JMIR Publications

ABSTRACT

Background:

The population of young individuals not in employment, education or training (NEET) are highly diverse but a common problem appears to be their mental health. NEETs due to illness or disability are of particular concern for social exclusion but little is known of how NEET with and without disability make use of, and gain from, employment interventions. There is also a scarcity of research on psychological interventions and mental health outcomes on NEET individuals. Acceptance and commitment therapy (ACT) has shown promising results on psychological outcomes on young adults.

Objective:

The study aimed to expand the knowledge on effects of an app-based intervention built on ACT on NEETs with and without disability.

Methods:

A two-armed randomized controlled trial was conducted in 2021 including 151 NEET individuals 16-24 years. Participants were recruited mainly via social media platforms and through organizations working with NEET individuals. The intervention group (n=77) used an app for psychological well-being with possibility for digital group meetings for 6 weeks and the control group (n=74) received film clips once a week. Outcomes were self-assessed through questionnaires. Statistical analyses were made using Chi2, Mann-Whitney U-test, GLM and logistic regression.

Results:

No differences in effects on mental health were seen between intervention and control group, neither overall nor between NEET individuals with or without disability. Usage data show that 68.6% of the participants in the intervention group downloaded the app and 24.7% completed all six modules. Effects on employment and education levels were only seen within the intervention group where those that had completed one or more modules had higher likelihood of being active in terms of employment and education compared to those that did not complete modules. No significant effects were seen in employment and education levels in relation to disability status. A high proportion of the participants had a disability, few were in contact with a youth employment center and female participants were overrepresented in general. Participants with disabilities had lower self-esteem, had less frequently completed high school, fewer had work experience and a larger proportion had been in the NEET situation over a year. A higher drop-out were seen among participants in the intervention group and among male participants.

Conclusions:

No effects of the app-based intervention were seen for psychological well-being between NEET individuals with disability and those without, but the results showed potential effects on employment and education levels related to engagement in the intervention. NEETs with disability are of particular concern and might need additional efforts or other types of interventions than the one investigated herein. Findings can be considered weak due to the low adherence and high attrition. Clinical Trial: Registered on 12 February 2021 at ISRCTN (#ISRCTN46697028), https://doi.org/10.1186/ISRCTN46697028