Youth employment, mental health and substance misuse: a challenge to mental health services.

Employment is the cornerstone of social inclusion, the means by which individuals play a full and active part in society and has a pivotal role in helping young people to negotiate the transitional period between the child and adulthood. Employment therefore should be seen as a right and given a higher priority by health and social care agencies. There are numerous difficulties preventing some young people from achieving full employment and these are compounded for young people with concurrent mental health and substance misuse problems (dual diagnosis). The coexistence of these two problems is on the increase and they are recognized as significant barriers to employment. Unemployment may lead to social alienation, criminal or other antisocial activity and a higher incidence of suicide. Consequently, there is a danger of young unemployed people slipping into a spiral of self-defeating, antisocial and risky behaviour. There is little evidence of health and social care agencies working in partnership with voluntary sector organizations to tackle the growing problem of dual diagnosis and youth unemployment, although there are obvious linkages between employment, psychological health, social inclusion and substance misuse. It is therefore worth exploring the issues surrounding work, mental health and substance misuse in young people if we are to generate new ways of thinking about and responding to the needs of this target group. This presents a challenge to mental health services, particularly nurses who face the impact of these issues in their day to day practice but often lack the preparation and support to adequately address them.