Lost Generation: Mental health, work and the Milburn Review

Brian Dow: Hello, my name is Brian Dow. I’m the Chief Executive of Mental Health UK, and we’re doing a special podcast in conversation with Alan Milburn. As many of you will know, the issue of young people and work are two issues which are incredibly, intrinsically connected. We have a growing number of young people who are struggling to get into work, struggling to stay in work, and Alan has been commissioned by the UK government to do an independent report into what I think you would agree is a slightly ugly term — NEET. People who are not in employment, education or training.

It’s a huge privilege to talk to you about that report, which has been published today. Can I start with the issue of what we see when we talk about young people — and address a couple of the myths, some of the unhelpful narratives that are out there about young people being snowflakes, not willing to try. You spoke at length to so many young people. What was your experience?

Alan Milburn: Well, it’s the reverse of that. You sometimes hear it said: they’re soft, they’re snowflakes, they haven’t got resilience, they’ve given up, they don’t want to work. Sometimes those things are unfair. Often they’re cruel. And they’re all wrong.

The young people I’ve spoken to in every part of the country — and we surveyed young people, talked to young people, had a small team going out to speak to them — these are not people who have given up. It’s not a shortage of effort. That’s the problem. It’s a shortage of opportunity and a shortage of help and support. That is the principal problem they face.

And increasingly, unfortunately, more of them are not in the education system and not in the employment system either. So the problem is getting worse, not better. This is a chronic issue. It’s been going on for very many years. But it’s not young people’s fault. The young people I talked to — honestly, you meet them and they are applying sometimes for dozens, sometimes hundreds of jobs every month. Usually they hear nothing. Literally nothing. No feedback, no response. And it’s the silence that kills, because it not only knocks their confidence, but it dents their hopes.

So there’s something going on in the labour market that’s not right. Young people’s employment prospects are lower than they were. And there’s something going on in education, skills, welfare and the health system that is leading to young people not getting the help and support that they need.

Brian Dow: And as a former Health Secretary, having looked at social mobility from so many different perspectives — one of the things that really strikes me in the report is that you’re looking at all of these different factors: both what you call the supply side — how we help young people themselves, give them skills and training — but also the demand side of the job market itself. How can we make these two parts work better than they currently are?

Alan Milburn: Well, they currently don’t work together. Six in ten of these young people have never had a job. A generation ago that was four in ten. The proportion of young people in education who were also holding down a job was about four in ten twenty years ago. It’s now two in ten — it’s halved. So there’s something going on in the labour market. What seems to be happening is those entry-level jobs — the Saturday job, the paper round — they’re disappearing.

Something has happened in the labour market. Jobs have been growing, but not for young people, and that’s been going on for decades.

And then every employer you talk to — they’re not unsympathetic to young people, they want to employ more young people — but they say the school system isn’t making young people work-ready. What do they mean by that? They mean: sure, you get your literacy, numeracy and qualifications, but are young people being set up with the right attributes to be successful in the labour market? Collaboration skills, communication skills, agility, adaptability. Those are the things employers are looking for, but that schools are not consistently providing.

When we’ve surveyed young people who are NEET, teachers and employers — done opinion polling of each group — they all say remarkably the same thing: the school system is great for getting young people qualifications; it’s less good for giving them the skills they need to succeed in the labour market.

One of the things I think is unique about this review is we’re looking at it in the round — everything from early years, schools and skills, to employment support, health and welfare, and what’s going on in the labour market. Unless you put those two things together, you can fix the supply side and make sure young people are transported from the world of education into the world of work, but if there’s no work for them, it doesn’t solve the problem.

Brian Dow: And speaking of cycles — the report details the psychological effect of continued rejection. You’re trying for a job, you haven’t got that first foot on the ladder, you’re writing to employers and not hearing back. What effect does all of that have?

Alan Milburn: It’s completely dispiriting. It makes people believe they’re not as good as they are. My starting proposition is a very simple one: everybody’s got something. Everybody’s different, but everybody’s got something — a skill, potential, an aspiration. Everybody wants to do something. Not one young person that you meet ever wants to be NEET. That is not what they aspired to in life. But that’s where we’ve managed to transport them. We’ve stuck them on the scrapheap.

And we know — you know this better than anybody at Mental Health UK — not being in work is a disaster for your health and a disaster for your mental health in particular. Work brings stresses and strains, of course. But the converse is even more true.

This generation is different. They’ve grown up in different times. They’ve lived through the pandemic. They’re right in the heart and soul of the digital age. They live a lot of their lives on their phones. It’s a world of uncertainty, and a world that seems to offer less opportunity to get that starter job.

Sure, young people are anxious, and sure, there’s a level of distress amongst young people that probably wasn’t in our day. And I think the job now for employers is: how do we meet them halfway? It’s not saying they should be like us — they are how they are. That’s just how it is. There’s a greater pastoral role that employers are going to have to play with this generation than with previous generations.

But there’s also a big question about public policy — what we do about mental health policy, welfare policy, employment support policy. Unless you fix all of these things together, the system is the problem. The truth is, there isn’t really a system. Everybody’s got some responsibility, but nobody in the end is fully accountable for making sure that every young person, regardless of their background or circumstance, gets the opportunity to learn how to earn.

Brian Dow: I speak to a lot of employers — both large employers and smaller organisations — and the thing that’s pretty constant is that sense of: where does my responsibility stop? Even if you’ve made that leap of faith, met young people where they are, and understood that they see the social contract differently — where does your responsibility end, and where is it someone else’s job, particularly when someone is suffering from a mental health problem? Was that something you encountered going through the process?

Alan Milburn: Very much so. When you look at the system — or what passes for a system — it’s really a series of vertical silos. Employers do a bit, employment support does a bit, education does a bit, local government does a bit, but no one joins the dots. And that’s particularly the case in local labour markets, because that’s where the matching function — matching young people with potential employment — actually happens. But no one in the end is fully responsible for that. That’s a really big problem. Employers are crying out for it.

We’re living in a world where virtually every employer in every sector — whether it’s hospitality at the bottom end of the labour market or technology at the top end — will say the same thing: the biggest shortage is skilled labour. And now that migration levels are coming down, employers can’t simply recruit from overseas and bring in skilled, experienced labour. They’re going to have to find a different pool. There’s a million people here. So how do we set the system up to match supply with demand?

Brian Dow: You talk about the system-wide problem, but you also highlight places where employers, job centres and young people are coming together to find solutions. So we don’t have to wait to fix everything to do something?

Alan Milburn: No, we don’t. There’s a systems problem and we’ve got to fix it at a structural and architectural level — clear accountabilities, clear incentives. That takes time. But you go around the country and you see amazing initiatives and programmes that people are running.

Go to other countries — the Netherlands, Germany, Belgium, Denmark — and they’re set up very differently. Young people there are no different from young people in the UK. But the NEET rate is three times lower in those countries than it is in the UK. They’re doing something different.

One of the things they do is integrate their services better at a local level — putting them together horizontally rather than operating in vertical silos. Employers are involved much earlier, particularly in schools, talking to young people from the outset. Work experience here is often an afterthought — you’re told to go and sort it out yourself. That’s great if you’ve got connections, but not so good if your family has never been in work. We have amongst the worst work experience provision in the OECD. That’s a really big problem.

Brian Dow: It’s an unflinching report. And at Mental Health UK, we’ve always believed it’s our responsibility to speak truth to power wherever it happens to be. You do call out some habits and behaviours amongst young people themselves — while being clear they are in part victims of the system. Can you talk about the responsibility young people have?

Alan Milburn: Yes. This problem is entrenched, chronic and getting worse, and the truth is we don’t have a system or a plan to deal with it. Everybody’s got a responsibility — local government, national government, employers, educators, charities like yours, the media — but there’s also a responsibility on parents and young people themselves. Aspiration isn’t something that can be gifted to people. It’s got to come from within.

My sense is that overwhelmingly, that’s what young people want. When we polled young people, 84% said they wanted to be in work or training. That is really, really good. But there is something about young people’s own habits that matters too.

The team going around the country talking to young NEET people would ask a very simple question: what time did you go to sleep last night? Two o’clock. Three. Four. Five. Sometimes never. And what are they doing? They’re on their phones, of course — which is understandable. You can say people are victims of that. But if you’re going to go into work and you can’t get out of bed, you won’t be in work.

So there’s got to be a deal. Societies like ours are built on contracts. The state does its bit. Employers do their bit. But communities, parents and young people have got to do their bit too. We’ve got to massively improve the opportunities and support for young people — but then they’ve got to grab those opportunities.

Brian Dow: So this is the diagnosis of why it’s happening. Without getting ahead of ourselves — if we’re sitting here in five years’ time, how will things be different?

Alan Milburn: I think, first of all, our society will have made a choice. And for me, that choice has got to be for the next generation. Britain relies on the next generation. This is an ageing society. We can’t afford to have more and more young people who are not in education, employment or training.

Right now it feels like as a country we’re in managed decline, and young people are the victims of that. This generation of young people may be the first one, perhaps for a hundred years, who feel like they’re not going to be better off than their parents’ generation. And that happens to be true. As I’ve gone around the country, I’ve found a concern — bordering on a fear — that the old social contract, which held that each generation would do better than the last, is being broken for this generation. The young people who are NEET — a million of them — they’re on the front line of that broken contract.

In five years’ time, I hope that we’ve repaired the contract. I hope that we’ve reformed it. I hope that we’ve reset the relationship between employers, the state and young people, such that we feel we’re not in managed decline, but we’re in managed ascent as a country.

Brian Dow: Fantastic. Well, it’s been a huge pleasure. I think, like you, we see this as a national endeavour — not just the job of government, not just the job of young people, but employers, charities, all of us. I hope the report lands as well as it should, and I look forward to working with you on finding those solutions.

Alan Milburn: Absolutely. Thank you for your support. Thank you.

The Milburn Review is an independent investigation led by Alan Milburn into the causes of rising youth unemployment and inactivity in the UK, particularly focusing on disabled people and people with health conditions. The government has asked him to identify the factors contributing to this rise and propose policy recommendations to improve opportunities for young people.

This interim report sets out the factors driving the rise in young people not in education, employment, or training (NEET). The next step is a final report with recommendations for change. We’ll be working hard to make sure those recommendations reflect the real experiences of young people with mental health problems, so that the solutions work for them.

The Milburn Review is part of the government’s work examining different parts of the same interconnected challenge around mental health as well as its relationship with other areas of life like money, independence and employment. We hope that when the Review is finished, the recommendations will be used to ensure that young people get the right support at the right time to improve their mental health and if appropriate, return to Education, Employment or Training.

Mental ill-health is a real and growing problem among young people, and it does make it harder to find and stay in work, education, or training, but that’s not the whole picture. Education, the jobs market, the NHS, and the social security system are stretched and falling short at the same time, and this does not help young people’s mental health. So while mental health is part of the story, it’s also a symptom of wider systems that aren’t giving young people what they need.

Mental health challenges, financial pressures and repeated knockbacks can make job‑seeking feel overwhelming. Even where young people have qualifications or experience, barriers such as travel costs, low pay and a lack of accessible opportunities can limit their options. At the same time, gaps in mental health support continue to create additional pressure. Many young people experience a “cliff edge” when moving from child to adult services, while long waiting times can leave them without help at critical moments. This creates a cycle where poor mental health makes it harder to engage with work, and being out of work further damages wellbeing.

NEET stands for Not in Education Employment, or Training. It describes young people who aren’t studying, working, or doing an apprenticeship, for example. Having good structure, purpose, and social connection is really important for mental health. The longer a young person is NEET, the more isolated they can become, and the harder it is to re-engage. But with the right support at the right time, young people can and do find their way back to something meaningful.

Speaking on LBC, Milburn used the phrase to describe young people whose social and working lives have contracted to their bedroom — driven by phone use, post-pandemic anxiety, and a lack of entry-level jobs to pull them into the world of work. The phrase captures the isolation and withdrawal that mental health services and employers both need to respond to.