HE2
Improved Mental Health
Mental Health
Health
Improved Mental Health
We all have mental health, just like we all have physical health. Our mental health is how we are feeling inside, our emotions, and informs how we respond to our life experiences. Improving mental health is often the intention of interventions. There are existing values relating to different shifts in mental well-being, and there are validated (tried and tested) ways to most accurately ask about mental well-being.
Key Value
A monetised social value of £30,700
This is the monetised value of 1 person having ‘good’ mental health as opposed to ‘poor’ over a year.
The values are guided by government policy (The Green Book) and sophisticated research into the relationship between mental health and wellbeing (measured by life satisfaction.)
The Green Book recommends that life satisfaction can be expressed as £ monetised wellbeing, using the value of £13,000 for 1 WELLBY, over one year (see section on life satisfaction.) Research using national datasets can estimate the isolated impact of a change in mental health on life satisfaction, after accounting for important controls such as age, health, socio-economics and other demographics.
This research has been done by State of Life (The WELLBY Value Guide), which found that even after accounting for all these other factors, a change from ‘poor’ mental health to ‘good’ mental health is associated with an increase in life satisfaction of 2.01 (Table 1 in the above link). Therefore this change in mental health is worth 2.01 WELLBYs, or 2.01*£13,000 = £26,186 (rounded to £26,000).
Adjusted for inflation to 2023 prices is £30,668. Our approach to inflation adjustments is explained on our Methodology page HERE
An overall rounded value of £30,700.
How to measure Improving Mental Health
If you’re just starting out, start with Bronze first. The result of a Bronze measurement is just an estimate, but requires the least effort; whereas Silver and Gold give more accurate results but require more effort.
Each level has an effort to accuracy indicator, choose the one that’s right for you.
Bronze
Effort
Accuracy
Monetised value:
Monetised social value: Multiply the proportion of your participants you expect to report substantially improved mental health by £30,700
APPLYING THE WELLBY VALUE: Consider the proportion of your participants you expect to move from ‘poor’ to ‘good’ mental health. Multiply this by £30,700 to obtain a value per person.
If you can’t ask people directly about their mental health because you’re unable to survey them, or this is a plan for a future project, then you can use this value as a proxy for ‘an improvement in mental health’.
It’s an estimate of what the impact of an intervention that’s effective at improving mental health (from ‘poor’ to ‘good’) might produce.
Here’s an example
You plan to work with young care leavers who have reported mental health issues and link them with mental health support workers. You anticipate 10 people will participate, and you anticipate some (6 out of 10) will report improved mental health and those who don’t will continue to be supported and referred to other services.
It’s important to be realistic about how many of your target group will reach the desired outcome; it’s unlikely all of them will, e.g 6/10 = 0.6.
Therefore you estimate 0.6*£30,700 = £18,420 value per person. Applied to 10 people who started means a total of £18,420*10 = £184,200 monetised social value.
At the bronze level (where you are assuming what the impact might be), your value is likely to overestimate the value of your intervention. We’ve only introduced the value of shifting from ‘poor’ to ‘good’. Realistically this sort of shift might take a lot of resources. Shifting between other categories has different values.
To get a slightly more accurate representation of your project, think realistically about what levels of mental health you might move people from and to (see Silver, which goes into detail of different shifts).
To get an accurate representation of your project, you should survey your participants directly (see Gold, which includes pre-written questions you should use).
Silver
Effort
Accuracy
Monetised value:
Monetised social value: Consider what categories of mental health you might shift people from and to. Therefore you can calculate an estimate of the overall shift, by applying the appropriate WELLBY values.
APPLYING THE WELLBY VALUE: Consider what categories your participants might realistically be starting in. Then consider what categories they might realistically shift to. Calculate the difference, giving you a net change in each category. Multiply these net changes by the corresponding WELLBY values.
This table outlines the WELLBY value which will be applied. They all come from The WELLBY Value Guide by State of Life and use data from Understanding Society. The coefficients indicate the difference in life satisfaction associated with being in each category. ‘Poor’ is the base group to which others are compared, hence why the coefficient and the value are both 0. Values for the other categories are all compared to the ‘poor’ group.
| Coefficient on Life Satisfaction | WELLBY VALUE in 2019 prices (coefficient *£13,000 and rounded) | WELLBY VALUE in 2023 prices (rounded) | |
|---|---|---|---|
| Poor | 0.00 | £0 | £0 |
| Fair | 1.23 | £16,000 | £18,800 |
| Good | 2.01 | £26,000 | £30,700 |
| Very Good | 2.59 | £34,000 | £39,500 |
| Excellent | 2.99 | £39,000 | £45,600 |
Here’s an example
You run a men’s choir group which is a safe environment for men to talk about their feelings. Realistically participants are not suffering from ill-mental health; you estimate half the participants have ‘good’ mental health and half have ‘very good’ mental health. Through taking part in the choir, you estimate there will be some shift; e.g. a quarter still have ‘good’ mental health, half still have ‘very good’ mental health, but now a quarter have ‘very good’ mental health.
| Comparison Group (Estimated %) | Intervention Group (Estimated %) | |
|---|---|---|
| Poor | 0% | 0% |
| Fair | 0% | 0% |
| Good | 50% | 25% |
| Very Good | 50% | 20% |
| Excellent | 0% | 25% |
Next, you calculate the shift in each category. There is a shift in the ‘good’ category is -25% * £30,700 = -£7,675, but this is outweighed by the shift in the ‘excellent’ group (+25%*£45,600 = £11,400). Summing the values gives £3,725 social value per person. This can be multiplied by the number of people participating in the choir.
| Comparison Group (Estimated %) | Intervention Group (Estimated %) | Change (I-C) | Value (to be applied) | Value of change | |
|---|---|---|---|---|---|
| Poor | 0% | 0% | 0% | 0 | £0 |
| Fair | 0% | 0% | 0% | £18,800 | £0 |
| Good | 50% | 25% | -25% | £30,700 | -£7,675 |
| Very Good | 50% | 50% | 0% | £39,500 | £0 |
| Excellent | 0% | 25% | 25% | £45,600 | £11,400 |
| Total value (per person): | £3,725 |
Gold
Effort
Accuracy
Monetised value:
Monetised social value: Measure actual improved mental health, and measure actual amounts of difference that improved mental health makes to people’s lives
At Gold level you are looking to build on your silver estimations by engaging with the person or people affected.
Therefore, at the Gold level, you should survey users about their actual levels of wellbeing rather than using the proxy value.
There are many options for surveying people on their wellbeing.
A good starting point for questions to ask directly through primary research with your stakeholders is the Maximise Your Impact Guide. This guide covers 10 overall impact questions. For Gold level practice you would be looking to understand the question ‘what changes do people experience?’ and ‘how much of each change happened’. Questions you might want to include in your survey to uncover the outcomes they experience could include:
- What changed for you (or happened to you) as a result of our activity or programme?
- Were there any other changes?
- Did these changes lead on to anything else?
- Were the changes all positive?
- Were any of them unexpected?
- What did you want to happen?
- How did your situation/ circumstances affect your experience?
A starting point for questions related to wellbeing is to look at the What Works Centre for Wellbeing website: https://whatworkswellbeing.org/about-wellbeing/how-to-measure-wellbeing/ .
As you start to measure wellbeing directly from the people affected, one set of questions it is important to consider is the ONS4 – the national measures for subjective wellbeing in the UK which asks the following 4 questions on a scale of 0 to 10, where 0 is ‘not at all’ and 10 is ‘completely’:
- Overall, how satisfied are you with your life nowadays?
- Overall, to what extent do you feel that the things that you do in your life are worthwhile?
- Overall, how happy did you feel yesterday?
- On a scale where 0 is ‘not at all anxious’ and 10 is ‘completely anxious’, how anxious did you feel yesterday overall?
You could also consider other data gathering activities, including direct observation, or focus groups.
How is mental health measured?
When surveying participants directly you should use validated (tried and tested) questions. For mental health, the most commonly used is the Warwick-Edinburgh Mental Wellbeing Scale (). We recommend the shorter version with 7 questions:
- I’ve been feeling optimistic about the future
- I’ve been feeling useful
- I’ve been feeling relaxed
- I’ve been dealing with problems well
- I’ve been thinking clearly
- I’ve been feeling close to other people
- I’ve been able to make up my own mind about things
For each question participants should choose one of the five answers: `None of the time`, `Rarely`, `Some of the time`, `Often` and `All of the time`.
Users of these WELLBY values should be aware that the categories are converted from the WEMWBSs scale. The 7 questions above are answered on a 5-point scale, where ‘none of the time’ = 1 and ‘all of the time’ = 5. Therefore the total will range between 7 and 35. This validated way of asking about mental health specifically covers different aspects of mental health, therefore it’s vital to use all 7 questions, and not pick and choose certain questions.
State of Life used the following transformation[1] to convert WEMWBS answers to the ‘poor’ to ‘excellent’ categories:
[7-18 = “Poor”]
[19-21 = “Fair”]
[22-25 = “Good”]
[26-28 = “Very Good”]
[29-35 = “Excellent”]
Users of these values should use this same transformation.
Surveying people directly, particularly in relation to personal topics such as changes in mental health, should be done with though and consideration. This is especially important if there are any vulnerabilities for the group you are engaging with, including any safe guarding issues.
Support in developing your Gold survey approach is available through the Measure Up partners, so please do reach out to Impact, State of Life or PRD.
Gold+
Effort
Accuracy
Monetised value:
At the Gold+ level, you are building on your Gold value calculation by assessing the value against the counterfactual, or ‘what would have happened anyway’.
To do this you should identify a control group suitable to assess in line with your intervention, in order to more accurately attribute any changes to your intervention.
You could also consider any other discount or causality elements linked to your job creation activity.
Support in developing your Gold+ counterfactual, causality and discount approach is available through the Measure Up partners, so please do reach out to Impact, State of Life or PRD.
| Value Type: | Master outcome |
What's this?
This is the type of value. Some values are outcomes, which means many different interventions might lead to them, others are specific interventions that have a set value. |
|---|---|---|
| UN SDG Categories: |
|
What's this?
The UN Sustainable Development Goals are global goals adopted in 2015 for all signed up nations to achieve for us to have a sustainable global future by 2030. There are 17 Goals that address the global challenges we face, including those related to poverty, inequality, climate change, environmental degradation, peace and justice. The Goals are all interconnected, and in order to leave no one behind, it is important that we achieve them all by 2030. |
| PN06/20 Categories: |
|
What's this?
PPN 06/20 Taking account of social value in the award of central government contracts introduced the Central Government Social Value Model in 2020 which all Central Government contracting authorities must use in their in scope procurements. It consists of 5 themes, 8 policy outcomes, and 24 Model Award Criteria which outline key priority areas to achieve more social value. |
Evidence
Measure Up focuses on empowering you to numerically measure the impact you’re having. We recommend that numeric reports are backed up with stories and other types of evidence to help illustrate, in human terms, the impact that’s being made on individuals.
We recommend seeing consent from one or more participants in your intervention to collect and tell their story. This should include a little background on the participant, a summing up of life before the intervention, the human impact of the intervention, and the longer term (if known) impact on the person’s life outside of, and after, the intervention.
Providing photographs, audio recordings, video interviews or even artefacts from the intervention (for example, writing, paintings, music, etc from creative interventions) can add more colour, and convey the emotional impact of interventions more directly.
In some cases it’s appropriate to anonymise or abbreviate the personal information of case study participants. No story should be published or shared without the recorded consent of the individual(s) it concerns. Individuals continue to own the rights to their stories and if they request you stop sharing the story or making it available online you should do so promptly and without need for justification.
Feedback
Measure Up is an open, collaborative and transparent. If you have any suggestions or feedback on our pragmatic, recommended approach to measuring and valuing social value, including wellbeing, economic, and fiscal impact, and effects on our environment, please get in touch so we can share and discuss this at our next Advisory Group meeting.
More help
We want to empower anyone to perform and improve their impact measurement – without needing a degree in economics.
If you need any more help, or just someone to do the legwork for you we can help signpost you to software, training and consultancy to help you get to grips with the impact you’re having.
