Background
The General Population Clinical Outcomes in Routine Evaluation (GP-CORE) and the Warwick-Edinburgh Mental Well-being Scale (WEMWBS) are two instruments often used to measure psychological distress or well-being in student samples. This study aimed to directly compare the ability of the two instruments to yield information on psychological distress in this population. Specifically, the ability of the scores to predict mental health service utilisation was compared.
Methods
GP-CORE and WEMWBS scores, sociodemographic and educational data were available for 1260 students at a UK University (Time 1) and for 265 students at 6-month follow-up (Time 2). Rasch calibration was performed on baseline data to evaluate test information, with item and person fit assessed using infit/outfit and item characteristic curves. Effect sizes (Cohen's d) and discriminative ability (area under the curve—AUC) were estimated for predicting future mental health service utilisation.
Results
Both measures were acceptably reliable (α > 0.8), though the WEMWBS was better at discriminating between respondents, as indicated by the person separation indices (GP-CORE = 2.34; WEMWBS = 3.06). The GP-CORE scores were more sensitive to service utilisation status (Cohen's d = 0.31, p = 0.02) compared to those from the WEMWBS (Cohen's d = 0.25, p = 0.06). The GP-CORE scores were statistically significantly superior at discriminating between students reporting service utilisation vs. those that did not (AUC = 0.59 vs. 0.43, p = 0.02).
Conclusion
Although the WEMWBS scores may be superior at differentiating between different levels of ‘psychological well-being’, the GP-CORE scores are more predictive of service utilisation and may be more appropriate when screening students for potential mental health issues that warrant formal support.
Implications
Implications for Practice
1. Integrate the GP-CORE into triage and assessment processes to support resource planning: GP-CORE scores showed a stronger association with mental health service utilisation, but the WEMWBS scores did not. This suggests that embedding the GP-CORE into standard triage or assessment pathways within Higher Education settings could enhance decision-making around resource distribution and clinical prioritisation.
2. Review barriers to help-seeking and service engagement within university systems: GP-CORE scores alone predicted ‘mental health service utilisation’, whereas the GP-CORE and WEMWBS scores predicted ‘help-seeking’. This highlights a potential gap between students' intentions and their actual engagement, indicating the need for institutions to review individual (e.g., stigma, literacy, symptom burden) and structural (e.g., accessibility, administrative processes) barriers within their support pathways.
3. Use the GP-CORE or WEMWBS for early identification of students whose mental health is worsening: The GP-CORE and WEMWBS are sensitive to identifying changes in distress and well-being levels in students within higher education settings, making them useful instruments for routine monitoring, enabling services to detect rising risk earlier and intervene in a timely manner.
Implications for Policy
Use GP-CORE and WEMWBS in ways aligned with the University Mental Health Charter (UMHC): The UMHC emphasises both promoting well-being across the whole university and providing accessible clinical support. The significant association between GP-CORE and mental health service use positions the GP-CORE as a more appropriate measure for informing policy decisions related to identifying students requiring clinical intervention and ensuring adequate service capacity, supporting evidence-informed approaches adopted within the UMHC framework. Although WEMWBS did not predict service utilisation, its precision in capturing population-level well-being makes it well suited for evaluating preventative and promotional initiatives encouraged by the UMHC.
CORE (COnnecting REpositories)
CORE (COnnecting REpositories)