Reneflot A, Evensen M. Unemployment and psychological distress among young adults in the Nordic countries: A review of the literature This article reviews Nordic research, published from 1995 and onwards, on the relationship between unemployment and mental health among young adults. Cross-sectional, longitudinal and time-series studies are included. Cross-sectional studies show that the unemployed experience more mental health problems than the non-unemployed. Leaving unemployment is associated with increased well-being. Economic problems, feelings of shame and poor social support increase the likelihood of psychological distress. The longitudinal studies show that unemployment increases the risk of psychological distress and attempted suicide, after initial mental health status and confounding factors are accounted for. The relationship remains significant when time-invariant characteristics of the individuals are controlled for. The time-series studies found no relationship between unemployment and suicide, but levels of psychological distress were found to vary with changes in the labour market. This relationship remained significant after excluding the non-employed, indicating that unemployment trends have effects beyond those directly associated with unemployment.

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Internalizing problems (anxiety and depression) are repeatedly reported to be associated with dropout from secondary school and adverse social and health outcomes later in life, but the evidence appears inconsistent. The aim of this study was to systematically review the evidence for internalizing problems as a risk factor for early school leaving. A systematic search in major databases with thematic search strings for both internalizing disorders and early school leaving yielded 3188 records, of which 14 were included after screening and reading of full texts by two researchers independently after preset inclusion and exclusion criteria. The review process identified four prospective, three trajectory and seven retrospective studies. Variation in measurements, design, adjustments and statistics precluded meta-analyses. The results were mixed. Internalizing problems were reported to increase the risk of early school leaving in prospective studies, but not when adjusted for conduct disorder and ADHD. It is somewhat unclear if the association is robust for adjustment for externalizing problems in studies applying trajectory analyses and non-diagnostic instruments. There were no systematic gender differences in reported associations. In conclusion, internalizing problems were repeatedly reported to increase the risk of early school leaving, but this association was partly or fully accounted for by adjustment for comorbid externalizing problems. However, whether this is adjusting for mediating or confounding factors remains unanswered.

Adolescent mental health problems reduce adult earnings, especially among individuals in the lower tail of the earnings distribution. Preventing mental health problems in adolescence may increase future earnings.