WHO-5 PDF Download
WHO-5 Well-Being Index
Ultra-brief positively worded questionnaire measuring well-being. Can screen for depression.
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Catch early warning signs before the next session
The WHO-5 is translated into over 30 languages and used globally
When to Use the WHO-5
WHO-5 Scoring Guide (Score Range: 0-100)
| Score | Severity Level | Clinical Action |
|---|---|---|
| 0-28 | Poor | Screen for depression |
| 29-50 | Low | Assessment recommended |
| 51-72 | Moderate | Monitor |
| 73-100 | Good | Positive mental health |
Key Features of the WHO-5
- Ultra-brief (5 items)
- Positively worded
- WHO-developed
What the WHO-5 Actually Measures
The WHO-5 is unique in assessing positive psychological well-being rather than symptoms of disorder. Its five items capture vitality, mood, interest, sleep quality, and engagement. This positive framing makes it less stigmatizing and more acceptable to patients resistant to 'mental health' screening.
Positive Mood (Items 1-2)
Feeling cheerful and in good spirits, feeling calm and relaxed—emotional well-being
Vitality (Item 3)
Feeling active and vigorous—energy and life force
Engagement (Item 4)
Waking up feeling fresh and rested—restorative sleep and readiness for the day
Interest (Item 5)
Daily life filled with interesting things—engagement with life and absence of anhedonia
What Scores Actually Mean in Practice
Good psychological well-being. No intervention indicated. These scores are protective against future mental health problems.
"I feel good most of the time. I have energy, I sleep well, and I enjoy my life."
Moderate well-being with room for improvement. May benefit from preventive interventions or lifestyle modifications. Monitor for decline.
"Things are okay. Some days are better than others. I wouldn't say I'm thriving, but I'm managing."
Poor well-being suggesting possible depression or other mental health concerns. Screen with PHQ-9 and consider intervention.
"I haven't been feeling like myself lately. Less energy, less interest in things. Mornings are hard."
Very poor well-being with high sensitivity for depression. Immediate follow-up with PHQ-9 or clinical interview. Active intervention likely needed.
"I feel worn down all the time. Nothing brings me joy anymore. I dread each day."
Common Misinterpretations
The WHO-5 is just another depression screener
The WHO-5 measures positive well-being, not depression symptoms. It captures the presence of well-being, not just the absence of illness. This makes it useful for tracking recovery beyond symptom reduction.
High WHO-5 scores rule out mental health problems
Patients can maintain some positive well-being despite anxiety, PTSD, or other conditions. The WHO-5 is sensitive for depression but less so for other disorders. Don't skip other screening based on high WHO-5 alone.
The WHO-5 is only useful for population health surveys
The WHO-5 is highly useful in clinical practice as a low-stigma screener, treatment outcome measure, and way to track recovery. Its positive framing makes it acceptable to patients who resist 'mental health' assessment.
A 10-point change is clinically meaningful
A 10% change (10 points on the 0-100 scale, or 2.5 points on the 0-25 raw scale) represents clinically meaningful change. Smaller changes may be noise.
The WHO-5 can't detect change during treatment
The WHO-5 is highly sensitive to change in both pharmacological and psychotherapy trials. It often shows improvement earlier than symptom-focused measures as patients begin to experience positive states.
What Low WHO-5 Scores Mean for Treatment Engagement
Patients with very low WHO-5 scores (≤28%) are experiencing profound absence of positive emotion and engagement. This state powerfully undermines motivation for treatment. Understanding the WHO-5 pattern helps tailor engagement strategies.
Key Retention Strategies:
- Low vitality scores (Item 3) predict difficulty with homework and between-session activities—simplify expectations
- Low engagement scores (Item 5) suggest anhedonia—behavioral activation approaches may be particularly helpful
- The positive framing of WHO-5 can be used therapeutically: 'Our goal is to help you feel more cheerful and energetic'
- Track WHO-5 alongside symptom measures—patients may notice well-being improvements before symptom reduction
- Very low scores (≤28%) have high specificity for depression—don't skip PHQ-9 follow-up
- Patients with low WHO-5 but low PHQ-9 may have adjustment issues, burnout, or life circumstances driving low well-being
- The non-stigmatizing language makes WHO-5 useful for patients resistant to 'mental health' treatment
- Improvement in WHO-5 during treatment reinforces continued engagement—share scores with patients
Frequently Asked Questions About the WHO-5
What is the WHO-5?
The WHO-5 (World Health Organization Well-Being Index) is a 5-item questionnaire measuring subjective psychological well-being over the past two weeks.
How is the WHO-5 scored?
Raw scores range 0-25. Multiply by 4 for a percentage score (0-100%). Scores below 50% suggest poor well-being; below 28% indicates likely depression.
You're not alone, and help is available.
If you are experiencing thoughts of suicide or feel at risk of harming yourself, please contact emergency services right away or reach out to the 988 Suicide & Crisis Lifeline (call or text 988 in the U.S.). If you are in immediate danger, call 911.
Related Assessments
Research Supporting Outcome Measurement
Evidence-based research on the importance of patient-reported outcome measures in behavioral health treatment.
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