Intended for healthcare professionals


Adolescents and young adults who are not in employment, education, or training

BMJ 2013; 347 doi: (Published 18 September 2013) Cite this as: BMJ 2013;347:f5270
  1. Jan Scott, professor of psychiatry1,
  2. David Fowler, professor of clinical psychology2,
  3. Pat McGorry, professor of youth mental health3,
  4. Max Birchwood, research director4,
  5. Eoin Killackey, associate professor3,
  6. Helen Christensen, executive director5,
  7. Nicholas Glozier, professor of psychiatry6,
  8. Alison Yung, professor of psychiatry7,
  9. Paddy Power, consultant in youth mental health8,
  10. Merete Nordentoft, professor of psychiatry9,
  11. Swaran Singh, head of department10,
  12. Elisa Brietzke, professor of psychiatry11,
  13. Simon Davidson, professor of child and adolescent psychiatry12,
  14. Philippe Conus, professor of psychiatry13,
  15. Frank Bellivier, professor of psychiatry14,
  16. Richard Delorme, professor of child and adolescent psychiatry15,
  17. Iain Macmillan, consultant psychiatrist16,
  18. John Buchanan, head of department17,
  19. Francesc Colom, clinical psychologist18,
  20. Eduard Vieta, professor of psychiatry18,
  21. Michael Bauer, head of department19,
  22. Phillip McGuire, head of department20,
  23. Kathleen Merikangas, head of department21,
  24. Ian Hickie, director22
  1. 1Department of Academic Psychiatry, Wolfson Unit, Institute of Neuroscience, Newcastle University, Newcastle NE4 6BE, UK
  2. 2Psychology Department, Sussex University, Brighton, UK
  3. 3Orygen Youth Mental Health Research Centre, University of Melbourne, Melbourne, Australia
  4. 4YouthSpace, University of Warwick, Warwick, UK
  5. 5Black Dog Institute, University of New South Wales, Sydney, Australia
  6. 6Brain and Mind Research Institute, University of Sydney, Sydney, Australia
  7. 7Institute of Brain, Behaviour, and Mental Health, University of Manchester, Manchester, UK
  8. 8Young Adult Service, St Patrick’s Mental Health Services, Dublin, Ireland
  9. 9OPUS Early Intervention Services, University of Copenhagen, Copenhagen, Denmark
  10. 10Department of Mental Health and Wellbeing, University of Warwick, Warwick, UK
  11. 11PRISMA Early Intervention Services, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
  12. 12Ontario Centre of Excellence for Child and Youth Mental Health, Ottawa, Canada
  13. 13Department of Psychiatry CHUV, Lausanne University, Switzerland
  14. 14Department of Adult Psychiatry and Addictions, University Denis Diderot, Paris, France
  15. 15Department of Child and Adolescent Psychiatry, Robert Debre University Hospital, Paris, France
  16. 16Early Intervention in Psychosis Service, NTW NHS Trust, Sunderland, UK
  17. 17Workplace Research Centre, Business School, University of Sydney, Australia
  18. 18Institute of Neurosciences, IDIBAPS-CIBERSAM, University of Barcelona, Barcelona, Spain
  19. 19Department of Psychiatry and Psychotherapy, Technische Universitat Dresden, Dresden, Germany
  20. 20Section for Psychosis Studies, Institute of Psychiatry, London, UK
  21. 21Genetic Epidemiology Research Branch, National Institute of Mental Health, USA
  22. 22Brain and Mind Research Institute, University of Sydney, Australia
  1. jan.scott{at}

Their problems are more than economic

The term NEET (not in employment, education, or training) refers to economically inactive adolescents and young adults.1 2 During economic crises, youth unemployment rises faster and recovers more slowly than general unemployment.1 In 2012, there were 7.5 million 15-24 year old (13% of the age group) and 6.5 million 25-29 year old (20%) economically inactive young people in the European Union. Together, they cost €153bn (£131bn; $204bn) in welfare benefits and lost productivity—1.2% of EU gross domestic product.2 International publications confirm global rates of 10-20% youth unemployment and highlight that the optimal solution is to increase retention in education and training.1 2 3 4 5

Prolonged economic inactivity has profound effects on mental health: the risks of depression (odds ratio 2.7), alcohol or substance misuse (3.4), and suicidal attempts (3.6) are significantly increased in economically inactive young people versus their economically active peers.3 However, action plans fail to recognise subgroups within the economically inactive population who are functionally impaired because of evolving or pre-existing mental disorders. During economic downturns, these people are especially disadvantaged and risk lifelong social exclusion and economic marginalisation unless their ill health is recognised early and their needs targeted more directly.4 5

Preventing or limiting economic inactivity alone could reduce rates of common mental disorders by 8-17%,6 but it would not completely solve the problem of the threefold greater risk of severe mental disorders in this group.3 The explanation for this is complex, but it is noteworthy that the peak age of onset of …

View Full Text

Log in

Log in through your institution


* For online subscription