Nearly one million young people in the United Kingdom are currently categorized as not in education, employment, or training (Neet), a group increasingly affected by mental health challenges. A promising approach to addressing this issue is a Finnish mental health therapy called “open dialogue,” which has shown significant benefits in re-engaging young people with work and education.
Open dialogue, developed over 40 years ago in Finland, is a therapeutic method that involves the patient's family, friends, and a consistent multidisciplinary team—including psychiatrists and peer support workers—engaging in regular network meetings. These meetings take place in the patient’s presence, encouraging transparency and inclusive discussion about the mental health challenges being faced.
The effectiveness of open dialogue was confirmed in a recently published randomized controlled trial involving almost 500 National Health Service (NHS) patients in the UK. The study revealed that individuals receiving this form of treatment were three times less likely to be admitted to psychiatric hospital compared to those receiving conventional care. The method is now being expanded throughout the NHS and piloted in schools.
Similar findings were reported from western Lapland, where a longitudinal study showed that over 80% of participants in the open dialogue program were engaged in work, study, or actively seeking employment two years after treatment. This contrasts with roughly 30% of those receiving standard mental health care. Additionally, only 42% of the open dialogue group were receiving disability benefits at this time, compared to 79% in the control cohort.
Mental health issues are considered a major driver behind the rise in the Neet population. A recent report by Charlie Mayfield, former chairman of John Lewis, highlighted a 76% increase since 2019 in 16 to 34-year-olds out of work due to long-term sickness related to mental health conditions—a rise of 190,000 people.
Government officials have underscored the need for a shift in policy to better support young people. Andy Burnham, mayor of Greater Manchester, has emphasized prioritizing investment in young people’s success rather than responding to failure. Alan Milburn, former cabinet minister and head of a government review on the Neets crisis, recently visited the Netherlands to assess their approach. The Dutch system mandates education or training until age 18 and includes active measures to prevent school dropouts, such as home visits and early tracking into academic or vocational streams. Collaboration between employers and educational institutions is also strong, with work placements integrated into the curriculum from age 16. Additionally, unemployed youth may be required to undertake volunteer work in exchange for benefits.
UK Work and Pensions Secretary Pat McFadden, after observing the Dutch model, noted that the British welfare system often funnels young people into long-term sickness benefits without sufficient support. He described the Dutch interventions as operating “at all levels” to prevent dropouts, suggesting the UK has the opportunity to reform its system to offer young people more promising futures.
Advocates of open dialogue and international education strategies argue that addressing mental health more holistically, while combining social and economic support, could be vital in reducing the number of young people disconnected from work and learning in the UK.