Abstract
PurposeThere are increasing concerns about the intersection between NEET (not in education, employment, or training) status and youth mental ill-health and substance use. However, findings are inconsistent and differ across types of problems. This is the first systematic review and meta-analysis (PROSPERO-CRD42018087446) on the association between NEET status and youth mental health and substance use problems.MethodsWe searched Medline, EMBASE, Web of Science, ERIC, PsycINFO, and ProQuest Dissertations and Theses (1999–2020). Two reviewers extracted data and appraised study quality using a modified Newcastle–Ottawa Scale. We ran robust variance estimation random-effects models for associations between NEET and aggregate groups of mental ill-health and substance use measures; conventional random-effects models for associations with individual mental/substance use problems; and subgroup analyses to explore heterogeneity.ResultsWe identified 24 studies from 6,120 references. NEET status was associated with aggregate groups of mental ill-health (OR 1.28, CI 1.06–1.54), substance use problems (OR 1.43, CI 1.08–1.89), and combined mental ill-health and substance use measures (OR 1.38, CI 1.15–1.64). Each disaggregated measure was associated with NEET status [mood (OR 1.43, CI 1.21–1.70), anxiety (OR 1.55, CI 1.07–2.24), behaviour problems (OR 1.49, CI 1.21–1.85), alcohol use (OR 1.28, CI 1.24–1.46), cannabis use (OR 1.62, CI 1.07–2.46), drug use (OR 1.99, CI 1.19–3.31), suicidality (OR 2.84, CI 2.04–3.95); and psychological distress (OR 1.10, CI 1.01–1.21)]. Longitudinal data indicated that aggregate measures of mental health problems and of mental health and substance use problems (combined) predicted being NEET later, while evidence for the inverse relationship was equivocal and sparse.ConclusionOur review provides evidence for meaningful, significant associations between youth mental health and substance use problems and being NEET. We, therefore, advocate for mental ill-health prevention and early intervention and integrating vocational supports in youth mental healthcare.
Highlights
IntroductionTransitioning from education into work is a milestone of emerging adulthood that about one in seven young people in economically developed countries struggle to attain [1], falling into the category of NEET—not in education, Canada 5 ACCESS Open Minds
Transitioning from education into work is a milestone of emerging adulthood that about one in seven young people in economically developed countries struggle to attain [1], falling into the category of NEET—not in education, Canada 5 ACCESS Open Minds (Pan-Canadian Youth Mental HealthServices Research Network), Montreal, QC, Canada 6 Department of Psychiatry, McGill University, Montreal, QC, Canada1 3 Vol.:(0123456789)Social Psychiatry and Psychiatric Epidemiology employment, or training
We excluded neurodevelopmental disorders and disabilities typically diagnosed in childhood since we expected developmental and learning problems to have a unique association with becoming NEET
Summary
Transitioning from education into work is a milestone of emerging adulthood that about one in seven young people in economically developed countries struggle to attain [1], falling into the category of NEET—not in education, Canada 5 ACCESS Open Minds Social Psychiatry and Psychiatric Epidemiology employment, or training. Concerns over these youth are growing worldwide [2, 3]. By 2019, between 5.6% (Luxembourg) and 28.8% (Turkey) of 15 to 29-year-olds in Organisation for Economic Co-operation and Development countries were NEET [1]. Economic fallouts of the COVID-19 pandemic are expected to swell these numbers [3], as even early on in the pandemic, data showed that NEET rates were higher in the second quarter of 2020 than the previous year in 45 out of 50 countries [5]. Being outside school and the workforce limits their ability to gain skills and experience that could improve their prospects [8–10]
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