Interventions to Foster Mental Health and Reintegration in Individuals Who Are Unemployed: Systematic Review

Unemployment is a risk factor for the development and perpetuation of psychological distress. Finding support for affected individuals can be particularly challenging, which causes a vicious cycle of psychological distress and unemployment.

The aim of this systematic review is to assess and summarize existing evidence regarding interventions that address both mental health and re-employment, emphasizing accessibility through community or social care structures.

A systematic literature search using PubMed and EBSCOhost and an additional search using reference list screening were conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. In order to identify interventions for the mental health and re-employment of individuals experiencing psychological distress and unemployment, an inclusion process according to the PICO (population, intervention, comparison, and outcome) scheme and the study design was applied. Title and abstract screening and full-text screening for eligibility were performed independently by 2 reviewers. Quality assessments using the Cochrane Risk of Bias Tools for randomized and nonrandomized trials were conducted by 2 independent reviewers.

The initial systematic search yielded 4442 results, and 15 articles were additionally identified via reference list screening. Eventually, 74 articles were subjected to a thorough evaluation process by 2 independent reviewers. The interrater reliability was determined to be good, with a Cohen κ score of 0.770. After a multistep extraction process, 17 studies remained for inclusion, with each focusing on the improvement of mental health, re-employment, or both outcomes. A heterogeneous pattern of results emerged, with most interventions showing improvement in either mental health or re-employment. Most studies were assessed as having a moderate (n=7) or high (n=9) risk of bias.

The results of the systematic research indicate that low-threshold services in close cooperation with institutions and exchange with other supportive stakeholders should be fostered. Derivable overarching themes and intervention content for integrative support measures can serve as guidelines for future interventions.

PROSPERO CRD42022378490; https://www.crd.york.ac.uk/PROSPERO/view/CRD42022378490.