Neuroticism and mental health outcomes for long-term unemployed youth attending occupational skills training programs

The Effectiveness of Health-Oriented Interventions and Health Promotion for Unemployed People-A Meta-Analysis

Background: Unemployment is known to have negative effects on mental and physical health. Yet, the effectiveness of interventions aimed at improving the health of unemployed people is unclear. Methods: We conducted a random-effects meta-analysis of extant intervention studies with at least two measurement points and a control group. A literature search in PubMed, Scopus, and PsycINFO in December 2021 identified 34 eligible primary studies with 36 independent samples. Results: For mental health, the average meta-analytic effect sizes for the comparison of the intervention group and the control group were significant and of small size after the intervention, d = 0.22; 95% CI [0.08, 0.36], as well as at follow-up, d = 0.11; 95% CI [0.07, 0.16]. Effects on self-assessed physical health status were small and marginally significant (p = 0.10) after the intervention: d = 0.09; 95% CI [-0.02, 0.20], and insignificant at follow-up. However, when job search training was not part of the intervention program (i.e., all available resources were used solely for health promotion), the average effect size for physical health was significant after the intervention, d = 0.17; 95% CI [0.07, 0.27]. Furthermore, the effects of physical activity promotion were significant and of small-to-medium size after the intervention, leading to increased levels of activity, d = 0.30; 95% CI [0.13, 0.47]. Conclusions: Population-based health promotion programs are recommended because even measures with small effect sizes can actually improve the health of a large group of unemployed people.

Mental health and unemployment: A systematic review and meta-analysis of interventions to improve depression and anxiety outcomes

BACKGROUND

Unemployment is associated with substantially greater depression and anxiety, constituting a considerable public health concern. The current review provides the most comprehensive synthesis to date, and first meta-analysis, of controlled intervention trials aimed at improving depression and anxiety outcomes during unemployment.

METHODS

Searches were conducted within PsycInfo, Cochrane Central, PubMed and Embase from their inception to September 2022. Included studies conducted controlled trials of interventions focused on improving mental health within unemployed samples, and reported on validated measures of depression, anxiety, or distress (mixed depression and anxiety). Narrative syntheses and random effects meta-analyses were conducted among prevention- and treatment-level interventions for each outcome.

RESULTS

A total of 39 articles reporting on 33 studies were included for review (sample sizes ranging from 21 to 1801). Both prevention and treatment interventions tended to be effective overall, with treatment interventions producing larger effect sizes than prevention interventions. The clearest evidence for particular intervention approaches emerged for prevention-level Cognitive Therapy/CBT, followed by prevention-level work-related interventions, although neither produced entirely consistent effects.

LIMITATIONS

Risk of bias was generally high across studies. Low numbers of studies within subgroups precluded any comparisons between long-term and short-term unemployment, limited comparisons among treatment studies, and reduced the power of meta-analyses.

CONCLUSIONS

Both prevention- and treatment-level mental health-focused interventions have merit for reducing symptoms of anxiety and depression among those experiencing unemployment. Cognitive Therapy/CBT and work-related interventions hold the most robust evidence base, which can inform both prevention and treatment strategies implemented by clinicians, employment services providers, and governments.

Personal Effectiveness Training for Unemployed People: Where to Now?

Unemployment remains a major social problem in Australia. Successive governments have attempted to address the problem, in part, by funding occupational skills-based training programs for the unemployed. This paper reviews the general area of occupational skills/personal effectiveness training for unemployed people, and reports on outcomes for individuals attending “typical” courses in Australia. Also reported are outcomes for unemployed people who attended specially devised training, based on the cognitive-behavioural (e.g., Beck, 1976) and learned optimism (Seligman, 1990) intervention approaches. This training aimed to improve well-being, confidence and coping abilities. Variables assessed included individual well-being (e.g. psychological distress), confidence (e.g. self-efficacy), attitude-to-work (e.g. work commitment), training climate and labour market outcomes such as return-to-work. More positive outcomes were identified for unemployed people attending the specially devised programs. The authors argue that training targeted at unemployed people must be based on sound theoretical principles to produce measurable long-term benefits. Future applications of personal development programs are discussed in relation to occupational skills-based training and as stand-alone programs.

EEPIC - Enhancing Employability through Positive Interventions for improving Career potential: the impact of a high support career guidance intervention on the wellbeing, hopefulness, self-efficacy and employability of the long-term unemployed - a study protocol for a randomised controlled trial

Background

Labour market policy (LMP) and its implementation have undergone rapid change internationally in the last three decades with a continued trend towards active LMP. In Ireland however, this shift has been more recent with ongoing reforms since 2012 and a concomitant move toward active labour market ‘work-first’ policy design (i.e. whereby unemployed people are compulsorily required to work in return for their social welfare benefits). Labour market policies vary from those that require this compulsory approach to those which enable the unemployed to move towards sustainable quality work in the labour market through upskilling (human capital approach). Despite this, however, long-term unemployment—a major cause of poverty and social exclusion—remains high, while current employment support approaches aimed at sustainable re-employment are, arguably, unevaluated and under examined. This study examines the effectiveness of a new high support career guidance intervention in terms of its impact on aspects of wellbeing, perceived employability and enhancing career sustainability.

Method

The study involves a single-centre randomised, controlled, partially blinded trial. A total of 140 long-term unemployed job-seekers from a disadvantaged urban area will be randomly assigned to two groups: (1) an intervention group; and (2) a ‘service as usual’ group. Each group will be followed up immediately post intervention and six months later. The primary outcome is wellbeing at post intervention and at six-month follow-up. The secondary outcome is perceived employability, which includes a number of different facets including self-esteem, hopefulness, resilience and career self-efficacy.

Discussion

The study aims to assess the changes in, for example, psychological wellbeing, career efficacy and hopefulness, that occur as a result of participation in a high support intervention vs routinely available support. The results will help to inform policy and practice by indicating whether a therapeutic approach to job-seeking support is more effective for long-term unemployed job-seekers than routinely available (and less therapeutic) support. The findings will also be important in understanding what works and for whom with regard to potentially undoing the negative psychological impacts of unemployment, building psychological capital and employability within the individual, and developing career trajectories leading to more sustainable employment.

Trial registration

ISRCTN registry, ISRCTN16801028. Registered on 9 February 2016.

Electronic supplementary material

The online version of this article (10.1186/s13063-018-2485-y) contains supplementary material, which is available to authorized users.

Are we failing young people not in employment, education or training (NEETs)? A systematic review and meta-analysis of re-engagement interventions

BACKGROUND

Youth comprise 40% of the world's unemployed, a status associated with adverse wellbeing and social, health, and economic costs. This systematic review and meta-analysis review synthesises the literature on the effectiveness of interventions targeting young people not in employment, education, or training (NEET).

METHODS

Randomised and quasi-randomised trials with a concurrent or counterfactual control group and baseline equivalence are included. Cochrane collaboration tools are used to assess quality, and a narrative synthesis was undertaken. The primary outcome is employment; secondary outcomes were health, earnings, welfare receipt, and education.

RESULTS

Eighteen trials are included (9 experimental and 9 quasi-experimental), sample sizes range from 32 to 54,923. Interventions include social skills, vocational, or educational classroom-based training, counselling or one-to-one support, internships, placements, on-the-job or occupational training, financial incentives, case management, and individual support. Meta-analysis of three high-quality trials demonstrates a 4% (CI 0.0-0.7) difference between intervention and control groups on employment. Evidence for other outcomes lacks consistency; however, more intensive programmes increase employment and wages over the longer term.

CONCLUSIONS

There is some evidence that intensive multi-component interventions effectively decrease unemployment amongst NEETs. The quality of current evidence is limited, leaving policy makers under-served when designing and implementing new programmes, and a vulnerable population neglected.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42014007535.

Are we failing young people not in employment, education or training (NEETs)? A systematic review and meta-analysis of re-engagement interventions

BACKGROUND

Youth comprise 40% of the world's unemployed, a status associated with adverse wellbeing and social, health, and economic costs. This systematic review and meta-analysis review synthesises the literature on the effectiveness of interventions targeting young people not in employment, education, or training (NEET).

METHODS

Randomised and quasi-randomised trials with a concurrent or counterfactual control group and baseline equivalence are included. Cochrane collaboration tools are used to assess quality, and a narrative synthesis was undertaken. The primary outcome is employment; secondary outcomes were health, earnings, welfare receipt, and education.

RESULTS

Eighteen trials are included (9 experimental and 9 quasi-experimental), sample sizes range from 32 to 54,923. Interventions include social skills, vocational, or educational classroom-based training, counselling or one-to-one support, internships, placements, on-the-job or occupational training, financial incentives, case management, and individual support. Meta-analysis of three high-quality trials demonstrates a 4% (CI 0.0-0.7) difference between intervention and control groups on employment. Evidence for other outcomes lacks consistency; however, more intensive programmes increase employment and wages over the longer term.

CONCLUSIONS

There is some evidence that intensive multi-component interventions effectively decrease unemployment amongst NEETs. The quality of current evidence is limited, leaving policy makers under-served when designing and implementing new programmes, and a vulnerable population neglected.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42014007535.

The General Health Questionnaire and Eysenck's Three-Dimensional Model of Personality

A sample of 115 men and women between the ages of 20 and 60 completed the 30-item General Health Questionnaire together with the short-form Revised Eysenck Personality Questionnaire. The data indicate psychological distress so assessed is correlated .43 ( p<.001) with Neuroticism and –.26 ( p<.01) with Introversion but is unrelated to Psychoticism scores.

Financial hardship, mastery and social support: Explaining poor mental health amongst the inadequately employed using data from the HILDA survey

Objective

This study analysed data from the Household Income and Labour Dynamics in Australia (HILDA) Survey to examine the relationship between employment status and mental health, and the mediating effects of financial hardship, mastery and social support. In addition, the study sought to explore the effects of duration of unemployment on mental health.

Methods

The primary analysis used three waves of data from the HILDA Survey with 4965 young adult respondents. Longitudinal population-averaged logistic regression models assessed the association of employment status and mental health, including the contribution of mastery, financial hardship and social support in explaining this association between employment groups (unemployed vs. employed; under employed vs. employed). Sensitivity analyses utilised a fixed-effects approach and also considered the full-range of working-age respondents. Regression analysis was used to explore the effect of duration of unemployment on mental health.

Results

Respondents’ who identified as unemployed or underemployed were at higher risk of poor mental health outcomes when compared to their employed counterparts. This association was ameliorated when accounting for mastery, financial hardship and social support for the unemployed, and was fully mediated for the underemployed. The fixed-effects models showed the transition to unemployment was associated with a decline in mental health and that mastery in particular contributed to that change. The same results were found with a broader age range of respondents. Finally, the relationship between duration of unemployment and mental health was not linear, with mental health showing marked decline across the first 9 weeks of unemployment.

Conclusions and implications

Mastery, social support and financial hardship are important factors in understanding the association of poor mental health with both unemployment and underemployment. Furthermore, the results suggest that the most deleterious effects on mental health may occur in the first two months of unemployment before plateauing. In order to prevent deterioration in mental health, these findings suggest intervention should commence immediately following job loss.

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Use of large longitudinal nationally representative data from three years.

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Compared to employment, unemployment and underemployment pose serious risk for poor mental health.

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Differences in mental health can be largely explained by hardship, social support and mastery.

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Underemployed also need to be considered in research as a group at risk for poor mental health.

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Mental health trajectory over time unemployed suggests a “shock” following job loss.

An evaluation of the choices for well-being project

The relationship between mental health, self-esteem and unemployment is well established. Emerging research suggests that interventions such as Cognitive Behavioural Therapy (CBT) can counter the negative effects of unemployment and may improve re-employment. This study evaluated the effectiveness of a manual-based programme, which combines CBT with job skills training, in improving the psychological health and job- seeking skills of unemployed individuals within the UK. One hundred and nine unemployed individuals, suffering mild to moderate mental health problems, were referred to the programme. Of these, 47 completed the programme and 32 attended follow-up. The impact of the manualised course was evaluated using a randomised control trial with a waiting list control. On completion of the programme, participants showed improvements in mental health, self- esteem and job-search self-efficacy as well as a reduction in the occurrence of negative automatic thoughts. Twenty participants gained employment and improvements persisted at follow-up. Considering the initial levels of psychological distress and mental health problems among the unemployed sample, the need for adequate service provision for the unemployed is recommended.

Psychological and physical well-being during unemployment: a meta-analytic study

The authors used theoretical models to organize the diverse unemployment literature, and meta-analytic techniques were used to examine the impact of unemployment on worker well-being across 104 empirical studies with 437 effect sizes. Unemployed individuals had lower psychological and physical well-being than did their employed counterparts. Unemployment duration and sample type (school leaver vs. mature unemployed) moderated the relationship between mental health and unemployment, but the current unemployment rate and the amount of unemployment benefits did not. Within unemployed samples, work-role centrality, coping resources (personal, social, financial, and time structure), cognitive appraisals, and coping strategies displayed stronger relationships with mental health than did human capital or demographic variables. The authors identify gaps in the literature and propose directions for future unemployment research.

Unemployment and health: the healthcare system's role

Experts from the South Western Sydney Area Health Service and the University of New South Wales say there are few reports of healthcare interventions to address the impact of unemployment on health. They outline possible strategies, which include providing accessible and appropriate healthcare; developing the healthcare system's capacity to deal with the health problems of unemployed people; collaborating with other agencies and sectors working on this issue; acting as an advocate for unemployed people; undertaking research; and providing training, work experience and employment opportunities within the healthcare system. Long term solutions lie in increasing employment and training opportunities. Nevertheless, there is a clear role for the healthcare system in reducing the health impacts of unemployment and ensuring that poor health does not act as a barrier to returning to work.