OBJECTIVES: The objective was to examine the content of EQ-5D and SF-6D against what individuals with mental health problems perceive to be important to their quality of life using  rigorous qualitative methods. METHODS: We first undertook a systematic review of qualitative research undertaken with people with mental health problems. This review provided the basis for the topic guide used in semi structured in-depth interviews undertaken with 19 people who had a broad range of mental health problems at varying levels of severity drawn from primary and secondary care services (including mood disorders and psychosis) in the UK.  The interviews were analysed thematically using framework analysis.  RESULTS: A framework analysis of 13 qualitative studies revealed six major themes: well-being and ill-being; control, autonomy and choice; self-perception; belonging; activity; and hope.  Despite widening the types and severity of mental health problems studied, our interview data fitted well with the themes from the review, any differences tended to be within the themes and related to the degree of impact of the themes on different levels of severity, chronicity and diagnosis. Physical health was also found to be more important amongst the interviewees, so it was added as a seventh theme as opposed to a minor sub-theme in the review. CONCLUSIONS: The review of qualitative research and our own interviews raises important questions about the content validity of the EQ-5D and SF-6D in mental health. While well-being and ill-being are partly covered by dimensions like ‘depression and anxiety’ and ‘feeling downhearted and low’, this leaves out other important aspects such as control, autonomy and choice; self-perception; belonging (to society); and hope.