Screening tool suitable for identifying mental disorders

Unemployment often leads to psychological stress. The goal of this project is an early intervention approach to reach out to young people who find themselves unemployed after graduation. The long term goal is to reduce the increasing number of early disability pensions among adolescents.

Background
Mental disorders are common in youth and adults. Symptoms of mental are aggravated by unemployment. Compared to the working population, the unemployed have higher rates of poor health, a tendency toward negative emotionality and depression, show symptoms of exhaustion more frequently, and experience disturbed sleep or have a sleep disorder. It can be reasonably expected that unemployment in adolescents and young adults causes the same symptoms and behaviours as in adults. In those youth with a mental disorder, particularly an untreated one, the transfer from school to the employment market can be hindered. At the same time, we notice an increase in early disability pensions due to mental health issues among adolescents. Thus, the early recognition and treatment of mental disorders and psychological strain is crucial in promoting the employment of young people and supporting their connection to the employment market.

Aims
With this project we want to implement an early intervention and reach out to unemployed youth. The use of a screening instrument would make the intervention possible. The aim of this study was to develop the screening instrument. We identified the period between graduation and first employment as the ideal moment of intervention, because this time period is a critical period in which young people are exposed to increasing personal challenges. Conducting an intervention before a psychological stress transforms into a mental disorder, can prevent harm and suffering to the afflicted person. In addition, early intervention could help prevent the need to enroll in the early disability pension program.

Study design
A total of 230 unemployed young people and young adults were recruited from the Cantons of Zurich, Basel Stadt and Aargau. The participants were taking part in various Motivation Semesters. They were surveyed by questionnaire on diverse health psychological aspects and later invited to a clinical interview.

Results
In this study, 74% of the participants met the criteria for one or more mental disorders. We found indicators of depression in 29% and substance abuse in 20% (alcohol) and 21% (cannabis) of the young people and young adults examined. From the data gathered, we created the Zürcher Adoleszenten Screening Instrument Psychischer Störungen (ZASIPS). ZASIPS is a brief screening instrument for early detection of mental disorders in adolescents age 16 to 25. The instrument is largely self-explanatory, simple, and takes little time. The goal is not diagnosis but rather triage of young people. Coaches and caregivers are able to identify mental health problems and point the young people to appropriate treatment options available in the existing network.

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