OECD Youth Policy Toolkit

Report

26 November 2024

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3. Pillar IV – Social inclusion and youth well-being

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The OECD Council recommends that Adherents to the Recommendation on Creation Better Opportunities for Young People (OECD, 2022[1]) promote social inclusion and youth well-being beyond economic outcomes, with measures targeted at young people in vulnerable and/or disadvantaged circumstances.

Recommendation IV.1

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Provide adequate income support for young people with insufficient means, subject to mutual obligation requirements and coupled with high-quality activation services, and ensure that access is based on the individual circumstances of young people, and not on parental income alone, to facilitate independent living.

Relevance

Young people can face significant income volatility during the transition period from education to work, as a result of temporary and non-standard contracts, low-paid jobs and precarious working conditions, a high risk of dismissal, and periods of unemployment or inactivity (Swedish Agency for Youth and Civil Society Affairs, 2023[2]). On average across the OECD, 12.3% of 18‑25 year‑olds lived in relative poverty in 2022, compared with 9.8% among the adult population (26‑65 years) (OECD, 2023[3]). Income volatility becomes problematic for young people when they cannot rely on financial support from their families and have limited savings or access to credit (Department of Children and Youth Affairs, 2015[4]). Poverty early in the career can also have long-lasting scarring impacts on their life‑time employment and earnings prospects, if it traps them into low-paid and low-quality jobs, unemployment, underemployment and inactivity, without opportunity to continue/return to education and break the vicious circle (Department of Children and Youth Affairs, 2019[5]).

The extent to which young people are covered by social protection systems varies across countries and depends on age‑related and other eligibility rules of the different social protection systems countries have in place, like unemployment insurance or unemployment assistance benefits, social assistance and guaranteed minimum income benefits (OECD, Forthcoming[6]). However, income from income replacement programmes alone may leave a substantial share of young people in poverty. Additional measures including housing benefits, health and education support, and employment measures are often necessary to reach adequate living standards.

Social transfers are important to prevent poverty among young people as they transition to the labour market, but additional measures are needed to put them on the path to self-sufficiency. On its own, social protection may disincentivise work and hinder the transition to the labour market, creating inactivity traps that can be large for young people with poor earnings prospects and in countries with relatively generous benefits (OECD, Forthcoming[6]).

Complementing social protection programmes with activation policies is therefore essential to promote self-sufficiency through secure and stable employment. There is strong evidence that social protection conditional on job search efforts and participation in activation policies increases the employment rates of young people (Blundell et al., 2004[7]; Dahlberg, Johansson and Mörk, 2009[8]; Kluve et al., 2019[9]; Hernæs, 2020[10]) and reduce inactivity among young people by promoting the accumulation of human capital (Bratsberg et al., 2019[11]).

Box 3.1. Young People’s Voices

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“You can see a big impact from small opportunities”.

Young people see that when they have a steady income, it can really make a difference. It gives them the chance to save up for other things, like further education, housing, or hobbies. These small steps can lead to bigger changes and help them feel more secure and ready for the future.

Consultations with young people and youth organisations

Youth specific OECD indicators

Poverty rate, 0-17 year-olds (OECD, 2024[12])
Satisfaction with government and social policy, 18-29 year-olds (OECD, 2023[13])
Social policy preferences, 18-29 year-olds (OECD, 2023[13])
Income support for young people during the COVID-19 pandemic (OECD, 2021[14])

Other related indicators

Adequacy of Guaranteed Minimum Income benefits (OECD, 2024[15])
Hours of work needed to escape poverty for workless families (OECD, 2024[16])

Integration allowance – Belgium

Context

Young people may not be entitled to unemployment insurance as workers typically need to have made contributions for a certain number of days within a given reference period. Ineligibility can refrain young jobseekers from contacting the Public Employment Service (PES), even though they would be entitled to job search support, regardless of their benefit entitlement. In Belgium, jobseekers under 36 must have worked the full-time equivalent of one year within the past 21 months, which precludes many recent graduates from benefit eligibility. The Integration Allowance encourages young people to register with the PES upon graduation and offers support to those who remain unemployed within the first years of labour market entry.

Description

Young people between 18 and 25 who have finished compulsory schooling and find themselves unemployed can receive an integration allowance since 1991 (albeit with modifications over time). Young jobseekers can receive the allowance for a period of three years, which can be extended in certain situations. For example, since 2014, entitlements can be extended to five years for individuals in particularly vulnerable situations (including those with certain medical or mental needs). Beneficiaries need to be available to the labour market and cannot refuse appropriate employment or vocational training.

Prior to receiving the monetary allowance, jobseekers must participate in a one‑year professional integration period, during which they must be available to work and comply with job-search requirements. Requirements include accepting a suitable job, vocational training or a first job agreement and attending meetings with employers, the employment service, or the vocational training department. During the integration period, jobseekers must obtain two positive behavioural evaluations from the PES. Non-compliance with the requirements set out by the PES is sanctioned by not counting the days of absence toward the integration period. Jobseekers may engage in paid work, self-employment activities, and short, non-intensive courses, during the integration period as long as they remain available to the job market.

Outcomes

Data for the period 2012‑16 show that around 90 000 young people aged 18‑29 registered per year for the first time for the integration period, with the bulk registering in the third quarter. 48% of them had an upper secondary diploma, 30% a tertiary diploma, and 22% a lower secondary diploma. On average over 2012‑16, 46% of young people participating in the integration period were working after one‑quarter. The share was higher (62%) for those who had some prior work experience (noting that only a minority of the participants had prior work experience: 14%). After one year, 62% of the participants were working, 10% were still unemployed, and the remaining 29% became inactive.

More recent data for 2022 shows a stock of 18 000 young people under age 30 receiving the integration allowance. The annual inflow has been gradually declining from 18 000 in 2016 to 8 700 in 2022.

Unemployment insurance for graduates – Denmark

Context

Unemployment insurance typically requires beneficiaries to have worked for a specific number of days within a defined period before receiving benefits. However young people, particularly recent graduates, often struggle to meet this requirement due to limited work experience, making them vulnerable to low income after graduation. To address this issue, Denmark has established special eligibility rules for newly graduated jobseekers and encourages them to register with the public employment service. This registration grants them access to unemployment insurance and job search assistance, including advice, guidance, and even job opportunities that may not be available to those who are not registered with the employment service.

Description

New graduates who completed a publicly recognised education of at least 18 months can receive unemployment insurance at a “graduate rate”. They are exempt from the typical minimum period of insurance and employment requirements. If they have been a member of an unemployment fund for at least a year before graduation, they can receive benefits immediately upon unemployment; otherwise, they must wait a month. Graduates must apply for admission within 2 weeks of graduation. Access to the unemployment fund is encouraged by offering free membership to students under 30 years of age one year before graduation, an offer which was enacted in 2009.

Graduates must still fulfill additional requirements, such as registering with the job centre, actively seeking employment, and attending certain meetings with their unemployment insurance funds. They must also reside in Denmark and, since May 2023, demonstrate proficiency in Danish. Failure to speak Danish means having to meet an employment requirement of 600 hours within 12 months of the last two years, which is still less strict than the employment requirement for non-graduate unemployed individuals at 1924 salaried hours within the last three years for full-time or 1 258 hours for part-time work.

Under the graduation rule, entitlement to unemployment benefit lasts for one year (1924 hours) within a two‑year reference period. Each hour worked within the reference period gives two hours extra on unemployment insurance and extends the reference period. However, the period can only be extended by a maximum of one year. The benefit amount ranges from 49 to 82% of the full unemployment benefit, depending on the graduate’s age, duration of unemployment, and whether they have children.

Outcomes

The scheme is widely utilised, as in 2015 47% of new graduates accessed graduate unemployment benefits within six months of completing their education – a period during which youth unemployment was still relatively high in Denmark following the global financial crisis. Overall, the Danish unemployment insurance system has been found to effectively motivate individuals to seek employment, evidenced by intensive activation programmes that boosted the average re‑employment rate by approximately 30% compared to non-participation in such a programme. Young unemployed are found to leave unemployment more quickly than older unemployed workers, for instance after 10 weeks 49.3% of people under 30 remained unemployed, while the same held for 56.5% of 40‑49 year‑olds. Another study concluded that the comprehensive policy package in the general Danish system reduced unemployment duration by roughly two weeks. Job search assistance, frequent meetings, and perceived threat of having to participate in future mandatory search activities all contribute significantly to transitioning out of unemployment.

National Employment Programme – Costa Rica

Context

Young people who have not completed their studies are often more vulnerable to unemployment and economic hardship. This correlation is visible across most countries in the world and is notably evident in Costa Rica, where nearly one‑third of young people were unemployed in 2022 (31%), amounting to approximately 104 000 young people. Young people residing outside the Greater Metropolitan Area face the greatest difficulty. In these regions poverty rates are higher, access to formal education is limited, and employment opportunities are scarce. To address the needs of vulnerable populations and improve their quality of life, Costa Rica established the National Employment Programme (PRONAE) in 2000. This initiative targets unemployed or underemployed individuals facing (extreme) poverty by providing conditional temporary economic aid and supplementary support services.

Description

PRONAE consists of five components: Productive Ideas, Training, Community Work, Community Work in Indigenous Territories, and Employment. The Employment component (Empléate) is the only component that specifically targets young people. It was integrated into the programme in 2012. Empléate facilitates the integration of young people in vulnerable situations into the labour market through comprehensive training and employment initiatives. Empléate encompasses three sub-components: Advancing More, For Me, and Inclusive Employment. The components target young people aged between 17 and 24 years (and up to 35 years in the case of Inclusive Employment).

Empléate provides temporary financial support contingent upon participation in training activities that prepare young people in disadvantaged situations for employment. Individuals can receive a monthly subsidy of CRC 200 000, which can go up to CRC 340 000 for intensive training, with benefits lasting on average six months. For context, minimum wage in Costa Rica in 2023 was CRC 352 165. The “Advancing more” initiative promotes technical and vocational careers for young people with high school diplomas. The “For me” component instead focuses on young people who have not finished high school. Lastly, the “Inclusive Employment” provides similar support to young people with disabilities.

Outcomes

In 2023, PRONAE provided support to 9 268 individuals. An evaluation from 2018 showed that 59% of participants stated that their involvement in PRONAE projects contributed to securing temporary employment. The evaluation also noted that it is imperative for initiatives like PRONAE to prioritise gender equality, invest in employment creation, and enhance programme awareness to maximise impact. The component Empléate covered 5 611 individuals in 2023. According to the evaluation in 2018, it supported 34 879 individuals between 2015 and 2017. Empléate partially fulfils its objective of improving young people’s employability and it demonstrates a positive, albeit small and temporary impact on the economic and social conditions of participants. Although Empléate initially motivates young participants, this enthusiasm disappears if they fail to find employment. To address these challenges, programmes like Empléate should focus on aligning their trainings with labour market needs and ensuring enough support within remote areas across the country.

Recommendation IV.2

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Align tax systems and benefit policies to make work pay for all young people, including for young parents and secondary earners.

Relevance

For many young parents and secondary earners financial incentives to enter or re‑enter the workforce can be lacking, due to the specifics of the various tax systems across OECD countries (OECD, 2022[31]). The decision to work is often influenced by the income gap between staying at home and pursuing employment. Tax systems can create disincentives for work by raising the replacement rate, which refers to the percentage of income from work that can also be received while on income replacement benefits (like unemployment insurance, unemployment assistance, social assistance, or guaranteed minimum income benefits). For instance, the average net replacement rate for unemployment insurance across the OECD for a parent of two children who has a spouse that earns an average wage is 86%, meaning that 86% of income from doing a nearly average wage job can also be gained from unemployment income (OECD, 2024[32]). These calculations show one way in which tax systems can inadvertently hinder labour force participation and economic independence, perpetuating cycles of dependency and inequality among young families and secondary earners.

Furthermore, potential secondary earners and single parents are often tasked with childcare responsibilities, which can be hard to afford when this parent enters the work force. Sometimes childcare support systems are not designed in a way that ensures that work pays once taxes, transfers and childcare costs are taken into account (OECD, 2018[33]). Lack of adequate support structures exacerbates financial hardships and increases the risk of poverty, making it challenging for people in vulnerable situations to balance work and family responsibilities while also achieving financial stability.

Aligning tax systems to ensure that work pays for everyone, including young parents and secondary earners, can yield numerous benefits for individuals and society as a whole (OECD, 2022[31]). By removing disincentives to work embedded within tax structures, more people are motivated to enter or remain in the workforce, contributing to higher levels of economic activity and productivity. Furthermore, fostering a tax environment that promotes labour force participation among secondary earners can enhance gender equity by empowering young mothers to pursue career opportunities and contribute to household incomes. Gender equity is further strengthened by improving other types of support like encouraging men to take care leave, increasing access to affordable childcare, and enhancing the availability of flexible working arrangements (OECD, 2018[33]). When tax systems and job benefits are designed to incentivise work and support income security, it not only improves individual financial well-being but also strengthens social cohesion and drives inclusive economic growth.

Box 3.2. Young People’s Voices

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“A better tax-benefits system is needed to set young people on the right track from early on.”

Young people indicate that when they are underpaid and/or working in jobs beneath their skill level, it sets them back. Over time, this situation can lead to bigger problems, like not being able to afford a home or save for retirement. They mention that fixing the system would help prevent these inequalities from piling up.

Consultations with young people and youth organisations

Youth specific OECD indicators

Tax-benefit web calculator, (OECD, 2024[34])
Satisfaction with government and social policy, 18-29 year-olds (OECD, 2023[13])
Social policy preferences, 18-29 year-olds (OECD, 2023[13])

Other related indicators

Net replacement rate in unemployment, (OECD, 2024[32])
Effective tax rate on increasing working hours, (OECD, 2024[35])
OECD Family Database, The labour market position of families, (OECD, 2024[36])

Free public pre‑school for 3‑4 year‑olds – Israel

Context

Accessible and affordable pre‑school for young children can aid child development and allow both parents to engage in the labour market. When care and education for young children is low-cost or free of charge, families across income groups can benefit from having their children attend school. The Israeli Government therefore implemented free and compulsory pre‑school education for 3‑4 year‑olds from 1999 onwards.

While pre‑school attendance in the Jewish sector in Israel had been relatively high since the 1970s, significantly lower proportions of children from the Arab sector were benefiting from pre‑school education. This difference was also reflected in parental labour market engagement: mothers’ labour supply among Israeli Arabs was significantly lower than that of their peers in the Israeli Jewish sector.

Description

Free pre‑school is available and compulsory for all children aged 3 and 4 across Israel. The Compulsory Education Act was passed in 1984, and free pre‑school started to be gradually implemented from 1999. The implementation process begun by prioritising geographical areas with lower socio-economic ranking to benefit disadvantaged areas first. The policy continued to be rolled out across the country until 2014. Parents can choose whether they wanted to enrol their children in public or private establishments.

This policy aimed to make pre‑school attendance more equal across socio-economic levels and religious sectors. Pre‑school was relatively widely provided in the Jewish sector prior to implementation, with estimates showing that 84% and 98% of Jewish 3‑year‑olds and 4‑year‑olds respectively attended public pre‑school in 1984. The implementation process was therefore particularly challenging in municipalities in the Arab sector where only around 20% and 30% of Arab 3‑ and 4‑year‑olds attended pre‑school in 1984. Significant infrastructure projects were thus needed to provide space for the required number of places.

Outcomes

Pre‑school attendance is now high in Israel: 99.7% of 3‑5 year‑olds were enrolled in pre‑school in 2020. One evaluation from the early stages of implementation found a significant positive effect on mothers’ labour market participation. The study uses the gradual implementation after 1999 causing variation across geographical areas over time for a quasi‑experimental design. The author uses data from the Israeli Labour Force Survey between 1998 and 2003 and a difference‑in-difference model to compare the outcomes of women in towns where the policy had been implemented to women in towns where it had not yet been so.

The analysis finds that preschool enrolment and mothers’ labour supply both increased sharply. The effect on labour supply was driven by higher-educated mothers’ increased engagement in the labour market. The author argues that the strong response to the intervention indicates economic incentives can play an important role in decision-making regarding labour supply. There is no evidence of an effect on mothers in affected towns who did not have children of preschool age.

Earnings disregard for single parents on welfare – Netherlands

Context

Single parents, and especially single mothers, participate in the labour force at a lower rate than other demographic groups. Combining childcare with work can be difficult for single parents, and the financial incentives to pursue employment are limited for low-paid jobs. Any additional income earned often leads to a corresponding reduction in non-work-related benefits, which means that increasing working hours becomes unappealing. Prolonged periods outside the labour market diminish prospects of securing employment in the future when the children are a bit older. If, on the other hand, single parents on welfare engage in part-time employment, they can accumulate valuable work experience, potentially facilitating easier access to full-time employment opportunities in the future, enabling them to transition away from welfare dependency.

In order to improve the labour market participation of single parents in the Netherlands, the Dutch Government implemented an earnings disregard for single parents receiving welfare between 2009 and 2010, as part of a broader experiment. In the Netherlands, welfare benefits guarantee a minimum income for all unemployed or part-time employed workers. Welfare benefits usually decrease one‑to‑one with any additional income that is earned. At the time of the experiment, about 300 000 individuals in the Netherlands received welfare benefits. Of these, a substantial 26% were single parents, predominantly single mothers. Out of all Dutch single parents, 10.6% relied on welfare benefits.

Description

As part of the experiment, 14 Dutch municipalities implemented the earnings disregard for single parents on welfare who had at least one child below the age of 12. The earnings disregard took the following form: single parents were allowed to keep EUR 4 for each hour worked, with a cap at EUR 120 net per month. To provide context, the minimum wage during that period was EUR 7.50 per hour and the net welfare benefit was approximately EUR 900 for single parents aged 21 to 65, while those under 21 received EUR 480. Importantly, the earnings disregard was not crafted to prompt an immediate outflow from welfare. Instead, its primary goal was to foster increased work experience, thereby potentially easing the path for single mothers to secure full-time employment later in life.

Outcomes

Between 2009 and 2010, 5‑6% of single parents in the target group received an earnings disregard. Some municipalities had over 10% of single parents applying for the disregard, while others stayed below 3.5%. For single mothers, the earnings disregard boosted part-time employment within 2 years by 13.9 percentage points on average (from 4.2% to 18.1%). Parents who were already working while receiving benefits increased their number of working hours, resulting in a 13.1% income boost for those who previously earned between EUR 250 and EUR 500. A difference‑in-difference analysis of the experiment revealed that the earnings disregard not only stimulated earnings for all single mothers but also notably increased (part-time) employment for immigrant single mothers. The experiment also showed that policies should focus on effective communication strategies to inform single parents about the availability of the earnings disregard, as one‑third of those interviewed in a study were unaware of these measures in their municipality.

Back to Work Family Dividend – Ireland

Context

The combination of tax and benefit rules can create financial disincentives for young parents and in particular secondary earners to enter or re‑enter the workforce. Childcare responsibilities and lack of affordable childcare can add to the challenges that parents face when considering entering or returning to the labour market. In Ireland, the social welfare system adds another layer of complexity to the issue of parental workforce participation as it offers different types of support based on familial circumstances, which can in some cases inadvertently dampen the motivation for parental employment.

In 2015, the Irish Government introduced a financial support scheme aimed at incentivising parents on social welfare payments to return to work, called the Back to Work Family Dividend. The scheme provides additional financial assistance to families to ease the transition from social welfare to employment by supplementing their income during the initial stages of employment, thereby encouraging greater workforce participation and reducing dependency on welfare benefits.

Description

Under the Back to Work Family Dividend, eligible families who were previously in receipt of certain social welfare payments, such as Jobseeker’s Allowance or One‑Parent Family Payment, and who secure employment for a minimum of 19 hours per week can receive continued financial support for two years. During the first year of employment, recipients receive a weekly benefit payment for each child, for up to four children, and half of that amount during the second year, regardless of their earnings. In 2024, the benefit amounted to EUR 46 per week for children under 12 and EUR 54 per week for children over 12.

To qualify for the scheme, individuals must have at least one child under 18 (or a child in full-time education under 22 who lives with them) and must have received social benefits for a minimum of 12 months, of which at least six months in the last year. Additionally, applicants must start working in Ireland within four weeks of leaving the social benefit scheme.

Outcomes

An evaluation of the scheme in 2015 showed that the Back to Work Family Dividend scheme significantly increases the financial incentives for unemployed parents to take up work. Another study from 2018 showed that parental in-work poverty in Ireland was very low compared with the EU average (respectively 5.1% and 11.2% in 2016) and the authors argued that this outcome was largely due to in-work benefits such as the Back to Work Family Dividend scheme (and the Working Family Payment). Ireland has one of the highest rates of children in jobless households, but that the share decreased considerably between 2013 and 2018, coinciding with the introduction of the scheme in 2015. In 2022, 2 678 families in Ireland received payments from the scheme. For context, in that year there were 102 800 Irish households with children in which neither of the parents were employed.

Recommendation IV.3

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Strengthen outreach to and support young people in vulnerable and disadvantaged circumstances in collaboration with regional and local stakeholders.

Relevance

Young people in vulnerable and disadvantaged circumstances face a range of challenges (e.g. in housing, social, health, education and employment) that require multiple interventions from different public services (OECD, 2023[49]; OECD, 2015[50]). Navigating different access points and pathways for these services can be a daunting task, especially for those with complex needs, such as low-skilled and low-wage workers, migrants, and persons with disabilities. Investing in personalised and integrated public policies and services is therefore critical to ensure that they get the right support (OECD, 2023[51]; Adams and Hakonarson, 2024[52]).

The challenges faced by young people vary greatly across cities and regions, which have very different demographic and industrial structures, housing options and support networks. Subnational governments therefore have a key role to play in adapting and tailoring services to respond to these local circumstances, and in bringing together services and stakeholders to co‑ordinate activities in support of vulnerable young people. Subnational governments also use their local knowledge and community networks to build trust and channels of engagement with vulnerable groups which may be otherwise mistrustful towards public authorities and initiatives (OECD, 2023[49]; OECD, 2020[53]).

Designing and delivering support programmes for vulnerable youth therefore requires strong multi-level governance arrangements (OECD, 2023[51]), to ensure that objectives, efforts and resources are well aligned. Effective multi-level governance arrangements should provide clarity of roles at each tier, ensuring that subnational governments have clear objectives, but room to tailor national policies and frameworks to local circumstances. They should also create space for dialogue and sharing between national and subnational actors, to identify target groups and priorities, share data, address gaps in service provision and work together to improve services (OECD, 2023[51]).

By strengthening outreach and support, governments can help break the cycle of disadvantage and provide youth with better equality of opportunities, empowering them to become productive and engaged citizens. Such policies can also have long-term benefits such as poverty reduction, crime prevention, social cohesion, economic growth, and enhanced trust in government (OECD, 2023[51]). Ultimately, supporting young people in disadvantaged situations to set them on the right path can avoid costly negative outcomes in the future (OECD, 2023[51]).

Box 3.3. Young People’s Voices

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Young people point out the struggles faced by those with disabilities. They say that educational buildings and resources are often still not accessible, excluding those with disabilities. Participants suggest more funding from both public and private sectors to make sure that schools and other spaces are truly inclusive and accessible for everyone. They also call for better communication about social programmes for vulnerable youth, stressing how important it is to reach local communities and different groups effectively.

Consultations with young people and youth organisations

Policies and practices

1. Providing integrated social, housing, health, employment and legal support that is informed by local and cultural contexts and tailored to young people through strengthening partnerships between employment, social and health services, youth centres, criminal justice agencies, the social economy, employers, trade unions, and education and training providers.

2. Enabling employment and social services to work closely with schools, youth centres, community organisations and other stakeholders to identify young people in vulnerable circumstances who are not in employment, education or training (NEETs) and have not reached out to public services for support.

3. Identifying and addressing barriers to access, participation and achievement in employment and education, including inadequate support for young people with caring responsibilities, and/or experiencing violence, discrimination, addiction, health conditions and disabilities.

Youth specific OECD indicators

Relative poverty by age group (OECD, 2023[54])
Youth not in employment, education or training (NEET), 15-29 year-olds, (OECD, 2024[55])

Building Opportunities – Costa Rica

Context

Young women in vulnerable situations such as teenage mothers and mothers-to-be are more likely to leave education early and face barriers to engage in work. In the absence of adequate conditions, including access to public services, healthcare and social support systems, teenage pregnancies and young motherhood can have considerable negative implications for girls. Measures tailored to the needs of this group can help mitigate the negative socio‑economic impacts of teen pregnancies and young motherhood.

Description

From 1999 to 2006 in Costa Rica, the programme Building Opportunities (Construyendo Oportunidades) provided comprehensive care to teenage mothers and mothers-to-be, as well as mothers in poverty and teenage girls at “social risk”. The programme covered both urban and rural areas across all ten regions of Costa Rica, prioritising areas with high levels of poverty and high incidences of teenage pregnancies.

Building Opportunities aimed to empower these girls and improve their quality of life through a “holistic care model” including several interventions: a six‑month capacity building programme for personal and social development; support for vocational training or continued education to facilitate insertion in the labour market; improved access to public services such as health, education, community housing and social services; and the dissemination and promotion of women, mothers and children’s rights amongst the target population. In parallel, institutional measures were taken to facilitate the rollout of this cross-sectoral care model on the ground, such as capacity-building and awareness-raising on care for teenage mothers and mothers-to-be among staff in relevant institutions (e.g. schools, health centres and social services, as well as national programme leads such as the National Women’s Institute and the Mixed Institute of Social Assistance), and institutional co‑ordination mechanisms at central and local government levels to facilitate care, including referrals and counter-referrals of the girls in the programme.

Since the Building Opportunities programme’s discontinuation in 2006, Costa Rica has set up several successor programmes to improve outcomes for young people, notably the Youth Entrepreneurship Incentive, the Footprint of Significative Leadership, and the Empléate modality of the National Employment Programme (PRONAE).

Outcomes

Between 1999 and 2006, about 3 000 to 4 000 girls between age 11 and 18 were reached annually. 30% of them were pregnant when they entered the programme, and 78% of them had children. The programme was evaluated in 2008, using government documents and appraisals; a telephone survey with open and closed questions; working sessions with institutions participating in the programme; and a focus group with programme participants from 2004. The results showed that Building Opportunities had a significant impact on the participants’ empowerment, and a moderate impact on the improvement of their quality of life, facilitating access to public services to some extent. The geographical areas prioritised by Building Opportunities (e.g. regions of Brunca and Limón) coincided with the regions of Costa Rica presenting the greatest social disadvantages according to national statistics.

Overall, young women having participated in the programme expressed a high degree of satisfaction with the programme, and the evaluation highlighted the positive institutional impact of the programme. By raising awareness, training officials, and creating space for reflection and dialogue on teenage pregnancies and motherhood, the programme changed institutional approaches to these groups, particularly in the education and training sector. The evaluation also identified inter-institutional co‑ordination and coverage (in terms of the number of young women corresponding to the targeted profile at national level) as two areas where improvements were required, to extend the scope and reach of the programme.

One‑stop guidance centres for young people – Finland

Context

Young people face many challenges during their transition from school to work: navigating the labour market, education and training, securing housing or getting established in a new community. To help young people meet their needs, Finland created universal one‑stop guidance centres, called “Ohjaamo”, providing face‑to-face and free‑of-charge wrap-around services to individuals under the age of 30. The Ohjaamo were implemented as part of the Youth Guarantee programme, an initiative of the European Commission, First piloted in 2014, Finland housed 70 local Ohjaamo centres in 2022.

Description

Ohjaamo centres work as “multi‑agency services” that bring together employment, social and other services in one physical location to overcome administrative silos. Services provided in different Ohjaamos can vary significantly based on local initiative. Some centres, for example, develop far-reaching partnerships with organisations such as chambers of commerce, NGOs and occupational health specialists, while others focus on a more limited set of services. The joint provision of services enables staff to address the various challenges young people face within a single public service – including accessing income support, housing, education and training, as well as mental or physical healthcare, social events, sport and creative activities.

Different administrations involved in Ohjaamo centres provide the staff within the centres. The Finnish Government introduced permanent supplementary funding for Ohjaamos and issued guidelines on the functioning of Ohjaamos. Additional funding for Ohjaamos can vary based on location as municipalities help fund Ohjaamos and provide physical space for activity.

Ohjaamos are a central point where young people receive guidance on and apply for different services. Young people do not need an appointment to receive Ohjaamo services. The “low threshold” method is meant to attract young people who would otherwise not take up employment and social services due to difficulties registering or identifying services. Ohjaamos emphasise face‑to-face services, feedback from young people and services adapted to young peoples’ own pace and preferences. Counsellors from different organisations in Ohjaamos do not always provide social services directly, such as social housing, but accompany young people through the application process. Service methods vary based on location to adapt to the availability of local services and the needs of young people in different places.

Outcomes

Promising but limited data on Ohjaamo outcomes is available for early phases of roll-out. In 2017, young people visited Ohjaamo centres nearly 120 000 times, suggesting 2 400 visits per centre. 22% of all young people for whom data was collected transitioned into open labour market jobs, 32% applied for training while 7% secured a place to live. Feedback from users in 2018 based on 409 respondents at 26 centres also indicates a positive experience among young people. Respondent gave centres an average score of 9.25 for the quality of Ohjaamo guidance on a scale of four to ten.

5‑day Hikikomori intervention – Japan

Context

An increasing number of young people are withdrawing from society, sometimes seeking extreme degrees of isolation and self-confinement. The term describing such forms of severe social withdrawal, hikikomori, originated in Japan, but is found across cultures, most commonly in urban areas and high-income countries. Hikikomori isolate themselves for at least six months, spend most of their time at home, and do not participate in society. They are likely to stay shut-ins for years, with the average time spent in this condition being around 10 years. According to the Cabinet Office of the Japanese Government, around 2% of Japanese people aged 15 to 39 were hikikomori in 2016, with the total group of hikikomori across all ages equalling a total number of 1.5 million people in 2023. Men are more likely to be hikikomori, making up 60% of the hikikomori population. Withdrawing from society often coincides with poor mental health. Furthermore, career prospects of young hikikomori are low. For instance, the Cabinet Office estimated that around one‑quarter of all people who are not in employment or in education are hikikomori. Seeking assistance is a major challenge for them, as it takes on average more than four years for hikikomori to access the help they need.

To target hikikomori, Japanese Government has many different policies including Community Hikikomori Support Centres, which provide counselling and can refer young people and their parents to specialised providers including the mental health services. Another effective intervention is the 5‑day hikikomori intervention, a pilot trial that was held in between November 2017 and June 2018 at Kyushu University hospital, with the purpose of providing family, primarily parents, of hikikomori with the tools to be able to support their suffering family members. A second programme targeting parents was held between 2019 and 2021 but could not be finished due to the COVID‑19 pandemic.

Description

The 5‑day hikikomori intervention consisted of five weekly sessions, each lasting two hours, designed to assist parents in supporting their hikikomori children. The intervention also included a monthly follow-up until six months after finishing the programme, to assess whether parents had become more adept at providing support and to evaluate any improvements in the circumstances of the hikikomori. The programme was based on the Mental Health First Aid (MHFA) and the Community Reinforcement and Family Training (CRAFT) programmes, which had been tailored for hikikomori cases. The 5‑day programme incorporated lectures, group activities like role‑playing, and homework. The training included MHFA skills for addressing depression and suicidal behaviour in hikikomori, along with methods of positive communication from CRAFT.

Outcomes

In a randomised trial, the programme proved to enhance participants’ (i.e. parents’) perceived skills in managing hikikomori with depressive symptoms and reduce stigma towards mental health issues. A reduction in parental stigma often improves help-seeking behaviour for hikikomori, who are less afraid to be judged. Additionally, the hikikomori exhibited a slight decrease in obsessive‑compulsive behaviour and a slight increase in physical activity. The evaluation suggested that future initiatives could adopt longer intervals between sessions, such as bi-weekly meetings, to allow participants more time to practice the variety of newly acquired skills in their homes. Furthermore, a stronger focus on essentials would allow parents to grasp better all the complexities of the MHFA and CRAFT programmes.

Recommendation IV.4

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Ensure affordable, accessible and quality housing for all young people and their dependants through close collaboration of all levels of government and the involvement of civil society and the private sector.

Relevance

The housing crisis poses significant challenges for young people across many OECD countries, with the enduring rise in house prices and rents making it increasingly difficult for young people to secure affordable accommodation (Cournède and Plouin, 2022[64]). Many young adults today are unable to afford down-payments or to qualify for a mortgage and they are more likely to rent (45% among 20‑29 year‑olds on average across the OECD compared with 35% among all households). Due to rising free‑market rents, and lower investment in social and affordable housing, access to quality, affordable rental dwellings has become increasingly difficult. In the OECD Risks that Matter survey in 2020, 53% of young people reported that they were concerned about not being able to find/maintain adequate housing in the next year or two (OECD, 2021[65]). The lack of quality affordable housing has also resulted in a large share of young people living with their parents, which was the case for around half or 20‑29 year‑olds across the OECD on average in 2020 (OECD, 2022[66]). These housing problems not only strain the financial resources of young people but also limit their ability to establish stable living situations and plan for their futures.

Young people in vulnerable circumstances, including young people leaving out-of-home care or prison, victims of domestic abuse, and homeless individuals, are faced with even more acute housing challenges, compounding their already precarious situations. Care leavers transitioning out of the foster care system or prison are often particularly vulnerable to housing insecurity amongst many other problems, due the lack of support networks and resources (Adams and Hakonarson, 2024[52]). Difficulties in accessing stable accommodation perpetuates cycles of homelessness and exacerbates the social and economic marginalisation experienced by these young people. Homelessness indeed drastically impacts people’s health, shortening their lifespans by up to 30 years (OECD, 2019[67]).

The effects of inadequate housing policies on young people are far-reaching and extend beyond individual hardships to impact society at large. Poor housing conditions or housing instability contribute to a myriad of negative outcomes for young people, including compromised physical and mental health and reduced opportunities for economic mobility (OECD, 2020[68]). Moreover, housing instability undermines social cohesion and exacerbates inequalities within communities. Homelessness in particular is very costly for governments, as it increases costs of counselling, interventions by emergency services and criminal justice systems (OECD, 2019[67]). By addressing housing challenges and making accommodation more accessible to young people, societies can unlock numerous benefits. Stable and affordable housing enables young individuals to pursue educational and career opportunities, fostering personal growth and socio-economic advancement. Moreover, adequate housing policies that benefit young people promote community stability and economic prosperity, laying the foundation for a more inclusive and resilient society.

Box 3.4. Young People’s Voices

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“If you live far away from your job or school it is harder to be punctual and flexible.”

Young people point out major challenges in finding affordable housing, especially in areas that are in high demand. Their difficulties are related to limited access to credit and prices pushed up by gentrification, making it even harder to live close to where they work or study.

Consultations with young people and youth organisations

Policies and Practices

1. Increasing housing affordability in areas of high demand and where training and jobs are available for young people, including through investment and reforms to land-use regulations that align with environmental best practices.

2. Ensuring that housing policies facilitate mobility among young people through portable housing allowances and by reducing barriers to mobility in the social housing sector.

3. Improving the targeting of public support schemes designed to facilitate home ownership among young people who would otherwise not be able to buy a home, and expanding housing support for young people facing financial barriers and seeking quality rental housing.

4. Investing in student accommodation to provide quality and affordable housing options for young people pursuing vocational, post-secondary and other education and training opportunities.

5. Tackling institutionalisation and segregation, homelessness and housing insecurity by supporting young people in vulnerable circumstances to navigate changing living situations, including transitions from institutional settings.

Youth specific OECD indicators

HM1.4.2 Living arrangements of youth, 20-29 years, (OECD, 2021[69])
HC1.4 Subjective measures on housing, 18-29 years, (OECD, 2021[70])

Other related indicators

National and Regional House Price Indices, (OECD, 2024[71])

Housing First – Ireland

Context

Housing is a complex issue that disproportionally challenges young people. In Ireland, 63% of young people aged 20 to 29 years continue living with their parents, compared with 49% in OECD countries on average, and it has been increasing fast during the last decade due to a lack of supply of houses to buy or rent, high constructions costs, and low supply of social housing. As of September 2023, young people aged 18‑24 make up 17% of all adults in emergency accommodation. Housing First for Youth has been implemented by Focus Ireland to tackle youth homelessness in Ireland. This approach, which has also been used in Canada, Scotland and the Netherlands, aims to provide young people at risk of experiencing homelessness with secure housing as quickly as possible, followed by intensive and targeted support services to help them transition to independent living and prevent future homelessness.

Description

Housing First for Youth by Focus Ireland is a comprehensive housing-led programme that prioritises housing stability for young people aged 18‑26 facing homelessness, irrespective of their background or the cause of homelessness. This approach is designed to break the cycle of homelessness by addressing the root causes. By offering secure housing and a range of age‑appropriate support services, the programme aims to empower young individuals, equip them with the skills needed for independent living, and ultimately break the cycle of homelessness. The programme’s goal is not only to provide immediate housing solutions but also to help young people transition to independent living successfully. This focus on long-term stability and independence is aimed at preventing future episodes of homelessness.

Housing First for Youth has two main target groups: 1) young people leaving state care, who can be especially vulnerable to homelessness due to the lack of family support and resources; and 2) non-care leavers who are facing homelessness due to other factors, including family breakdown, mental health challenges, economic pressures, or unemployment.

In contrast to Housing First for adults, Housing First for Youth recognises that young people may change homes frequently, and it provides flexible, tailored support that remains with them even if they switch residences. Support services also involve collaborating, as needed, with child protection agencies, mental health providers, educational institutions, employers for enrolment in vocational training programmes, healthcare providers, and financial advisors and assistance with familial relationships. Focus Ireland collaborates closely with various partners, including local authorities and Ireland’s Child and Family Agency, Tulsa, to ensure the programme’s success. This partnership model allows for the pooling of resources and expertise to effectively address the complex issue of youth homelessness.

Outcomes

The Youth Housing initiative has yielded positive results. In the Mid-West, for example, 40 young people have been placed in secure homes, with many engaging in education or employment. Similar successes have been seen in Waterford and Cork. To date, the programme has been successful in achieving zero homelessness for young people in the programme, a sustainment rate of 96%, tenancies for 76% of young people and access to education or employment for nearly a third of participants. Further, Focus Ireland plans to expand the Youth Housing First service to other regions in Ireland as needed. However, this expansion will take time and require ongoing support from local authorities and partners. Results from the implementation of Housing First in the Netherlands have shown promising results as well, with for instance an estimated savings of EUR 20 000 per participant compared to regular extramural support.

Staying Close – United Kingdom

Context

The passage from adolescence to adulthood can be a difficult transition phase, in particular for young people who leave out-of-home care like foster or institutionalised care, often referred to as care leavers. They often express feeling unprepared for the challenges of independent living and can have a lack of a strong support network, leading to financial difficulties and sometimes loss of tenancy. Care leavers are therefore at heightened risk of homelessness. In 2021/22 the number of care leavers between the ages of 17‑21 in England totalled 45 940. To help care leavers in their transitions, the UK Government introduced the Staying Close initiative in 2017‑18, initially piloted by five Local Authorities and three private providers in England. An additional 15 Local Authorities were funded in 2022‑23 to expand this programme.

Description

Initiatives within the Staying Close programme offer tailored support for young individuals aged 17‑21 leaving care from children’s homes. They include move‑on accommodation and personalised practical and emotional support, often from trusted figures like their former children’s home staff. The programme prioritises accommodation stability but also aims to build confidence and essential skills for independent living while improving physical and mental well-being. They also target crime reduction and improved participation in education, employment and training. Local Authorities wanting to participate in Staying Close in the financial years 2023‑25, could apply for funding within an indicative range of GBP 22 000 to GBP 32 000 per care leaver to deliver the programme.

Outcomes

A series of evaluations conducted in 2020 investigated the effectiveness of all eight Staying Close pilots funded under the Innovation Programme. These evaluations, mostly qualitative due to the small scale of the Staying Close pilots, aimed to assess their impact. For instance, In North-East Lincolnshire, approximately 35 young people were eligible for Staying Close, with 23 accessing Staying Close support. Further evaluation is planned for the new locations in 2023‑25, with randomised controlled trials set to provide more evidence.

Across the 8 Staying Close pilots, certain consistent outcomes have emerged. The pilots were largely successful in achieving the outlined goals. Participants and staff viewed the interventions positively, mentioning that Staying Close provided a type of support for the young people that previously did not exist in their areas. Certain pilots also reported significant cost reductions for their local authorities due to implementing Staying Close initiatives. The initiatives primarily focused on achieving accommodation stability, while counselling services and peer support networks facilitated improvements in mental health. Targeted interventions and mentorship programmes successfully reduced antisocial behaviour and criminal activity. Additionally, the initiatives enhanced outcomes in education, employment, and training among participants and fostered strong relationships and support networks through staff contact and mentoring, promoting social connectivity. Moreover, independent living skills development, including cooking, budgeting, and time management, equipped care leavers with essential life skills.

There is a Future – Spain

Context

Secure housing is fundamental for people’s well-being. Housing insecurity and homelessness lead to heightened stress, health issues, and lack of societal inclusion amongst other problems. Young people are disproportionately affected by precarious employment conditions, low wages, and the escalating costs of rental properties, making them particularly vulnerable to housing instability, compared to their older counterparts. Becoming homeless at a young age not only entails the loss of stable accommodation but also a disruption of social connections with (adult) people around the young person. This experience can be traumatic especially if it is due to abuse or neglect. In Spain, an estimated 6 000 people between the ages of 18 and 29 experienced homelessness in 2022. This number represents an increase of 36% from 2012 to 2022, while homelessness for the entire population rose by 24%. To help the most vulnerable homeless young people in Spain, the organisations Provivienda and Hogar Sí have started a pilot programme called H4YF (There is a Future), which started in 2022 and ends in December 2024.

Description

The pilot programme is grounded in the Housing First methodology and targets 105 first-time homeless individuals aged 18‑25 in Madrid and Mallorca. Among the participants, 78% are men, with an average age of 22 years and an average duration of homelessness of 21 months. There is a Future facilitates upskilling and reskilling processes for approximately 110 professionals within the homelessness care system. The project is financed by the Spanish Recovery, Transformation, and Resilience Fund under the framework of the Next Generation EU Funds. It offers intensive and tailored support services to assist individuals in transitioning to independent living and mitigating the risk of future homelessness. There is a Future empowers young people to gain autonomy while helping them take care of their needs. The intervention is founded on two key approaches: early person-centred care and a trauma-focused approach. The emphasis on trauma distinguishes There is a Future from conventional Housing First programmes.

The programme is guided by five principles. Firstly, young people have the right to housing without preconditions. Secondly, choice, participation, and self-determination are central to the programme, which aims to ensure that young people’s voices are heard, and they play a role in shaping the service. Thirdly, the programme adopts a positive stance toward the development and well-being of young people, emphasising their strengths, resources, and virtues alongside vulnerabilities. The trauma-based approach is instrumental in fostering these resources and tools. Fourthly, the programme offers individualised support without time constraints, offering services until the individual is prepared to move out of the programme. Lastly, the programme fosters social inclusion and community integration by strengthening young people’s sense of community, their ability to engage within it, and expanding their support networks.

Outcomes

The pilot programme is ongoing, and a full evaluation will be made available after the project finishes in December 2024. So far, 75 people have participated in Madrid and 30 in Mallorca. Preliminary results of the pilot project show that access to housing in a community improves mental health and employability in people who are homeless. Young people transitioned from a high threshold of mental health impairment to a threshold similar to that of the societal average. The project helped participants feel in control, which translates into feelings of improvement in other aspects of life, including mental health and recovery. After 7 months, 97% of the people remain in their housing solutions and have initiated autonomous exit plans, with some of them leaving the project on their own. Furthermore, the care professionals find the focus on housing to be positive and show a willingness to move away from traditional paternalistic attitudes.

Recommendation IV.5

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Promote health and well-being for all young people and pay equal attention to both mental health and physical health in youth policy.

Relevance

Young people have unprecedented access to medical and social innovations that have the potential to transform their health and well-being. Yet at the same time, many of these developments have added to the mental stress and pressures facing young people, for example in navigating peer interactions through social media and online threats. Mental health pressures were heighted by the pandemic, which saw the number of 18‑29 year‑olds reporting a mental health issue more than double in several countries compared to 2019 (when more than one in six young people – more than 14 million people – reported a problem). At the same time, it challenged already-stretched mental health care services. Around half of young people in the EU reported unmet needs for mental health care in the spring of 2021 and 2022, rates over double those of the general adult population (OECD/European Union, 2022[83]).

Young peoples’ health and well-being outcomes are influenced by several policy domains. While there is a need to strengthen young peoples’ access to for medical care in many countries, policy makers must also tackle the causes of poor health upstream. This includes measures to ensure educational institutions work to promote healthy lifestyles at every stage, as well as measures to address digital risks, promote quality work with job security and work-life balance, and to enhance access to green space and sporting opportunities. Increasing young people’s opportunities to participate in sports and enjoy quality free time can be a particularly powerful means of supporting both physical and mental health (OECD, 2021[84]).

Subnational governments, from regions to cities, can play a powerful role in designing, delivering, and aligning policies to promote youth health and well-being. Across the OECD, subnational governments account for more than half of public spending and investment across education, environment, housing and community amenities (OECD, 2019[85]). At the same time, governments at all levels should be attentive to uneven access for youth to key services between groups and places, including in medical care as well as social and sporting opportunities. These gaps can be particularly pronounced between rural and urban areas, exacerbating inequalities across places and undermining quality of life for rural residents. For example, across OECD countries, rural areas facing long travel times to healthcare facilities: for instance, in Canada and Mexico, people in rural areas face about 200 percentage points longer travel times than the national average (OECD, 2023[86]).

Box 3.5. Young People’s Voices

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“Mental health is crucial to include in all policies. We need to break the stigma: it is okay not to be okay.”

Young people mention that the stigma and stereotypes around mental health make it hard for people to understand and talk about it openly. A lot of young people feel anxious and insecure because of the job market. As they say, feeling undervalued or dealing with gender-related issues at work and insecurity about the future can really affect their mental health. This anxiety gets worse with worries about the high cost of living, as well as the pressure from social media.

Consultations with young people and youth organisations

Policies and practices

1. Providing timely, good quality, accessible and affordable physical and mental health support to young people through the health system and in educational institutions, workplaces, employment services and youth centres, and promoting literacy of health issues, including reproductive health and mental health;

2. Promoting equitable working time arrangements and work-life balance, including through ensuring access to paid parental leave and affordable, good quality and flexible early childhood education and care options for young parents; and

3. Investing in accessible infrastructure and eliminating barriers to provide access to green and public spaces to promote sports, physical activity and culture and volunteering in both rural and urban areas, through local action in schools, youth centres, sports organisations, cultural institutions and the broader community.

Youth specific OECD indicators

Share of young people with symptoms of depression, 18-29 year-olds, (OECD, 2022[87])
Life satisfaction, 16-29 year-olds (OECD, 2024[88])
Negative affect balance (share of people feeling more negative than positive emotions on the previous day), 15-29 year-olds (OECD, 2024[88])
Perceived social support, 15-29 year-olds (OECD, 2024[88])
Mental health measures taken during the COVID-19 pandemic, (OECD, 2021[14])
Feeling lonely, 16-29 year-olds (OECD, 2024[88])
Depressive symptoms, 15-24 year-olds (OECD, 2024[88])
Satisfaction with time use, 16-29 year-olds (OECD, 2024[88])
Satisfaction with personal relationships, 16-29 year-olds (OECD, 2024[88])

Youth Aware of Mental Health Programme – multiple countries

Context

Suicide was the fourth leading cause of death among 15‑29 year‑olds globally in 2019. Researchers have established links between suicide and mental health disorders as well as sudden crises or life stresses. Large proportions of psychopathological changes have their onset in childhood and adolescence, which makes young people an especially important target group for prevention and intervention measures.

The Youth Aware of Mental Health Programme (YAM) targets preventable deaths from suicide. YAM is, or has been, active in several countries, including Australia, Austria, Estonia, France, Germany, Hungary, Ireland, Italy, Norway, Slovenia, Spain, Sweden, the United Kingdom, and the United States, as well as in India and Romania.

Description

YAM is a universal, school-based intervention involving booklets, posters, and five hours of instruction by two trained adults over three weeks. All instructors have previous experience in working with young people and receive rigorous training before being certified. The programme aims to help students reflect on risk and protective factors associated with suicide, as well as on different coping strategies in difficult situations. YAM aims to help grow solidarity among young people and promote positive mental health practises.

Instructors focus on creating a safe environment and valuing young people as experts on their own mental health, relying on role‑play and student-led discussions. Putting student experience centre‑stage helps ensure the cultural adaptability of the programme.

Outcomes

More than 85 000 teenagers across 16 countries have participated in YAM and there is strong evidence that YAM is effective at preventing suicide in young people. It was evaluated in a cluster-randomised controlled trial (the Saving and Empowering Young Lives in Europe (SEYLE) study) covering pupils with a median age of 15 across ten European countries and 168 schools. After 12 months, the risk of a student reporting a suicide attempt was more than 50% smaller in the group receiving the YAM intervention than in the control group. Out of 1 000 pupils, 11 attempted suicides in the control group while only five did in the treatment group. Figures were similar for severe suicidal ideation: the risk in the treatment group was 49.6% lower relative to the control group.

Another study considers whether YAM operates through interaction with five coping strategies captured in the SEYLE questionnaire, i.e. learn, help-seeking, sports, arts, and fight. The authors find that the YAM intervention was particularly effective among those who did not frequently use the suicide protection strategies of learn and help-seeking (strategies that tend to be efficient in preventing suicide ideation). Finally, examining experiences and opinions captured in the SEYLE, another study shows that adolescents both learned about mental health and enjoyed the experience of participating in the programme.

headspace – Australia

Context

Against the backdrop of an international movement to improve youth mental health services, Australia established its first 10 headspace services in 2007. The services provide comprehensive support for young people aged 12‑25 and their families to improve mental health and well-being. In 2023, there were 154 services across Australia, comprising the largest national network of youth mental health services world-wide. Similar service approaches in youth mental health care are now being implemented in many other countries, including Ireland, Canada, Denmark, Israel, the United Kingdom, and parts of the United States.

Description

Headspace is an early intervention and prevention model, designed to assist young people managing mild to moderate, high prevalence mental health conditions. Every year, headspace services support around 100 000 young people in Australia – often reaching young people with non-diagnosed mental illnesses. Overall, 3 out of 4 users are experiencing depression and/or anxiety issues, with nearly 22% resulting in a diagnosis by a headspace professional or through referral.

Headspace services cover four core areas – mental health, related physical and sexual health, alcohol and other drug support, and vocational assistance – as part of the objective of providing holistic, integrated support. The service has been praised for bringing together support options and for being co-designed with participants to ensure it meets their needs. Young people can benefit from professionals in behavioural and occupational therapy, counselling, social work, general practitioners and even employment support. The approach encourages young people to take action to promote their own health and well-being.

One prominent feature of the programme is the regional and rural spread of services, which has vastly improved since the programme was founded. Of the 154 services in operation in 2023, 84 are in “regional Australia”, which refers to towns, villages and small cities outside the state capitals and major cities. Headspace services benefit from partnerships with state and local government, and each headspace service is supported by a local consortium, a collaborative advisory group made up of local service providers and organisations. The consortium provides partnership opportunities, strategic direction, and resources to enhance the headspace service’s capacity to meet local community needs.

Outcomes

A recent evaluation, based on survey responses from users of the services from mid‑2019 to mid‑2020 assessed the programme’s impacts on three core areas of mental health: psychological distress, psychosocial functioning, and quality of life for young people accessing headspace. More than 70% of the 50 000 users covered by the study experienced a significant improvement on at least one of these measures during the period.

Following headspace going online during the COVID‑19 pandemic, a June 2020 survey of users showed that 78% agreed or strongly agreed that the mode of service they received had been appropriate for their needs, and around half indicated they would like to use telehealth again in the future. While not all young people have been comfortable using digitally enabled services for support, it played an important role in ensuring service continuity during the pandemic. A more recent evaluation by KMPG shows evidence of positive outcomes in terms of mental health improvements and cost-effectiveness when compared to other interventions. However, more progress is needed to address issues for hard-to-reach groups.

True Love – Mexico

Context

Although often overlooked in discussions about health, the World Health Organization declared physical and emotional dating violence a global public health concern as early as 2002. Dating violence has been associated with adverse health outcomes such as depressive symptoms, substance abuse, physical injuries, and the perpetuation of aggressive behaviours. The ramifications of dating violence on adolescents additionally encompass hindered personal development, heightened risk of teenage pregnancy, and later risky sexual behaviour.

According to the National Survey on Dating Violence in Mexico, approximately three‑quarters of adolescents encountered psychological violence in 2007, while 15% endured physical violence in their relationships. The survey also revealed that 16.5% of female adolescents in Mexico experienced sexual assault. The survey emphasised the prevalence of violence within adolescent relationships, affecting both genders. Violence was disproportionately prevalent among poorer youth. In order to prevent dating violence, the Colegio de Bachilleres, a public high school system in Mexico, collaborated with the Inter-American Development Bank (BID), the National Institute of Public Health, and the non-profit organisation ALBANTA to create a pilot programme. This collaboration resulted in a programme titled “Amor... pero del bueno” (True Love) in 2014.

Description

True Love was piloted in two urban, low-income high schools in Mexico City. The intervention spanned 16 weeks and covered topics on gender roles, dating violence, sexual rights, and strategies for coping with dating violence. The programme included both school-level and individual-level components. The school-level component aimed to create a supportive environment through schoolyard activities and a workshop for staff. All students attending the school were exposed to information on preventing dating violence through the school-level intervention. The individual-level component of True Love consisted of a classroom-based curriculum, in addition to the schoolyard activities. The classroom curriculum encouraged critical thinking about gender norms, dating violence, and effective communication skills, using a behavioural theoretical framework that drew from theories on intimate partner violence. The schoolyard activities empowered students to apply what they learned in class as agents of change within their school.

Outcomes

The True Love pilot programme engaged 1 604 students, with 744 participating in the individual-level curriculum and 860 experiencing the school-level component. Short-term impact assessment revealed a notable 58% reduction in the prevalence of perpetrated psychological violence and a 55% reduction in experienced psychological violence among males who engaged in the classroom curriculum compared to those exposed only to the school component. Additionally, both male and female participants exhibited significant but relatively small reductions in beliefs and attitudes justifying sexism and violence in dating relationships. Successfully implementing a programme like True Love necessitates making sure that students are exposed to all facets of the programme, by for instance ensuring compulsory curriculum attendance. It is also important to address high school dropout rates, and involve the community outside of the school to increase the impact of the intervention.

References

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