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Briefing

How to build young people’s health and participation in work and education
Recommendations for government

Published September 2026
Time to read clock icon About 25 mins
Authors
Three young people receiving support from an adult

In this briefing

Topics

Key points

  • Poor health is an increasingly important issue for young people not in education, employment or training (NEET). In 2025, 44% of 16–24-year-olds in the NEET category reported a work-limiting health condition, up from 26% a decade earlier. 
  • Improving young people’s health, and reducing the impact of poor health on employment, could bring substantial benefits. Restoring the health of 16–24-year-olds to 2014 levels could add £7.3bn a year to economic output, with substantially greater fiscal and economic gains accumulating over time. 
  • Ahead of the final report of the Milburn review of young people and work, this briefing draws on the experiences of young people and insights from policy, delivery and academic experts to set out recommendations for helping young people with health barriers stay in, or return to, work and education. 
  • Our recommendations focus on prevention: helping young people stay engaged, tackling health barriers early and recognising that needs vary widely, both between individuals and across different points of a young person’s life. Government should: 
    • work with local partners to develop a caseworker-led offer for young people at greater risk of persistent NEET status as they transition from school 
    • strengthen school-based mental health support teams and roll out early access mental health support hubs to every local authority in England
    • introduce reforms to ensure those aged 25 years and younger are engaged more actively through the welfare system and improve guidance and advice for employers to help them recruit and retain young people with health conditions. 
  • Bringing existing services together into a more cohesive offer could expand access to the support set out in these recommendations, but delivering it at scale will also require additional upfront investment and a sustained policy commitment. This will be challenging in a tight fiscal environment but – as the interim report from the Milburn review argues – over the long term, earlier support should reduce reliance on more costly clinical and welfare services.
 

Introduction

Over the past decade, a growing share of working-age people have reported health conditions that limit their ability to work. The sharpest increase has been among 16–24-year-olds, the proportion of whom report a work-limiting health condition having risen from 9% in 2015 to 16% in 2025.

Mental health and neurodevelopmental conditions account for most of the rise in ill health among 16–24-year-olds. The review into mental health conditions, ADHD and autism led by Peter Fonagy suggests that this reflects a genuine increase in distress as well as greater recognition and reporting. Young people are growing up in a challenging environment, with the impact of digital technologies, a stuttering youth economy and strained health and support systems all potentially contributing. 

Successive governments have failed to act on these wider factors impacting young people’s health, and the costs are now being felt by both individuals and the economy. Our analysis suggests that restoring ill health to 2014 rates for 16–24-year-olds could increase annual economic output by £7.3bn. This estimate reflects a static, single‑year snapshot of the gap between the economy we have and one in a world where working-age health has improved. Actual gains would be far greater over the lifetime of a young person who maintains better health. 

Most of the additional economic output from better health would come from more young people being in work. This puts the 980,000 16–24-year-olds who are not in education, employment or training (NEET) firmly in the spotlight. Worsening health is particularly apparent within this group: 44% reported a work-limiting health condition in 2025, up from 26% in 2015.

Young people in the NEET category bear much of the immediate cost of being out of work and education through lost earnings, disrupted education and fewer opportunities to build skills and experience. But they will also carry costs far into the future. Periods out of work or study are associated with poorer subsequent employment, income and health outcomes – and for young people with a health condition or disability, these periods tend to last longer. As ill health becomes more prevalent among young people in the NEET category, there is a risk that they will face more severe long-term economic and health consequences.

By contrast, participation in work or study generally supports young people’s health. It provides income, routine, social connection and self-confidence. Alongside the Fonagy review, Alan Milburn’s independent review of young people and work presents government an opportunity to both address ill heath among young people and reduce the long-term health harms that arise from time out of work and education. 

Drawing on consultation with young people with lived experience alongside insights from policy, delivery and academic experts, this briefing sets out how government can better support young people facing health barriers to manage their health and remain in, or return to, work and education. 

With Toynbee Hall, we held four focus groups in July 2026. 25 young people aged 18–24 years and out of work and education participated from across England, including 11 who reported a disability. Anonymised quotations from these sessions are used throughout. 

Action for Children supported the study by organising site visits and interviews with employability services in Scotland and Wales. A range of policy, delivery and academic experts from different organisations also contributed through workshops to inform and evidence the policy recommendations. 

UCL’s Equalise: ESRC Centre for Lifecourse Health Equity produced new longitudinal analysis of school-based predictors of NEET status. The work also draws on relevant Health Foundation programmes, including the Commission for Healthier Working Lives and the Young People’s Future Health Inquiry.

 

Barriers to participation

Poor health is only part of why the UK’s NEET rate is high. Wider economic and institutional factors, including the availability of entry-level jobs, also have a significant impact. The UK is particularly weak on vocational routes: low numbers in vocational education and training explains much of why the UK’s underlying NEET rate remains higher than that in many comparable countries.

These wider factors also show concerning trends, with vocational and further education facing continued funding pressures and long-term structural changes to the economy (including through the emergence of AI) potentially reducing traditional entry points into the labour market. In focus groups, young people recognised a lack of job opportunities as one of the key drivers of the high NEET rate. 

‘My main concern is… the amount of job vacancies in the job market.’

‘Even at entry level, I feel like experience to get experience is now competitive… Even unpaid experience.’

                                                          Young people in the NEET category (focus group participants)

Alongside declining work opportunities and insufficient vocational routes into employment, there are also longstanding weaknesses in the ‘supply side’ of the youth labour market, including: 

  • a lack of support that prepares young people for work and helps them overcome barriers to earning or learning, such as poor health
  • an education and skills system that often lacks clear pathways to work for young people and tends to favour academic routes
  • the absence of a coherent approach to supporting participation in work or study, which has left support services highly fragmented and difficult to navigate.

The following sections focus primarily on how government can create a more cohesive and preventative support system to help young people experiencing or at risk of health-related barriers to work or study. Young people’s health needs are varied, and growing numbers appear to be seeking help for mild or moderate conditions. In many cases, identifying problems early and providing the right advice can prevent the need for clinical intervention, which may be costly and disproportionate to a young person’s needs.

A better support system alone will not improve the NEET rate: the strength of the economy will continue to play a major role. But it would help make the transition to adulthood fairer and ensure the system is better prepared if the labour market weakens, particularly in the context of more young people reporting work-limiting health conditions. 

Our recommendations for government focus on three key periods in young people’s lives:

  • at school and during childhood
  • through the transition from school into work or post-school education or training
  • while out of work and claiming benefits
 

Supporting young people at school and during childhood

Ensuring health problems do not disrupt young people’s participation in education, employment or training during the transition to adulthood often requires early action. This starts with ‘primary prevention’ approaches, which aim to prevent poor health from developing in the first place. Primary prevention approaches include early years and family support, ensuring families have an adequate income and strengthening other building blocks of health, such as access to decent homes. 

With a growing number of children and young people reporting health conditions, public services also need to identify and respond to problems before they worsen and disrupt participation in education or work. This is often described as ‘secondary prevention’. 

This section sets out recommendations to strengthen the education, health and employment systems’ capacity to support health and sustained participation for those with emerging health barriers before school-leaving age. 

Strengthen mental health and neurodevelopmental condition support 

Any system that aims to support young people’s wellbeing and long-term economic participation will have a key role for schools. They are where young people spend much of their time, form friendships and ambitions, learn and can access additional help and guidance.

But many young people describe struggling to adapt and thrive in the school environment. A narrow focus on academic attainment and inflexible approaches to behaviour can be challenging for some young people, including many with neurodevelopmental or emerging mental health conditions. As the following quote from a young person suggests, over time, early feelings of anxiety or non-belonging can easily develop into poor behaviour and disengagement from the classroom.

‘I used to overthink. In subjects like history, I would just talk. I was trying to distract myself… I’d get in trouble and then get put in detention… It got to the point where I’d just put myself in isolation for a whole day… The teachers didn’t try and understand what's going on with the student.’

                                                          Young person in the NEET category (focus group participant)

Early signs of difficulty can signal risks to young people’s future trajectories. Using longitudinal data, Figure 1 shows that students reporting a greater number of negative school experiences (including misbehaving in class, bullying or being unkind to others, unauthorised absence, suspension or exclusion) had a higher predicted likelihood of being out of work or education at age 23 years.

Figure 1

How schools recognise and manage early manifestations of poor mental health, neurodevelopmental conditions or wider life challenges can thus be critical. This is particularly important given the rapid increase in the number of young people reporting a mental health or neurodevelopmental condition. Although this partly reflects changing cultural attitudes towards and increasing awareness of mental health and neurodevelopmental conditions (in part due to higher diagnosis rates), evidence suggests there are more young people experiencing distress and symptoms of depression and anxiety.  

The government’s main policy approach has been to roll out mental health support teams (MHSTs) that provide early support for mild to moderate mental health problems. MHSTs also help schools develop whole-school approaches to mental health and connect pupils with more specialist services where needed.

Nearly 80% of secondary schools now have access to an MHST, with coverage planned to extend to all schools and colleges by the end of 2029/30. Although there has not yet been a full, high-quality impact evaluation, school leaders are positive. The latest Department for Education survey saw 92% of respondents ‘strongly’ or ‘somewhat’ agree that their MHST had provided beneficial mental health support, and 87% of respondents ‘strongly’ or ‘somewhat’ agreed that their MHST helped improve the school’s or college’s overall approach to mental health and wellbeing.

MHSTs provide a promising architecture for better early intervention around young people’s mental health and participation. However, there are two important gaps government should address. The first is in post-16 and alternative provision education settings. As Figure 2 shows, only 42–44% of learners in post-16, alternative and special school settings are currently covered by MHSTs.

Figure 2

Extending MHST coverage to these settings should therefore be a priority for government, although the model may need to be adapted to reflect their lower contact hours and the different relationships between staff and students, characteristic of further education colleges in particular.1

MHSTs should also develop stronger expertise in supporting neurodevelopmental needs to reflect the fast-growing number of young people with diagnoses or on diagnostic pathways. Evaluations have identified this as a gap in current provision, and increasing capacity to identify and manage such needs early could improve outcomes for young people and reduce reliance on clinical services. 

These changes would strengthen MHSTs’ capacity to identify and address needs earlier. But whether young people thrive at school also depends on the wider school and policy environment. The government’s SEND reforms could complement MHSTs by helping schools better support pupils with lower-level needs (without the need for a diagnosis) and expanding specialist provision for those with more intensive needs. Other school policies, including behaviour and accountability frameworks, should reinforce an emphasis on inclusion and rapid access to support.

Bridge school-based and clinical support with community-based services 

While schools have an important role to play in preventing, identifying and managing early signs of mental health risk, there is a gap between school-based and clinical support. 

MHSTs offer basic therapeutic interventions, but some young people have different personal preferences or support needs that are better managed in a different environment. Specialist NHS children and young people mental health services are designed primarily for those with more complex or persistent mental health problems, and might not be the right type of intervention for those with mild to moderate support needs.

Young people in focus groups identified this gap between school-based and clinical support, noting that seeking clinical help seemed disproportionate for what they needed.

‘The part about [children and young people mental health services] where if you don't qualify for the referral, I kind of related to it… sometimes it's not… maybe as severe, but it's just something that you want to talk about or like just get it off your chest or come for some advice, but you need to meet like a strict boundary of things to even be able to be referred, and it kind of just puts people off.’

                                                          Young person in the NEET category (focus group participant)

However, another young person shared that their school relies on clinical labels as prerequisites for providing support, which can leave emerging issues to worsen. 

‘Whatever mental health problems you have… they (schools) just don't care about it. And until it gets to a point where it can be under a label, then it's kind of beyond recovery because it is left for so long because it couldn't be identified.’

                                                          Young person in the NEET category (focus group participant)

A reliance on diagnoses to unlock support, along with limited preclinical mental health support for young people, may be contributing to the long waits young people continue to face for diagnosis and treatment. In 2024/25, more than 1 million children had an active referral, with 35% still waiting for treatment at the end of the year and more than 60,000 waiting over 2 years. As the focus group participant observed, long waits for help have been linked to young people’s mental health issues worsening and can make the help they eventually do receive less effective. 

To bridge the gap between school-based and clinical support, the government should strengthen the community-based offer. Early support hubs provide an existing foundation, with 24 hubs explicitly catering to 11–25-year-olds currently receiving central government funding. Estimates suggest more than 60 comparable services operate across the country with support from the NHS, local authorities and charities. 

The role of the hubs is to provide access to specialist preclinical support and advice for young people without a referral or diagnosis. This can include light-touch support with self-management as well as therapies and advice on wider issues such as employment, money and relationships. Hubs could also help triage those with more severe needs towards NHS support. A strength of the community-based model is that it can provide continuity of support across the transition into adulthood, avoiding the cliff edge between children’s and adult NHS mental health services.

Hubs are also well placed to coordinate peer support networks, which were singled out by the young people we spoke with as a key intervention for supporting mental health.  

‘It just makes me feel less alone knowing that there's other people going through it as well… I feel like [peer support groups] would also be helpful because something that I struggled with after leaving school is having routine, having that structure. And I find myself to not really do well when I don't have a routine or structure.'

'Like, just being able to sit in a group of people that has gone through the same thing as me, I would find it motivating to… know that I'm not on my own and this is actually quite common.’

                                                          Young people in the NEET category (focus group participants)

Government should set a target of expanding early access hubs to every local authority in England by the end of the parliament, with devolved nations replicating the approach. These hubs should provide a route to support for young people awaiting specialist care, those with needs that exceed or are not appropriate for the kind of support MHSTs provide and those who want or need support outside their school or college.  

Expanding early access to hubs would require additional investment. Estimates have placed the cost of replicating the current model in every English local authority at £170m–£210m a year. While substantial in a tight fiscal environment, this is relatively modest compared with the estimated £456m annual cost of universal MHST coverage and the £7.3bn in economic output lost annually due to deterioration in the health of 16–24-year-olds over the past decade.2 By providing earlier help outside specialist settings, hubs may also reduce pressure on clinical services, although evidence on the impact of existing government-funded hubs on clinical demand and NHS spending is not yet available. There may also be a role for digital tools in providing young people with advice and guidance on managing their health and directing them to appropriate local services. However, any tools offering medical advice would require evidence of their effectiveness.

 

Supporting young people during the transition from school

The transition to adulthood after school-leaving age can be particularly challenging for young people. Some move smoothly into work or higher education, while others experience repeated false starts or struggle to engage at all. 

Alongside health support, many young people experience wider pressures, including difficult family circumstances, caring responsibilities or problems with housing and money. These pressures can become particularly disruptive at transition points, such as leaving school, starting college or training, or moving into work, when established sources of support may fall away. 

Currently, young people transitioning out of school can seek advice through their local job centre or careers service. However, the young people we spoke with who needed help expressed deep dissatisfaction with the employment support they had received.

‘My experience with the job centre has not been very good. Like, they basically just haven't really offered anything. And I have to travel 45 minutes there and 45 minutes back. The meeting lasts between 5 and 10 minutes every week. So, it's like sometimes I literally just go in there, sit down, they go, ‘How is the job search going? Have you applied to jobs?’ I go, ‘Yes, I applied to this one, this one’... And they go, ‘Okay, bye.’

                                                          Young person in the NEET category (focus group participant)

The problem is a mismatch between what young people expect and the support the system has historically been designed to provide. Employment support has prioritised rapid movement into work backed by conditionality intended to discourage prolonged periods out of employment. It has largely not been oriented around building confidence, understanding longer term ambitions or addressing wider barriers to participation.

What is often missing is continuity: a trusted person who can help the young person navigate the transition, coordinate support and ensure their new setting understands and accommodates their needs. Existing social or emotional support tends to be tied to the institution a young person is leaving, while parents may lack the knowledge or capacity to fill the gap. Young people we spoke with called for a designated person who could remain alongside them through these transitions.

‘It's so overwhelming with so much information and so many points of contact that it feels like even accessing the right support is a chore in itself… You have to fill all the gaps yourself. [A designated person] would also stop you from having to over explain yourself or any sort of health things that you might be going through in detail with a lot of random people.'

'I just felt like if I had someone that had guided me, sometimes maybe even pushed me a little bit to get where I wanted to get to, then I felt like I would have definitely had more of a positive experience with job searching.’

                                                          Young people in the NEET category (focus group participants)

There are strong international precedents for named caseworkers who support young people through the transition between education and work. In Denmark, young people with complex needs can be assigned a continuous named contact person who coordinates support across education, employment and social services until the young person is securely established in education or work. Similar schemes also operate in Norway and the Netherlands. Programme evaluations suggest that these systems can improve the continuity of support and facilitate re-engagement with work or study, although robust evidence isolating the impact of the named-practitioner model remains limited. 

In the UK, such provision remains isolated to individual local projects. To strengthen continuity in the support system and provide better help through transitions to adulthood, government should work with strategic and local authorities in England and the devolved administrations to scale a participation support offer for young people at a higher risk of longer term detachment from work or education. 

Eligible young people would have a named caseworker responsible for coordinating support through key transition points, including leaving school or alternative provision, entering further education or re-entering work or study. The caseworker would work with the young person and their family, coordinate services, negotiate appropriate adjustments and remain involved while a new placement becomes established. 

Participants could be identified using existing tools to indicate those at risk of NEET status, as well as data on those who have stopped attending school or college. Longitudinal research by NatCen tracked pupils in year 11 between 2010 and 2012. It identified around 11% as being at elevated risk of spending at least a year in the NEET category between ages 16 and 24 years based on their background characteristics, with around 2% at very high risk. Applied to current school cohorts, this equates to roughly 75,000 young people in each year group in England at elevated risk, including around 13,000 at high risk who may need more intensive one-to-one support.3

Emerging evidence suggests that young people in elective home education (at least 1.5% of school-age children in England) are also at particularly high risk of later NEET status, not least because in many cases, parents have decided the school system was not meeting their needs. There should be a particular focus on reaching this group and their families. 

The aim of this caseworker model would be to build capacity to ‘follow’ a young person as they navigate work and education, reducing the frictions associated with transitions and providing emotional and practical help. Those identified as having less severe barriers to work or study may only require a light-touch intervention, such as periodic advice and signposting. Those with more substantial barriers may require more intensive forms of support. The caseworkers could also identify other trusted adults in the young person’s life, whether parents or others, and support them to provide the young person with ongoing help. 

The government’s recent commitment to give mayors of strategic authorities greater flexibility to bring together health, employment and education resources for young people could be a significant opportunity to widen access to caseworker support. Currently, centralised funding and accountability frameworks can make it difficult for local and strategic authorities to join up provision. Greater local powers and devolved funding should allow strategic authorities to reduce duplication between services, make better use of existing resources, create a more cohesive system of provision and design support around local needs and opportunities. 

Redeploying existing staff and resources could offset some of the cost of expanding caseworker-led support for young people at risk of persistently falling into the NEET category, but additional investment will likely be needed. Comparable intensive employment support programmes for young people have cost around £2,600 per participant, however, lighter touch interventions can be delivered more cost effectively. Evidence suggests that caseworker interventions of varying intensity can offer value for money by improving employment outcomes.4 Many of the fiscal returns accrue over a number of years beyond the initial intervention, as higher employment reduces benefit spending and increases tax revenues and economic output. For young people, these gains can also accumulate over many years, but realising them requires government to take a long-term view. 

 

Supporting young people who are out of work and claiming benefits

For many young people out of work, Universal Credit is the main gateway to employment support. Those in the Intensive Work Search regime are expected to look for work and meet regularly with a job centre work coach. At the other end of the system, young people assessed as having limited capability for work and work-related activity due to health conditions or disabilities receive additional financial support through the Universal Credit health element but have no mandatory requirement to prepare for or seek work.

The problem is that neither end works particularly well for young people who need additional help. As the young people in our focus groups identified, those closest to work can receive support that is brief, transactional and focused heavily on job-search activity, even where confidence, experience or wider barriers are holding them back. By contrast, those furthest from work, including many with serious health conditions, have relatively little proactive engagement or support, if any, to help them move towards education or employment. 

A better approach would engage young people more consistently while tailoring expectations to their health, circumstances and distance from work. Government is already considering a baseline expectation of engagement for people receiving the Universal Credit health element. For those aged 25 years and younger, this should form part of a wider participation offer, with education, training and steps towards work all treated as legitimate goals. For someone with significant health barriers, initial engagement might involve support to manage their health, rebuild routine and confidence, and gradually reconnect with education or employment (more detail set out in the next section). Those closer to work would receive more intensive careers advice, employer contact and job-search support as well as any skills development or training needed.

This approach would require a young person to have a consistent adviser with the time and expertise to understand their health, education history and wider circumstances and agree realistic goals. Missed appointments or failed placements should prompt outreach and a review of what has gone wrong before sanctions are considered, as is routine in other countries. Requirements should be reduced or removed where a young person’s health or disability makes participation unmanageable – this could be determined by PIP assessment scores in conjunction with multi-disciplinary assessment. 

Financial incentives should reinforce this approach. Universal Credit already allows people with limited capability for work to earn some income before their payment is reduced, but government should test whether larger work allowances or other targeted incentives could make initial steps into employment (including part-time work) more worthwhile for young people. 

The government has separately consulted on preventing most people aged 22 years and younger from accessing the Universal Credit health element. Simply withdrawing payment would risk increasing hardship among young people with significant health needs already on a low income. A more effective approach would preserve an adequate income floor while expecting and enabling more young people to take appropriate steps towards improving their health and confidence and moving towards work or education.

Employment support for those with greater health and participation barriers

A key gap in the current landscape is support for young people facing greater barriers to participation, including poor health. Unless this gap is addressed, welfare reform that seeks to support young people with health problems while expecting greater engagement is unlikely to succeed.

Government has invested in ‘supported employment’ schemes, such as Individual Placement and Support and supported internships, with the Milburn review set to recommend further expansion. These schemes are well evidenced to support people with a range of health conditions into work. However, they may not suit young people who are not yet ready to enter the workplace due to more limiting health conditions or other social or economic barriers. 

For this group, support should include:

  • a named coach or caseworker providing continuity and helping the young person identify goals, coordinate support and navigate transitions between services
  • a low-pressure approach, starting from the young person’s priorities, whether these relate to work, education, health or independent living
  • accessible community-based provision, with self-referral available for those not claiming benefits
  • flexible engagement, including one-to-one support, peer groups and employer visits
  • practical help that addresses barriers such as transport and debt alongside basic workplace skills.

Support for young people further from work has suffered from the short-term and fractured funding environment that characterises employment support across the UK. Time-limited programmes make it difficult to build trusted local provision that can identify and support young people within communities, and commissioning models that prioritise rapid job outcomes can discourage providers from investing in young people further from work.  

‘The secret is that [the young people] don’t realise that we're doing employability. It's more important about us building their relationships, making them feel comfortable, building their self-esteem and their confidence, basically.

                                                                                Employability service manager, Edinburgh

The Youth Guarantee trailblazers, operational from 2025, are the latest initiative to support youth participation. They are already testing promising approaches to engaging young people with complex barriers, including personalised coaching, community outreach and better coordination between employment, health and wider services.

Government should use the trailblazers to establish a permanent progression offer for young people who are further from work to dovetail with a welfare approach that more actively engages a wider range of young people. The priority should be identifying what works from the trailblazers and related programmes, such as Connect to Work, and providing stable, multi-year funding so that this becomes an established part of the employment support system rather than another temporary programme. Examples of such support already exist, like SkillsPlus+ in Wales (see Box 2).

Funding should be devolved through mayoral strategic authorities and relevant accountable bodies elsewhere, building directly on the infrastructure and partnerships developed through the trailblazers. National government should set a small number of core expectations, including access for young people outside the benefits system, continuity of support and progression measures that recognise movement towards work or study as well as immediate job outcomes. 

SkillsPlus+ supports care-experienced young people aged 14–24 years across Cardiff, Western Bay and North Wales. It combines therapeutic support with practical life skills, drawing on dialectical behaviour therapy and cognitive behavioural therapy. 

Practitioners help young people develop emotional regulation, mindfulness and distress tolerance alongside soft skills like communication and problem-solving, while also building practical competencies such as budgeting, cooking, managing a tenancy and independent living. In South Wales, a dedicated transition worker helps the young people to identify, secure and sustain progression into education, training or employment. 

The service has incorporated ASDAN accreditation as an alternative progression route for young people who are not yet ready for employment or formal education. ASDAN programmes provide a structured way to recognise and evidence skills development achievement through smaller, meaningful steps towards participation. 

In 2025/26, the service supported 120 young people. 96% showed improvement in their mental health and emotional wellbeing, 94% reported improvement in their social functioning, 96% engaged with learning and training that optimises their future employment opportunities and 40% took part in training, volunteering or employment opportunities.

The role of employers

The NEET rate is significantly influenced by employer demand and the wider economic cycle. Subsidised employment schemes, such as those introduced through the Youth Guarantee, can help reduce the financial risk of recruiting young people with limited experience or additional needs. But employers can also do more to make recruitment and workplaces accessible.

Young people described a particular frustration with recruitment processes. Disproportionate multi-stage applications can create unnecessary barriers to entry-level jobs, especially for those with neurodevelopmental conditions, while AI-based assessments and pre-recorded interviews were also cited as practices that can increase alienation and disengagement.

‘Pre-recorded interviews. I think that should be abolished, and I hate them so much. It's like not only as a neurodivergent person and somebody with like high anxiety, but like the least I deserve is to have somebody – like, if I'm recording an interview… I'm talking to a computer screen… are we really at that point?

The few… job interview processes that I have been able to get through, all of them had at least four stages. And this was for entry level jobs. I'm currently in the middle of one that has seven stages. Which I think is just crazy.’

                                                          Young person in the NEET category (focus group participant)

Government does not currently prescribe how private sector employers recruit, unless such processes directly or indirectly discriminate against people with a protected characteristic. But government both can and should set expectations through its own recruitment practices and use guidance, procurement and employer engagement to encourage more inclusive approaches. 

Part of the challenge is that today’s young people, being more likely to report ill health, may also have different expectations of the support employers should provide. In many cases, meeting these expectations may simply mean employers consistently follow good practice in recruitment and onboarding. But alongside financial support through the Youth Guarantee, employers may benefit from practical advice to help them recruit, onboard and retain young people with health conditions, particularly in the light of recent employment legislation that employers report is creating additional burdens and risks around recruitment. 

The Keep Britain Working review’s proposed standards for a healthy working lifecycle provide a useful vehicle for clearer employer responsibilities. More targeted advice and business support may also be justified, particularly in sectors employing large numbers of young people, such as retail and hospitality. 

For young people with more significant health or other barriers, a more intensive offer may be needed. This could include caseworker support that continues into the early stages of employment, helping the young person settle into work, liaising with the employer and advising on adjustments or problems as they arise.5

 

Conclusion

Our recommendations have focused on strenghtening the support system for school-age children and those making the transition from school into adulthood. They aim to address two weaknesses in the way young people are supported to participate in work and education: gaps in provision for those facing more significant health barriers, and a wider system that is too fragmented and difficult to navigate. Improving these areas will require investment. But as rising ill health among young people brings growing costs for individuals, public services and the economy, the cost of inaction is substantial. 

Over time, a prevention-focused system should reduce reliance on more intensive and costly clinical and welfare services. Investment in younger people can offer particularly high returns, because the benefits of better health, stronger participation and higher employment can accumulate over the course of a lifetime.

Challenges around work and health are not unique to young people. Fragmented and limited work and health support affects people of all ages, as both our Commission for Healthier Working Lives and the Keep Britain Working review have shown. The measures proposed here should therefore sit alongside wider reforms, including expanding access to caseworker support to prevent health-related job loss, reforming the UK’s ineffective statutory sick pay system and embedding rehabilitation more firmly within the welfare system.

Creating a more effective and joined-up system will also require a longer term approach to policymaking. The UK has often been better at piloting promising approaches than at embedding them consistently. The Fonagy and Milburn reviews provide opportunities to build a more coherent offer for young people, but success will depend on sustained collaboration between the departments for work and pensions, education and health and social care.

The rewards of getting it right would be substantial: more young people staying engaged in work and education, fewer experiencing long periods of disengagement and, over time, lower costs to both the state and individuals. 

  1. This was previously highlighted by the Resolution Foundation as part of the Health Foundation’s Young People’s Future Health Inquiry. See https://www.resolutionfoundation.org/publications/weve-only-just-begun/.
  2. Health Foundation calculations. See method here https://www.health.org.uk/sites/default/files/upload/publications/2026/Health_Foundation_Health%20as%20an%20economic%20asset_2026.pdf
  3. These figures are indicative estimates based on published data from NatCen’s NEET Risk Index. We define ‘elevated risk’ as a score of 40 or more. Among year 11 pupils studied in 2010–12, 11.2% fell into this group, and around 46% went on to spend at least 12 consecutive months in the NEET category between the ages of 16 and 24 years. We define ‘high risk’ as a score of 60 or more. This applied to around 2% of the cohort, of whom around 71% subsequently spent at least 12 consecutive months in the NEET category. Changes in the underlying characteristics of young people since 2010–12 mean that the proportion in each risk band may be different for the current cohort of year 11 pupils. See Tables 12 and 13 in Addario, G., Wilson, C., Crowley, J., Beardsworth, S. and Moller Vallgarda, L. (2026), NEET Risk Index: Methods Report. London: National Centre for Social Research. Research funded by Youth Futures Foundation.
  4. Preventing health-related job loss: An evidence-based response to what is needed to provide effective early-intervention caseworker support in the UK. RAND Europe. Funded by the Health Foundation. Forthcoming.
  5. Preventing health-related job loss: An evidence-based response to what is needed to provide effective early-intervention caseworker support in the UK. RAND Europe. Forthcoming.

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