Labour market initiatives: potential settings for improving the health of people who are unemployed.
OBJECTIVE
Unemployment is detrimental to health. The Unemployment and Health Project in South Western Sydney sought to work with labour market programs to improve the health, particularly, mental health, of unemployed people. This paper describes the experiences of the Project.


METHODS
Phase one commenced in 1995 and involved consultation with the majority of Skillshares (labour market programs under the Labor government) in south-western Sydney to identify potential areas of action. Phase two commenced in 1998 and involved the development of a brief cognitive behaviour therapy intervention that was delivered in Job Network Settings (the next generation of labour market programs under the Liberal government).


RESULTS
The cognitive behaviour therapy intervention has been successful in improving mental health in five small scale trials but the intervention has proved difficult to scale up and evaluate comprehensively. Generating more general interest in improving the health of unemployed people through the Job Network has also been difficult. This is related to different understanding and valuing of evidence, a highly volatile context, lack of shared core business by the health and employment sectors, and the changing nature of work in Australia.


CONCLUSIONS
There are theoretical and practical reasons why it is difficult for labour market programs to be a setting for improving the health of unemployed people. However, the reach of labour market programs into the high risk groups warrants more attention by mental health promotion programs.
Harris
Elizabeth
E
Centre for Health Equity Training Research and Evaluation, University of New South Wales, Australia. e.harris@unsw.edu.au
Rose
Vanessa
V
Ritchie
Jan
J
Harris
Neil
N
D015928:Cognitive Behavioral Therapy / Q000458:organization & administration*; D006078:Government Programs / Q000458:organization & administration*; D054624:Health Status Disparities; D006801:Humans; D008603:Mental Health; D014478:Unemployment / Q000523:psychology*