Abstract
Epidemiologic evidence highlights the harmful consequences of unemployment on health and well-being. This emphasizes the need to design low-cost interventions to prevent the adverse mental health effects of unemployment. The main aim of this study was to create expert-consensus regarding development and implementation of a brief, sustainable, and effective intervention program for promoting mental health among unemployed. The Delphi technique entailed a selected panel of 75 experts from various relevant professional backgrounds. Panel members were asked to state their level of agreement (5-point Likert scale) regarding (a) required characteristics for an effective mental health intervention for unemployed people and (b) key variables for assessing the effectiveness of that intervention. Consensus was obtained throughout two rounds of data collection through e-mail contact, with structured questionnaires. Items of the questionnaire were based on literature reviews about community-based interventions for unemployed individuals. Overall, 46 experts collaborated with the Delphi process (final participation rate: 61.3%). Based on a review of the literature, 185 items were identified and grouped into two broad categories (set of characteristics of the intervention and set of variables for effectiveness assessment), aggregating a total of 11 dimensions. The two Delphi rounds resulted in the selection of 35 characteristic items for the intervention program and 54 variables for its effectiveness assessment. Brief group interventions were considered to be effective and sustainable for mental health promotion in unemployment conditions if targeting mental health literacy, training interpersonal skills, and job-search skills. As agreed by the panel of experts, a brief, sustainable and effective intervention can be developed and implemented by accounting for unemployed capacity-building for mental health self-care and adequate job-searching attitudes and skills. These results should be further implemented in community and multisector-based standardized interventions, targeting mental health among unemployed people, ensuring adequate conditions for its effectiveness assessment.
Highlights
Job loss represents an involuntary and disruptive event with multiple and extended impact on individuals’ life
Relevant amount of literature identified factors that shape the association between socioeconomic outcomes and periods of exacerbated unemployment rates
The recent European Union crisis and its strong reflections on the Portuguese labor market conditions provided a context of “natural experiment” for assessing health outcomes of individual unemployment status and to develop strategies to minimize their potential mental health effects. This Delphi panel study contributes toward the designing of effective interventions for mental health promotion among unemployed workers
Summary
Job loss represents an involuntary and disruptive event with multiple and extended impact on individuals’ life. Portugal has the highest prevalence of mental health illness (22.9% according to the World Mental Health Survey) [3] while current life satisfaction of Portuguese people remains comparable as in the time of the economic crises—the bottom third of the OECD country ranking [4]. These socioeconomic and labor market trends raise the ongoing debate about the relationship between unemployment and individual well-being. Epidemiologic evidence highlights the harmful consequences of unemployment on health and well-being This emphasizes the need to design low-cost interventions to prevent the adverse mental health effects of unemployment. The main aim of this study was to create expert-consensus regarding development and implementation of a brief, sustainable, and effective intervention program for promoting mental health among unemployed
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