For decades, terms like mental well-being, flourishing and positive mental health have meant different things to different researchers.
A new international study published in Nature Mental Health in 2026 has now produced the first formally agreed answer, identifying 19 specific dimensions that together describe what good mental health actually looks like.
The work used the Delphi method, a structured process in which experts anonymously rate and re-rate a set of ideas across several rounds until stable agreement emerges.
The panel, reported by PsyPost, included 122 academics from 26 countries and 11 disciplines, from clinical psychology and psychiatry to economics, sociology, philosophy and theology. Participants averaged about 20 years of experience in the field.
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"Put very simply, there is very little agreement on what we mean when we say mental wellbeing, flourishing, positive mental health, or related terms," lead author Matthew Iasiello of Be Well Co and Adelaide University's School of Biomedical Science told PsyPost. The panel's job was to fix that.
The six dimensions with the strongest agreement
Nineteen dimensions cleared the study's 75 percent consensus threshold. Six of them cleared 90 percent, marking them as the most widely accepted core of positive mental health.
According to the researchers, those six are meaning and purpose, life satisfaction, self-acceptance, connection with others, autonomy, and happiness. Together they cover a sense that life is worthwhile, a positive overall appraisal of how it is going, a settled relationship with oneself, close relationships, a feeling of ownership over one's choices, and pleasant everyday emotional states.
"Positive mental health is broad. It's more than feeling happy and more than simply not being unwell," Iasiello said.
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The full list of 19 dimensions
Alongside the top six, the panel agreed on 13 further dimensions that make up the broader picture of positive mental health, as summarized by PsyPost's coverage of the study:
Dimension | What it captures |
|---|---|
Meaning and purpose Also read: 8 warning signs of stomach cancer most people mistake for indigestion | A sense that one's life and work are worthwhile |
Life satisfaction | A positive overall evaluation of one's life |
Self-acceptance Also read: If you take antibiotics, these common foods may make them less effective | Viewing oneself positively and without harsh judgment |
Connection with others | Feeling close to loved ones and part of a wider circle |
Autonomy Also read: 8 warning signs of an overactive thyroid most people blame on stress | A sense of ownership over one's choices and behavior |
Happiness | Pleasant, moderate-intensity emotional states |
Acceptance | Coming to terms with what lies outside one's control |
Achievement | Reaching goals through personal effort |
Activities and functioning | Satisfaction with everyday tasks and leisure |
Belonging | Feeling part of a group, place or community |
Calmness | Low-arousal pleasant feelings such as serenity |
Competence | A sense of being effective and capable |
Development | Experiencing personal growth over time |
Engagement | Being fully absorbed in what one is doing |
Fun | Light-hearted pleasure and enjoyment |
Optimism | A positive outlook on the future |
Self-congruence | Acting in line with one's values and beliefs |
Sense of safety | Feeling relatively secure in daily life |
Vitality | High-arousal pleasant states such as energy and aliveness |
The panel also found it hard to say which of these dimensions cause good mental health and which are the result of it. In practice, most of them appear to feed one another.
Why researchers wanted a shared definition
Public health specialists have long argued that mental health is not simply the absence of mental illness. But without a shared vocabulary, measurement tools, prevention programs and policies have pulled in different directions.
Co-author Joep van Agteren told Medical Xpress that everyday institutions already shape these dimensions, often without noticing. "Whether it's government departments creating spaces for connection, or teachers building optimism in kids at school, many of us are already contributing to well-being without realizing it," he said.
The framework also lines up with a broader shift in research showing that lifestyle factors influence mental health as well as physical health. Regular movement, for example, appears to matter for mood in ways comparable to some medical treatments, as covered in earlier reporting on how exercise can perform on par with antidepressants for some patients.
What it means for readers
The list is a working definition, not a checklist a person is supposed to score full marks on. The researchers describe positive mental health as a mix that varies from person to person and across the course of a life. Someone can rank high on connection and low on autonomy at the same time and still be doing well overall.
The panel skewed toward experts based in Western countries, with 84 percent identifying as Caucasian or European. Follow-up work in other regions will test whether the 19 dimensions hold up across cultures. In the meantime, the framework is now published and available for researchers, clinicians and public health authorities to build on.
Anyone experiencing persistent low mood, anxiety or thoughts of self-harm should speak to a licensed health professional rather than rely on a self-check against a list of dimensions.
This article is made and published by Jesper Bengtson, who may have used AI in the preparation.