Wellbeing, meaning and measurement
The 2014 Scottish Universities Insight Institute (SUII) seminar series on wellbeing is a timely opportunity to explore the concept from diverse perspectives. I am part of the Good Lives and Decent Societies (GLADS) team, considering individual and societal factors to support wellbeing across relevant policy areas.
The first of three events in the series took place on 25th February. A unifying concern on this day was to expand understanding of societal progress on more than economic measures, to include wellbeing and sustainability. The opening contributions from GLADS team members set the discussion in the context of historical Scottish figures, from Adam Smith to Samuel Smiles. We were also invited to consider the plethora of wellbeing models already in operation, including an appraisal of their strengths and limitations. http://www.scottishinsight.ac.uk/Programmes/Wellbeing2014/GLADSGoodLivesAndDecentSocieties.aspx
Attempts to agree on a definition of wellbeing stirred up a lively debate, particularly on whether wellbeing or happiness was the more useful concept, and questions of wellbeing measurement were more contentious still.
This first seminar provided an opportunity to consider how wellbeing and its measurement relate to a 2013/14 ESRC research project of which I am co-investigator: Meaningful and Measurable. The project builds on ten years of research and knowledge exchange on the theme of personal outcomes, largely in heath and social care. We have worked with the Scottish Government and national agencies since 2006, figuring out how to embed personal outcomes in practice. This approach has helped us to develop a language to understand wellbeing via subjective measurement of progress towards particular outcomes.
A central shift in focus has been to move away from service led approaches towards clarifying the purpose of engagement and activity, considering the role and assets of the person. Talking Points personal outcomes approach involves engaging with the individual about their priorities, through good conversations and communication, and basing decisions and any support required around those priorities. The approach has demonstrated the importance of focusing on three types of outcome:
• Quality of life outcomes, such as being as well as you can and feeling safe
• Change outcomes, associated with recovery, such as improving confidence and managing symptoms
• Process outcomes, which include being listened to and respected.
The approach fits well with work by Stiglitz, Sen and Fitoussi who argue that a multidimensional definition is required for understanding wellbeing. http://www.stiglitz-sen-fitoussi.fr/documents/rapport_anglais.pdf
We have found it is possible to measure outcomes at the individual level, and through combining and analysing scale measure and qualitative data, to understand what is working with regard to outcomes at service level. In many areas in Scotland this information is feeding into planning and community development. Interestingly, where qualitative data is being used, this highlights the importance of conversations and relationships for people engaging with services over time. Good engagement with individuals already achieves outcomes, through providing an opportunity to be heard, to reflect, and to consider themselves as active participants in shaping their lives.
The central concern throughout has been the tension between the improvement potential of engaging with individuals in working towards optimal wellbeing and independence, and the performance management agenda. We are now in the midst of the knowledge exchange project which involves 3 universities, 8 practice partners and 4 national organisations, seeking to further reconcile meaning and measurement in the context of people’s lives.
The first GLADS seminar highlighted themes that resonate strongly. These include the need to develop a common language, and common definitions. And in particular, with regard to measurement, Neil Thin questioned an over reliance on statistical means of measuring wellbeing, or ‘pathological numerophilia’, arguing for a broader approach to understanding wellbeing, based on conversations.
Our second GLADS seminar raises practical challenges for my quest to link with the Meaningful and Measurable project, as the second two day ‘data retreat’ for the latter is being held on the same dates as the GLADS workshop. However, given both events are in Edinburgh I am sure we will find a way of making a link, which can be pursued further in the final GLADS seminar in June.