments will be useful.
Please feel free to share this page with anyone who might be interested. Please complete the survey by 11th April 2022.
We will update this page with the results from the survey and news of any developments as this work progresses. Thank you.
If you have had treatment or support from mental health services in the NHS or through organisations like Healthy Minds, you are likely to have been asked questions about your feelings and how well you're doing on different areas in your life.
Below are two examples of these "outcome measures" that are currently being considered for use in mental health services throughout West Yorkshire (and possibly further afield). We want to gather views so that we can tell NHS England what people think, and they can take this into account in deciding what measures to use.
Please take a look at the two example sets of wellbeing measures below and complete the survey questions further down the page. It should only take a few minutes to complete the survey. You won't be able to fill in the wellbeing measures - they're just shown to illustrate the questions they ask. We would like you to compare the two sets of measures and tell us what you think. You might want to consider how they look, how easy they are to fill in, and the language they use - but you can say as much as you want and all comments will be useful.
Please feel free to share this page with anyone who might be interested. Please complete the survey by 11th April 2022.
We will update this page with the results from the survey and news of any developments as this work progresses. Thank you.
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Set 1
This set asks people to rate how they have felt in the last week against 10 statements (plus one on physical health). 1. I found it difficult to get started with everyday tasks 2. I felt able to trust others 3. I felt unable to cope 4. I could do the things I wanted to do 5. I felt happy 6. I thought my life was not worth living 7. I enjoyed what I did 8. I felt hopeful about my future 9. I felt lonely 10. I felt confident in myself Please describe your physical health (problems with pain, mobility, difficulties caring for yourself or feeling physically unwell) over the last week. Each answer produces a score, and the total score indicates a range for clinicians to determine a person’s quality of life. This set was developed by clinicians and a group of "expert service users". You can find out more about how this set of measures was developed, and how it is used in practice, here. |
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Set 2
This set asks people to say how much they agree with 8 statements. The questions are asked at first contact with the service: this gives a starting point for each person. People are asked to answer the questions again every so often (e.g. 3-monthly). For these, there is a slightly different scale: Much Better / Somewhat better /About the same / Somewhat worse / Much worse This measures the difference in wellbeing over time. This set of measures has been developed with people receiving support. The group looked at lots of different types of measures that are often used and devised this set based on the similarities in those, and what they felt was most meaningful for their ongoing recovery. |
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