Development and preliminary validation of the Well-being and Workload Assessment Tool (WWAT)

Sustainability of global mental health initiatives depends not only on service user outcomes but also on the well-being of those delivering care. Despite growing recognition of the psychological demands faced by non-specialist providers (NSP), there is a lack of standardized instruments capturing their psychosocial well-being in relation to workload within task-sharing contexts. This study developed and preliminarily validated the Well-being and Workload Assessment Tool (WWAT), a brief, contextually grounded instrument assessing NSP experience. Following expert consultation and cognitive interviews, data from 111 NSP were analyzed using exploratory and confirmatory factor analyses (EFA; CFA) to examine internal structure, reliability, and convergent validity. The final 13-item WWAT assesses four domains: well-being, workload, emotional burden, and vicarious trauma. EFA supported a four-factor solution explaining 58% of variance, retained on theoretical grounds. CFA indicated acceptable model fit (χ2/df = 1.54; CFI = 0.895; TLI = 0.861; RMSEA = 0.070; SRMR = 0.083). Internal consistency was satisfactory for the total scale (α = 0.71) and for well-being (α = 0.78) and workload (α = 0.72), while emotional burden (α = 0.59) and vicarious trauma (α = 0.39) showed lower reliability. Convergent validity was supported through associations with the Professional Quality of Life Scale and WHO-5. The WWAT is a promising tool for assessing NSP well-being and workload in task-sharing settings. Further refinement and validation are needed. Its integration into monitoring systems may support sustainable and evidence-informed mental health service delivery.