Nineteen answers to a question nobody had agreed on

Ask someone how they’re doing and you’ll usually get one word back. Fine. Good. Alright. Not great.

It’s a remarkably small container for a remarkably big question, and most of us never look inside it. What would it even mean to be doing well? Not better than yesterday, not coping — well. If you had to say what the word was actually pointing at, could you?

It turns out the people who study this for a living have been struggling with exactly the same thing.

The definition problem

Earlier this month, Nature Mental Health published a study that set out to fix a surprisingly stubborn gap: after decades of research into wellbeing, flourishing, thriving and positive mental health, there is still very little agreement about what any of those words mean.

Matthew Iasiello, one of the researchers behind it, put it plainly to PsyPost: “there is very little agreement on what we mean when we say mental wellbeing, flourishing, positive mental health, or related terms.” Psychologists, economists, public health officials and philosophers all use overlapping vocabulary for slightly different ideas — which makes evidence hard to compare and leaves governments and funders, in his words, “guessing about what to measure and where to invest.”

So the team tried something unglamorous and rather sensible. They asked.

How they did it

The study used the Delphi method: a structured way of surveying a group of experts over several rounds until a consensus emerges, or clearly doesn’t. The panel was 122 academics from 26 countries across 11 disciplines — clinical psychology, psychiatry, public health, philosophy, nursing, economics and more — with an average of nearly twenty years in their fields.

In round one they rated 26 candidate dimensions of positive mental health, from irrelevant to essential. A dimension had to reach at least 75% agreement to survive. Later rounds added expert-suggested items and asked whether each dimension was more of a driver of wellbeing or an outcome of it.

Nineteen dimensions made the final list. Six cleared 90% agreement: meaning and purpose, life satisfaction, self-acceptance, connection, autonomy and happiness.

The other thirteen are worth reading slowly, because they’re broader than the usual shortlist: acceptance, achievement, activities and functioning, belonging, calmness, competence, development, engagement, fun, optimism, self-congruence, a sense of safety, and vitality.

Fun is on the list. So is calmness. So is feeling relatively safe in your ordinary day.

Some things didn’t make it. Avoidance coping — trying to not-think your way past a stressor — reached only about 20% agreement and was excluded outright. More interestingly, physical health (62.8%) and personal circumstances (62.5%) both fell short of the threshold, suggesting the panel saw them as forces acting on wellbeing rather than parts of it.

Why we keep coming back to this one

The sentence that stayed with us is Iasiello’s summary for a general audience: positive mental health “is more than feeling happy and more than simply not being unwell.”

That second half is the part worth sitting with. A lot of us quietly run on a one-dimensional model — there’s struggling, and then there’s not struggling, and not-struggling is assumed to be the finish line. This study is nineteen separate arguments that it isn’t. You can be nowhere near struggling and still be missing connection, or meaning, or the ordinary experience of finding something fun.

The other finding we liked was the one the researchers themselves found surprising. When they asked the panel to sort the dimensions into drivers and outcomes, most of them refused to sit neatly on either side. Connection can be the thing that lifts a week, or the thing a lifted week produces. “Most of the 19 included dimensions could be seen as both an outcome or a driver,” Iasiello said, “depending on the research question or population.”

There’s something oddly freeing in that. If there’s no single lever, there’s also no single lever you’re failing to pull.

The honest caveats

This is a consensus study, not an experiment. It tells you what a particular group of experts agreed on — it doesn’t measure anyone’s wellbeing or prove that any dimension causes any other. The response rate was around 10% of those invited, and the panel was heavily Western and English-speaking; roughly 84% identified as Caucasian or European.

The researchers say so themselves, which we appreciated. Iasiello’s warning is that “the main misinterpretation is thinking that this work is a finished product,” and he points to ikigai — the Japanese sense of a reason for being — as an idea that may not sit neatly inside a Western-built framework. It’s a starting point. It’s meant to be argued with.

The reason we built Nagi

Nagi isn’t going to hand you a score across nineteen dimensions, and we’d be sceptical of anything that claimed to. But this study sits close to a decision made early on.

We didn’t want to bolt a few questions together and call it a wellbeing measure, so we built the S8 — and rather than assume it works, we’re running a formal validation study to find out whether it holds up. That’s slower than shipping a number and moving on. Research like this is a good argument for the slow version.

The everyday half is simpler. Somewhere underneath the taxonomies, there’s just you, on a Wednesday, trying to work out how you’re actually doing. That’s what the four-tap check-in is for: mood, sleep, energy, done in seconds, kept private. No name, no email. Not an assessment of nineteen things — just one honest, repeatable note, so that over weeks a pattern can show you something a single evening never could.

Where that leaves us

You don’t need a taxonomy to take how you’re doing seriously. But it helps to know that the experts, after three rounds and 26 countries, landed on a definition of well that has room in it for fun, for safety, for calm, for being at peace with yourself — and not only for the absence of a bad week.

If “fine” is the only word you’ve been using lately, it might be worth asking which of the nineteen it’s standing in for.

If you want a private place to start noticing your own patterns, Nagi is on Google Play and the App Store — or in your browser at app.nagiandme.app. The first 15 messages are free. No name, no email. Just you, checking in.

— The Nagi team

Source: Scientists identify 19 core dimensions of positive mental health in new consensus study, PsyPost, 12 August 2026. Underlying study: Iasiello, M. et al., A Delphi consensus study on the dimensions of positive mental health, Nature Mental Health (2026).

Nagi & Me is a mental health companion app, not a medical device, and nothing here is medical advice. If you’re struggling, please reach out to a professional or someone you trust.