The purpose of this study was twofold: to investigate the psychosocial well-being of young men exempted from compulsory military or civil service and to assess the effects of the Time Out! Getting Life Back on Track support programme targeted at this group of men.
The study involved a total of 356 men exempted from military or civil service and 440 young men conscripted for service in Helsinki and Vantaa in Finland. Men exempted from service were randomly assigned to an intervention group (n=182) and a control group (n=174). Respondents in the intervention group were offered a personal counsellor, a professional working in municipal social and health services and providing the support programme as part of their basic duties. The counsellors were specially trained for the intervention. The support programme was based on an interactional model for prevention. Together with the counsellor the men were able to discuss their current life situation, such as mental health, substance abuse and general well-being, as well as receive support and encouragement in resolving the situation. The research data were collected using questionnaires, interviews with the men and register data. Information on the implementation of the support programme was collected at different stages. A one-year follow-up survey was conducted.
Men exempted from military or civil service differed significantly from conscripts in their background, living habits, life situation and psychosocial well-being. Compared with conscripts, they had already been in a more disadvantaged position with regard their childhood living conditions. In adulthood, they had met with a greater number of mental and social problems than conscripts: substance abuse, economic problems, unemployment, homelessness and mental distress. One third of the young men exempted from compulsory military or civil service reported serious suicidal ideation. Of the men with serious suicidal ideation, one third had attempted suicide. Various childhood adversities and current stressful life events and problems were associated with suicidal ideation. Accumulation of problems was characteristic for men exempted from service.
In particular, the Time Out! Getting Life Back on Track support programme reached out to young men suffering from mental distress and an accumulation of problems. However, the men with the most problems could not be reached at all. At one-year follow-up psychological distress decreased in the intervention group more than in the control group. The intervention had no impact on young men’s alcohol consumption, self-assessed quality of life, problem accumulation, self-confidence or contentment.
Men exempted from compulsory military or civil service comprise an important target group in the prevention of psychosocial problems or suicide. Health service providers should be well aware of social factors that may elevate the risk of mental ill-health or suicidal behaviours. Supporting a healthy network of family and peer relationships should be an important issue in preventive activities among young people. Further, it is important to be aware of early risk indicators such as maternal or paternal alcohol-related or mental health problems.
The accumulation of problems poses a challenge for the development of interventions targeted at young people. The Time out! Getting Life Back on Track support programme is a good example of a comprehensive intervention for young men. Even small-scale support can have a positive impact on the general well-being of young men. This study highlights the complexity of adherence in psychosocial interventions. Young men who do not comply with preventive interventions are a heterogeneous group. The need for support may vary widely - even within an identified risk group. Reaching out to young men at risk involves intense activity among service providers.
