--- - |2+ Abstract Objective The literature suggests a distinction between illness (negative health) and the ability to cope with challenges such as illness (positive health). The two continua model of mental health distinguishes psychiatric symptoms (illness) from well‐being (positive health). Well‐being consists of hedonic, eudaimonic, and social well‐being, constituting one factor that is moderately correlated with psychopathology in the general population. In a mental health care population, we examined whether the three dimensions of well‐being are distinguishable and whether well‐being is also moderately correlated with symptoms. Method A representative sample of 1,069 patients (63% female, 47% male; mean age: 42 years) voluntarily completed the Mental Health Continuum‐Short Form (MHC‐SF), a 14‐item test that assesses three components of well‐being. Results Confirmatory factor analysis revealed a model with strong correlations between the three subscales of the MHC‐SF, indicating poor discriminant validity. Furthermore, the MHC‐SF was strongly correlated (r = −.71) with the symptomatic distress scale of the OQ‐45. Exploratory factor analysis permitted a two‐factor solution, providing support for the two continua model of mental health. However, the explained variance of the second factor (well‐being) was meager in comparison with the first factor (psychopathology). The results of a canonic correlation did not confirm the two continua model, and only a model with one common canonical factor was significant. Conclusions For patients with clinical levels of psychopathology, the level of well‐being and psychopathology correlate much higher than in the general population. Well‐being and psychopathology are so entwined that the supposed distinction should be seriously questioned. - Journal of Clinical Psychology, EarlyView.