Questionnaire template
Well-Being Index (WHO-5)
Screens adults' current mental well-being over the past two weeks with the free five-item WHO-5 index.
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Healthcare · Mental health assessment. All Healthcare templates
Questions in this template
Mood
Thank you for taking part. Five short statements ask how you have been feeling recently, and your answers will help shape future health initiatives.
This questionnaire is the WHO-5 Well-Being Index, developed by the World Health Organization Regional Office for Europe and the Psychiatric Research Unit, Mental Health Centre North Zealand (Per Bech and colleagues). It is free to use.
Your result is a screening aid, not a diagnosis. If you are worried about your mood, please talk to a health professional.
Please indicate for each of the five statements which is closest to how you have been feeling over the last two weeks.
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Over the last two weeks: I have felt cheerful and in good spirits
Choose one:
- All of the time
- Most of the time
- More than half of the time
- Less than half of the time
- Some of the time
- At no time
-
Over the last two weeks: I have felt calm and relaxed
Choose one:
- All of the time
- Most of the time
- More than half of the time
- Less than half of the time
- Some of the time
- At no time
Energy
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Over the last two weeks: I have felt active and vigorous
Choose one:
- All of the time
- Most of the time
- More than half of the time
- Less than half of the time
- Some of the time
- At no time
Rest and Interest
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Over the last two weeks: I woke up feeling fresh and rested
Choose one:
- All of the time
- Most of the time
- More than half of the time
- Less than half of the time
- Some of the time
- At no time
-
Over the last two weeks: My daily life has been filled with things that interest me
Choose one:
- All of the time
- Most of the time
- More than half of the time
- Less than half of the time
- Some of the time
- At no time