Measuring wellbeing: What does the Warwick-Edinburgh Mental Well-being Scale have to offer integrated care?

Abstract

Integrated health care differs from orthodox care in a number of ways one of which is that many of the complementary and alternative medicines that contribute to integrated care include a focus on improving wellbeing. Concepts of wellbeing derive from diverse disciplines, but all agree that wellbeing is more than the absence of disease. Current conversations about its nature focus on mental wellbeing rather than the physical aspects which are already reasonably well addressed and spiritual components which remain ‘a step too far’ for many. The currently accepted definition of mental wellbeing – feeling good and functioning well – encompasses also concepts from several disciplines.Outcome measurement is important for evaluation in all aspects of health care, and traditional disease-specific measures rarely perform well in the evaluation of interventions designed to enhance wellbeing. There are therefore strong arguments for incorporating measures of mental wellbeing in the evaluation of integrated health care and a range of wellbeing or proxy wellbeing measures are already in use in the context. These may be used in conjunction with disease-specific measures.One wellbeing measure deserves particular attention in the UK because it has been incorporated in government health and social care outcomes frameworks, so demonstrating effectiveness with this measure carries added value. This measure, Warwick-Edinburgh Mental Well-being Scale (WEMWBS) is well validated, sensitive to the changes occurring in integrated health care settings, and well-liked by practitioners, patients and the public. Undertaking comparative evaluations of integrated health care using WEMWBS as an outcome could strengthen arguments for its provision in government funded integrated care.