Mental health issues among unemployed and employed sports science graduates in Tunisia post-revolution

Abstract

This study investigates the relationship between employability and mental health among Tunisian sports science graduates post-2011 revolution, within the context of a prolonged socio-economic crisis and persistent unemployment lasting up to 10 years. The research included two studies. Study (1) quantitatively assessed 156 unemployed and 162 employed graduates for major depressive episodes (MDE), dysthymia, social phobia (SP), and generalized anxiety disorder (GAD). Study (2) qualitatively explored mental health experiences through semi-structured interviews with 20 participants (10 employed, 10 unemployed, balanced by gender). In Study (1), it was observed that unemployed individuals, especially older adults, women, and those experiencing long-term unemployment, exhibited elevated prevalence rates of MDE, dysthymia, and SP, while employed individuals exhibited higher GAD rates. Study (2) revealed widespread anxiety, fear, and low self-esteem among participants, driven by political and economic instability, career stagnation, and the devaluation of the sports profession. Many interviewees expressed a desire to work in Gulf countries due to attractive salaries and better job opportunities, while also calling for curriculum reforms and showing interest in entrepreneurship. The study concludes that employment alone does not guarantee mental health stability. Socio-demographic factors, economic issues, and political instability significantly affect mental health. To prevent brain drain and ensure mental well-being, developing economies must provide secure, opportunity-rich futures for young professionals. This research offers practical recommendations for policymakers in similar contexts.

Keywords:

• Tunisia post-revolution
• mental health
• individual factors
• unemployed
• employed
• sports sector

Reviewing Editor:

• Mike Rayner, University of Portsmouth, Portsmouth, UK

Subjects:

• Social Work
• Sports Development
• Political Studies
• Health & Development

Introduction

Thirteen years after the Tunisian revolution, the country continues to face significant socio-economic and political challenges, particularly impacting young people and higher education graduates (Desrues & Gobe, 2023; Hamdi & Weipert-Fenner, 2020; Kashina, 2022). Despite ongoing social and political transformations (Kuznetsov, 2022; Enwere, 2021), young Tunisians, especially those aged 15–24 (40.9%) and higher education graduates (23.4%), face high unemployment rates. Among higher education graduates, these rates are marked by gender disparities (13.8% for men vs. 31.2% for women), contributing to heightened socio-economic tensions (National Institute of Statistics [NIS]¹, 2023). This prolonged economic, social, and political instability creates a critical backdrop for investigating the mental health impacts associated with employability (Bousnina, 2022).

The relationship between unemployment and mental health is explained through various theories, including economic deprivation, stress, control models and Jahoda’s latent functions model. These theories highlight different aspects, from individual psychological factors to social support and environmental impacts (Janlert & Hammarström, 2009). Empirical studies using panel data have shown how employment and unemployment affect mental health over time, emphasizing the dynamic nature of this relationship (Banerjee et al., 2017; Krug & Eberl, 2018; Schmitz, 2011). Global research reveals that unemployment significantly increases risks of depression, anxiety and other mental health issues, affecting quality of life and economic productivity (Breslin & Mustard, 2003; Herbig et al., 2013; Mousteri et al., 2018; Lim et al., 2018; Morrish et al., 2022; Yasar & Turgut, 2020; Sowislo et al., 2014; Astell-Burt & Feng, 2013; Burda et al., 2020; Strandh et al., 2014).

Additionally, poor teaching quality, substandard diplomas and mental health issues among students contribute significantly to university failure and unemployment (Hanapi & Nordin, 2014; Gelle et al., 2021; Bantjes et al., 2021). As recent graduates search for employment, they face higher risks of depression, anxiety and stress (Rafi et al., 2019). In terms of gender, unemployment generally increases mental health risks for both men and women (Cunningham et al., 2022). However, gender differences in unemployment and mental health remain inconclusive due to cultural and social role variations (Altweck et al., 2021; Gedikli et al., 2023; Tattarini & Grotti, 2022).

The social context of unemployment and working conditions also significantly impacts mental well-being, influenced by life experiences, family circumstances and professional life (Mokona et al., 2020; Allen et al., 2014; Rugulies et al., 2023). For this research, stable employment refers to full-time, long-term positions that provide job security, reliable income and benefits, such as health insurance and pensions, which help mitigate the adverse effects of unemployment by ensuring economic stability. In contrast, unemployment encompasses individuals who are jobless, actively seeking work, and available for employment, including those experiencing frictional, structural and cyclical unemployment (US Bureau of Labor Statistics, 2021).

However, stable employment does not necessarily ensure job satisfaction or optimal mental well-being, especially in Tunisia’s fragile socio-political and economic climate. The trend of brain drain, driven by poor working conditions and low remuneration, highlights the urgent need for strategies that go beyond creating jobs. These strategies should focus on improving job quality, fostering career development and addressing the causes of talent emigration to mitigate the adverse effects on the nation’s human capital and economic progress (Musette, 2020; OECD, 2014).

The sports sector is not immune to employment crises and the prevalent aspiration to work in Gulf countries. According to a 2020 survey by the National Sports Observatory, 83.2% of Tunisians do not engage in physical or sports activities, slightly up from 82.8% in 2010, highlighting a fundamental rights issue (Sakli et al., 2021). On average, sports science graduates wait a decade for employment in public education, where only 66% of primary schools and high schools benefit from physical education due to a teacher shortage. This deficit is particularly severe in rural areas and primary schools, exacerbated by poor working conditions and adaptability challenges for non-locals. Furthermore, private sports facilities represent 20.47% of total infrastructures, providing only 7.7 facilities per 10,000 inhabitants. This context underscores the unique employment challenges faced by sports science graduates, making their mental health a crucial area of study. Especially given the lack of research in Arab countries (Maalouf et al., 2019), applying results from other studies directly may not yield definitive conclusions (Sermet & Khlat, 2004).

Given the challenges faced by university graduates in Tunisia, this study focuses on sports science graduates who face unique employment difficulties. It examines how employment status – particularly stable employment versus unemployment – affects their mental health, considering personal factors and the socio-economic and political context of post-revolution Tunisia. The research questions guiding this study are: (i) How does employment status impact the mental health of sports science graduates in Tunisia? (ii) How do personal factors and the socio-economic and political context influence this relationship?

To address these questions, this research uses a two-pronged approach: a quantitative study (S1) and a qualitative study (S2), merging datasets for a comprehensive analysis of mental health issues. This methodological triangulation deepens our understanding of mental health in Arab nations, addressing research scarcity and ensuring reliability and validity (Patton, 1999). By comparing the mental health outcomes of unemployed individuals with public education employees, this study aims to provide insights for policy development and interventions to improve employability and mental health in similar global contexts. In Africa, the number of unemployed individuals rose from 37.8 million in 2017 to 40.1 million in 2019 (Kuhn et al., 2018), underscoring the broader relevance of addressing unemployment and mental health issues in regions facing significant employment challenges.

Study 1 (S1)

Method

The study design was approved by the medical ethics committee of the Faculty of Medicine of Sousse, Tunisia (reference number: CEFMS 125/2022). In accordance with ethical guidelines, all participants volunteered without any payment and were informed about the study’s academic purpose, with assurances of confidentiality. For the quantitative study, we employed a social networking survey distributed via Google Forms. This approach was necessary due to the absence of a comprehensive contact database for unemployed and employed individuals in Tunisia. This lack of a database made direct access to the target population challenging. Social networking platforms provided an effective means to reach a broad and diverse group of participants. Ensuring accessibility and inclusivity was crucial for achieving a representative sample (Jones et al., 2020; Smith & Wiggins, 2019a, 2019b).

This study aimed to estimate the prevalence of four mental disorders: major depressive episode (MDE), dysthymia, social phobia (SP) and generalized anxiety disorder (GAD). These disorders were assessed based on their current symptomatic presentations:

• Major depressive episode (MDE) involves persistent low mood, diminished capacity to experience pleasure, and prolonged fatigue.

• Dysthymia is characterized by enduring depressive symptoms, disruptions in eating and sleeping patterns, diminished self-esteem, and hopelessness.

• SP is typified by anxiety related to fear of judgment and scrutiny, shame, shyness, and avoidance behaviors.

• Generalized anxiety disorder (GAD) involves cognitive, physical and behavioral symptoms from excessive and persistent anxiety about daily events.

The measurement instrument utilized was the French version of the Mini-International Neuropsychiatric Interview (MINI), aligning with the official language of university instruction in Tunisia. This instrument is validated for diagnosing various psychiatric conditions and is known for its reliability and validity across cultural contexts (Hergueta et al., 2015). The MINI uses a binary response format (‘yes’ or ‘no’) to estimate the prevalence of specified mental disorders, ensuring standardized and comparable diagnostic criteria.

The survey included two convenience samples: (i) unemployed graduates with degrees in sports science and (ii) public education employees with stable, full-time employment. We primarily used Facebook, leveraging the networks of myself and five colleagues to disseminate the survey invitation through our personal connections. We targeted 500 individuals (250 unemployed graduates and 250 physical education teachers) over one month. Out of these, 318 graduates voluntarily responded to the survey: 156 unemployed and 162 employed, resulting in a response rate of 63.6%. Reasons for refusal were not sought to respect participants’ choices. While this response rate provides valuable insights, the 36.4% non-response rate is a notable limitation in survey-based mental health research, especially among those with severe issues who may be less likely to participate, potentially skewing results (Jones et al., 2020; Smith & Wiggins, 2019a, 2019b). Nevertheless, our mixed-methods approach, combining quantitative surveys with qualitative interviews, enhances the robustness of our findings by capturing a wide range of experiences and mitigating some concerns regarding non-response bias (Newman, 2014; Graham, 2009; Kosinski et al., 2015; Pedersen et al., 2015).

The demographic breakdown of the sample is presented in Table 1. The details are as follows:

Table 1. Descriptive data of the study population.

Individual factors/groups (%)		G1 (N = 156)	G2 (N = 162)	Total (N = 318)
Sex	Men	23.0	31.1	54.1
	Women	26.1	19.8	45.9
Age	<25	22.5	0.3	22.8
	<25–35 >	24.7	18.7	43.4
	> 35	2.2	31.6	33.8
Statues of graduates	License	32.4	28.3	60.7
	Postgraduate	16.7	22.6	39.3
Number of years of unemployment	<3	23.3	13.8	37.1
	3–5	7.2	12.6	19.8
	5–7	4.1	10.4	14.5
	7–10	6.9	8.2	15.1
	> 10	7.5	6.0	13.5

G1: group employed; G2: group unemployed.

• Sex: Men (54.1%) and Women (45.9%).

• Age Groups: Under 25 years, 25–35 years, and over 35 years.

• Educational Attainment: The categories of ‘License’ (equivalent to a bachelor’s degree) and ‘Postgraduate’ (including master’s and doctoral degrees) were chosen based on their significance in previous research on educational attainment and mental health outcomes (Demange et al., 2023; Smith et al., 2021).

• Unemployment Duration: Categories ranged from less than 3 years to over 10 years.

This study used a cross-sectional design to examine the relationship between employment status and mental health among sports science graduates in Tunisia post-revolution. Cross-sectional studies capture data at one point in time, limiting their ability to establish causality and identifying associations rather than causal effects (Field, 2018). To simplify analysis and enhance interpretability, we categorized responses, a common practice that helps identify significant trends and makes findings more accessible (Altman & Royston, 2006). This approach allows for a clearer focus on key relationships, essential for informing policy and practice in Tunisia’s socio-economic context.

Results for S1

Statistical methods and analytical protocols

To ensure the robustness and validity of the findings, various statistical methods and analytical protocols were employed. Reliability was confirmed with Cronbach’s alpha values of 0.809, 0.706, 0.710 and 0.713 for MDE, Dysthymia, SP, and GAD, respectively, indicating moderate to high consistency (Field, 2018). The normality of the data was assessed using the Shapiro–Wilk and Kolmogorov–Smirnov tests (Stephens, 1992), both of which indicated non-normal distributions (p < 0.005). Consequently, nonparametric statistical tests were deemed appropriate (Shapiro & Wilk, 1965; Stephens, 1992).

The Wilcoxon–Mann–Whitney test was used for group comparisons, revealing significant differences between the employed and unemployed groups across most mental health variables and sociodemographic indicators (Mann & Whitney, 1947). Chi-Square tests and Cramer’s V measured associations between categorical variables and their strengths (Cohen, 1988; Cramer, 1946). Additionally, multinomial logistic regression assessed the influence of mental variables and sociodemographic factors on the two study groups, confirmed by the model’s Chi-square probability (Hosmer & Lemeshow, 2013). Importantly, a comprehensive audit of the dataset in Excel confirmed there were no missing data, ensuring the reliability and validity of our findings (Newman, 2014; Graham, 2009).

Trends in the prevalence of mental disorders

Table 2 presents the prevalence rates of mental disorders within distinct groups, categorized by various socio-demographic indicators. Both groups exhibited a notable prevalence of GAD at 64.5%, MDE at 62.9%, dysthymia at 61.9% and SP at 33.6%. Notably, unemployed individuals displayed higher prevalence rates across all study variables when compared to their employed counterparts. Furthermore, women exhibited slightly elevated prevalence rates in comparison to men in both groups, with figures of 69.2% and 57.6%, respectively.

Table 2. Prevalence rates of mental disorders by group and individual factors.

Mental disorders/individual factors		MDE (62.9)			Dysthymia (61.9)			SP (33.6)		GAD (64.5)
		G1	G2	T	G1	G2	T	G1	G2	T	G1	G2	T
Sex	Men	33.7	23.8	57.6	32.6	26.7	59.3	19.8	14.0	33.7	30.2	29.1	59.3
	Women	39.7	29.5	69.2	39.7	25.3	65.1	26.0	7.5	33.6	34.2	36.3	70.5
Age	<25	66.7	1.4	68.1	63.9	1.4	65.3	36.1	–	36.1	54.2	1.4	55.6
	<25–35 >	45.3	20.9	66.2	45.3	21.6	66.9	30.2	7.2	37.4	43.2	26.6	69.8
	> 35	4.7	50.5	55.1	4.7	48.6	53.3	3.7	23.4	27.1	2.8	60.7	63.6
ST	License	37.8	24.9	62.7	38.3	24.4	62.7	22.3	11.4	33.7	33.7	29.0	62.7
	Postgraduate	34.4	28.8	63.2	32.0	28.8	60.8	23.2	10.4	33.6	29.6	37.6	67.2
Nbr of y. u.	<3	43.2	19.5	62.7	42.4	18.6	61.0	26.6	6.8	33.1	35.6	22.9	58.5
	3–5	30.2	31.7	61.9	27.0	28.6	55.6	15.9	17.5	33.3	22.2	42.9	65.1
	5–7	17.4	39.1	56.5	21.7	37.0	58.7	8.7	15.2	23.9	19.6	41.3	60.9
	7–10	41.7	31.3	72.9	37.5	35.4	72.9	25.0	8.3	33.3	37.5	39.6	77.1
	> 10	41.9	18.6	60.5	44.2	20.9	65.1	34.9	11.6	46.5	44.2	25.6	69.8

MDP: major depressive episode; GAD: generalized anxiety disorder; SP: social phobia; G1: group employed; G2: group unemployed; T: total; ST: statues of graduates; Nbr of y. u.: years of unemployment.

Among the unemployed, young individuals under the age of 25 and those between 25 and 35 years reported the highest prevalence rates for all four mental disorders, surpassing the figures for employed individuals aged over 35 years. Likewise, among the unemployed individuals, those with a lower educational qualification (license) displayed marginally higher prevalence rates compared to their counterparts holding postgraduate degrees, which diverged from the pattern observed among the employed group. However, concerning the duration of unemployment, the most elevated rates were identified in the subgroups with 7–10 years of unemployment among the unemployed, while those with over 10 years of unemployment exhibited the highest prevalence rates among the employed.

The high prevalence rates of mental disorders among unemployed individuals highlight the severe psychological impact of unemployment. The elevated rates among younger individuals and those with lower educational qualifications suggest that these groups are particularly vulnerable. The findings also indicate that prolonged unemployment exacerbates mental health issues, with those unemployed for 7–10 years showing the highest prevalence rates.

Relationship between the study variables

The Wilcoxon–Mann–Whitney test revealed significant differences in mental health variables and sociodemographic indicators between the employed and unemployed groups, with the exception of GAD. Table 3 provides detailed results of these comparisons.

Table 3. Comparison tests – unemployed and employed groups.

Variables/tests	Mann–Whitney U/Wilcoxon W
	Z	Sig
MDE	−4,147	0.000
Dysthymia	−4,004	0.000
SP	−4,624	0.000
GAD	−0.336	0.737
Age	−13,397	0.000
Sex	−2,557	0.011
Statues of graduates	−1,908	0.056
Number of years of unemployment	−2.160	0.031

MDP: major depressive episode; SP: social phobia; GAD: generalized anxiety disorder.

The substantial differences underscore the significant impact of employment status on mental health. The lack of a significant difference for GAD suggests that anxiety disorders may be influenced by factors other than employment status alone, such as work-related stress among the employed (Astell-Burt & Feng, 2013).

Chi-Square tests indicated significant associations between three mental health variables (MDE, dysthymia and SP) and all sociodemographic indicators (gender, age, educational level and years of unemployment). Cramer’s V test further quantified the strength of these associations, showing particularly strong interdependence for age (0.801), years of unemployment (0.261) and SP (0.260), among others. Table 4 summarizes these associations.

Table 4. Pearson chi-square, Fisher and Cramer tests for study variables.

Study variables/tests	Pearson Chi-square				Fisher’s exact test
	Value	Df	Asymp. Sig. (2-sided)	Cramer’s V	Exact Sig. (2-sided)	Exact Sig. (1-sided)
MDE	17,250	1	0.000	0.233	0.000	0.000
Dysthymia	16,085	1	0.000	0.225	0.000	0.000
SP	21,452	1	0.000	0.260	0.000	0.000
GAD	0.113	1	0.737	0.019	0.815	0.413
Age	202,610	32	0.000	0.801	–	–
Sex	6,559	1	0.010	0.144	0.013	0.007
Statues of graduates	3,652	1	0.056	0.107	0.066	0.036
Nbr of y. u.	21,719	4	0.000	0.261	–	–

MDP: major depressive episode; SP: social phobia; GAD: generalized anxiety disorder; Nbr of y. u.: years of unemployment.

The strength of these associations, as measured by Cramer’s V, highlights the substantial interrelation between age, years of unemployment and SP with mental health outcomes. These findings suggest that younger individuals and those unemployed for longer periods are at greater risk of mental health issues, reinforcing the critical need for targeted interventions for these vulnerable groups.

Multinomial logistic regression was conducted to assess the influence of mental health variables and sociodemographic factors on employment status. The model’s fit was confirmed with a Chi-Square probability of 275.854, significant at the 5% level. The regression analysis revealed significant associations between the two study groups and variables, such as age and years of unemployment, underscoring their critical impact on mental health. Specifically, younger individuals and those with longer unemployment durations were more likely to experience mental health issues. However, no significant associations were found for gender or educational level, indicating that these factors may not play a crucial role in determining mental health outcomes in the context of employment status. Table 5 presents the likelihood ratio tests.

Table 5. Likelihood ratio tests.

Effect	Model fitting criteria	Likelihood ratio tests
	−2 Log likelihood of reduced model	Chi-square	df	Sig
Intercept	155,808^a	0.000	0
Age	359,537	203,728	1	0.000
Sex	156,820	1,012	1	0.314
Statues of graduates	155,904	0.095	1	0.757
Nbr of y. u.	167,042	11,234	4	0.024
MDE	160,616	4,808	1	0.028
Dysthymia	158,975	3,167	1	0.075
SP	165,141	9,333	1	0.002
GAD	168,328	12,520	1	0.000

MDP: major depressive episode; SP: social phobia; GAD: generalized anxiety disorder; Nbr of y. u.: years of unemployment; a: This reduced model is equivalent to the final model because omitting the effect does not increase the degrees of freedom.

The Wald test results indicated significant effects for all considered variables, except for gender, educational status and specific categories of unemployment duration. The analysis showed negative regression coefficients for age and certain unemployment durations, suggesting higher likelihoods of unemployment for younger participants and those within specific unemployment durations. Conversely, GAD showed a positive regression coefficient, indicating a higher likelihood in the employed group. These detailed findings are summarized in Table 6.

Table 6. Regression multinomial for study variables.

Group^a	B	S.E	Wald	df	Sig	Exp(B)	95% C.I. for Exp(B)
							Lower	Upper
Intercept	17,589	2.179	65,172	1	0.000
Age	−0.499	0.062	65,676	1	0.000	0.607	0.538	0.685
Men	0.440	0.440	1.004	1	0.316	1,553	0.656	3.676
Women	0^b			0		–
License	0.128	0.413	.096	1	0.757	1,136	0.505	2.555
Postgraduate	0^b			0		–
<3 Nbr of y.u.	–528	727	0.527	1	0.468	0.590	0.142	2.453
3–5 Nbr of y.u.	−1.902	0.673	7.993	1	0.005	0.149	0.040	0.558
5–7 Nbr of y.u.	−1.492	0.630	5.611	1	0.018	0.225	0.065	0.773
7–10 Nbr of y.u.	−1.083	0.558	3.762	1	0.052	0.339	0.113	1.011
> 10 Nbr of y.u.	0^b			0		–
MDE – No	−1.701	0.798	4.540	1	0.033	0.183	0.038	0.873
MDE – Yes	0^b			0		–
Dysthymia – No	−1.247	0.708	3.102	1	0.078	0.287	0.072	1.151
Dysthymia – Yes	0^b			0		–
SP – No	−1.468	0.495	8.809	1	0.003	0.230	0.087	0.607
SP – Yes	0^b			0		–
GAD – No	2.535	0.821	9.543	1	0.002	12,622	2,526	63,058
GAD – Yes	0^b			0		–

^aThe reference category is employed; ^bthis parameter is set to zero because it is redundant.

Nbr of y. u.: years of unemployment; MDP: major depressive episode; SP: social phobia; GAD: generalized anxiety disorder

The Wald test results and regression coefficients provide further insights into the complex interplay between employment status and mental health. The negative coefficients for age and certain unemployment durations indicate that younger individuals and those unemployed for shorter periods are more likely to be unemployed. The positive coefficient for GAD among employed individuals suggests that while employment generally protects against some mental disorders, the stress and demands associated with work may increase the risk of anxiety disorders.

Conclusion for S1

Both unemployed and employed sports science graduates exhibited high prevalence rates of mental health disorders, with the unemployed showing particularly elevated levels. Despite their stable employment, employed graduates also faced significant mental health issues, indicating that job stability alone does not ensure mental well-being. The statistical analyses provide robust evidence of the associations between mental health outcomes and sociodemographic factors, highlighting the need for targeted interventions to support these vulnerable groups. The forthcoming qualitative study will delve into the underlying causes of these mental health issues, offering valuable insights for policymakers and mental health professionals.

Study 2 (S2)

Method

Based on the quantitative results, we aimed to explore the potential influence of situational factors on mental health through semi-structured interviews. Participants were selected by requesting volunteers from our initial quantitative survey respondents. We contacted all participants via Facebook Messenger and selected the first respondents from each group. We continued this process until we reached information saturation, ensuring that no new themes emerged from additional data (Guest et al., 2006). Those who accepted voluntarily participated in the Zoom interviews. Remote interviewing was chosen to facilitate participation regardless of geographical and/or time constraints and to maintain consistency in the interview process (Archibald et al., 2019). All participants provided verbal informed consent to participate in the study. Prior to commencing the interviews, participants were informed about the purpose of the study, the recording of the interviews and the use of data for research purposes, with assurances of maintaining anonymity. This approach was deemed necessary due to the logistical challenges of obtaining written consent remotely and to ensure a higher participation rate by simplifying the consent process (Dickert & Grady, 1999). Each interview lasted between 35 and 45 min, emphasizing active listening and open-ended questioning to allow participants to freely express their thoughts and experiences.

The interview guide focused on four themes: individual experiences of unemployment and employment and their psychosocial effects, the influence of the political and socio-economic environment on mental health, interactions between the work environment in the sports sector and mental health, and career prospects and labor market conditions. These themes were based on theoretical frameworks: Folkman’s Stress and Coping Model (2013) for stress management, Bronfenbrenner’s Ecological Systems Theory (1979) for environmental impacts on mental health, Kalleberg’s Employment Relations Theory (2009) for job quality and security, and Becker’s Human Capital Theory (1964) for the role of education and skills in employability. This approach strengthened the qualitative analysis and ensured reliable and valid findings.

The thematic analysis was conducted following the procedures outlined by Braun and Clarke (2006), which involve familiarization with the data, generating initial codes, searching for themes, reviewing themes, defining and naming themes, and producing the final report. This rigorous process ensures a systematic approach to identifying and analyzing patterns within the data. To manage interviewers’ and researchers’ perspectives and minimize bias, we incorporated reflexivity and peer debriefing, where colleagues reviewed the coding and thematic analysis to provide feedback and ensure that the findings were grounded in the data (Lincoln & Guba, 1985).

We retained a total of 20 participants from the initial survey, equally divided between the unemployed and employed groups, with each group comprising five women and five men. Women in the study had an average age of 30.15 years (26.1% for the unemployed and 34.2% for the employed), while men had an average age of 30.4 years (26.2% for the unemployed and 34.6% for the employed). Unemployed individuals had an average of 3.4 years of unemployment experience, whereas the employed group had an average of 8.5 years (8.4 years for women and 8.6 years for men). All unemployed participants were single, living with their parents, and financially dependent on them. In contrast, the employed group comprised four married women and four married men, residing separately from their families and enjoying financial independence. The remaining individuals lived with their parents but actively contributed to family expenses.

Results for S2

Three main themes emerged prominently from the interviews, reflecting their prevalence in the thematic areas discussed: high anxiety and diminished self-esteem primarily driven by environmental factors, a restrictive political and economic context and a negative social perception of sports, accompanied by recommendations for the development of the sector.

High anxiety and low self-esteem

Both unemployed and employed individuals reported feeling overwhelmed by anxiety, giving rise to anticipatory anxiety, an emotional state characterized by the fearful anticipation of impending danger or misfortune, accompanied by feelings of worry, distress, and somatic symptoms of tension (Roehr, 2013). Additionally, both groups expressed common feelings of shyness, difficulty in articulating themselves in public and a pervasive sense of inferiority. The fear of negative judgment in the context of an unsatisfactory professional situation was identified as the principal cause of this social anxiety, aligning with characteristics indicative of low self-esteem (Norström et al., 2014; Orth et al., 2014). Self-esteem, in this context, encompasses ‘the experience appropriate to life and its demands. More precisely, self-esteem involves: 1. having confidence in one’s capacity to think and navigate life’s challenges, and 2. possessing confidence in one’s entitlement to happiness, a sense of worthiness, deservingness, and empowerment to assert one’s needs and desires and to relish the rewards of one’s efforts’ (Branden, 1992, p. 8).

The study found that both unemployed and employed individuals engage in coping behaviors to alleviate psychological and social tensions. Unemployed individuals temporarily escape their distorted self-image through daytime sleep, while employed individuals experience shame and disappointment when comparing themselves to peers. Both groups exhibited defensive strategies, both verbal and behavioral, to manage their personal and social challenges. In this context, participants advocated for increased understanding from their social circles and the recognition of the value of sports in society. Furthermore, three women and one man from the employed group emphasized the advantages of physical exercise, such as stress reduction, freedom from workplace pressure and the availability of leisure time during adverse weather conditions, particularly considering the dearth of indoor sports facilities in Tunisian public institutions.

‘Unemployment has affected my personality a lot. I feel depreciated and abandoned. I prefer to stay in bed so as not to face the gaze of others. I don’t even dare to go out to see friends or family, how embarrassing!’

To quantitatively assess their psychological and social perceptions, participants were tasked with rating their feelings regarding this reality on a scale ranging from 1 to 10, where 10 represented the most severe response. In the realm of psychological assessments, the obtained scores fell within the range of 6–10 for both groups, yielding an overall average of 7.75. Regarding their social experiences, the scores spanned from 5 to 8, with an average score of 6.45. Notably, the working group exhibited a lower score (5.8) compared to the unemployed group (7.1). These findings collectively signify the presence of indications of mental health issues within both groups.

A restrictive political and economic context

Participants from both groups shared a common perception of unemployment as an enduring challenge in their lives, attributing this persistent issue primarily to the country’s ongoing political crisis and socioeconomic deterioration. They underscored that the succession of thirteen governments following the revolution had collectively failed to resolve it. Furthermore, they voiced their belief that the absence of political will and a coherent government strategy for effectively tackling unemployment served as an enduring hindrance to the country’s progress. Consequently, these university graduates harbored skepticism about the possibility of securing positions in the public education sector.

Despite this, the entire unemployed group explored the private sector as a potential solution to their unemployment predicament. These initiatives were pursued individually, involving activities, such as training courses, which were entirely the responsibility of the job seekers themselves. However, both groups expressed reservations about private-sector employment, citing concerns about wage disparities, underemployment, job security and financial stability in the sector. As a result, their preference leaned toward employment in the public education sector, while simultaneously expressing a strong interest in seeking opportunities in Gulf countries. This desire was widespread and grounded in the appealing salaries and promising career prospects offered by these rapidly expanding Arab nations.

‘I feel trapped here with no opportunities. The idea of moving to the Gulf for better pay and career prospects is very appealing. Staying in Tunisia seems like a dead end.’

The lack of political stability and effective government intervention continues to exacerbate the employment crisis, pushing both unemployed and employed graduates to seek opportunities abroad. The salaries and opportunities there are far more promising.

A negative social image of sports and recommendations for the development of the sector

Considering this prevailing reality, the individuals interviewed conveyed a profound sense of despair and disillusionment regarding their prospects in Tunisia. Whether unemployed or employed, they exhibited pronounced apprehension about the future and held pessimistic outlooks concerning their career trajectories. The primary sources of this pervasive discontent were identified as the absence of opportunities for professional advancement and the challenging working conditions.

The first factor contributing to this dissatisfaction stemmed from the unfavorable positioning of the Physical Education and Sport (PES) teaching profession, not only within the education system but also in Tunisian society at large. According to the interviewees, the occupation did not enjoy a positive professional image, a concept denoted as a global representation of the job in individuals’ minds, corresponding to the set of mental representations formed as a result of an individual’s exposure to various internal and external stimuli (Brillet & Gavoille, 2016).

The second factor contributing to their discontent pertained to unfavorable working conditions. These encompassed the scarcity and, at times, the absence of sports facilities, subpar equipment and the deteriorating state of auxiliary amenities, such as changing rooms and sanitary facilities (Sakli et al., 2021). Consequently, all interviewees perceived the profession as unappealing to society, which in turn limited its potential role in contributing to the overall health and well-being of Tunisians.

In pursuit of effective solutions, a group of eight unemployed individuals and five employed workers advocated for substantive reforms to university curricula. They emphasized the need to enhance skills and align them with the current demands of the international market. According to their perspective, existing curricula primarily emphasize teaching in the saturated public sector. They recommended a shift toward a more diverse approach, encompassing other sports-related professions such as coaching, animation, adapted physical activity, management and emerging sports technologies. In the view of these participants, this strategy of diversification, as opposed to specialization, could significantly bolster employability, both domestically and in external markets.

‘This crappy job degrades us and leaves us embarrassed in front of our colleagues, the administration, and even our students, who don’t give us any importance. We are disgusted, and work has become nothing but a daily ordeal for us.’

Furthermore, fourteen interviewees proposed entrepreneurship as a pragmatic response to the challenges of unemployment and professional growth. This group comprised four men and three women from the unemployed segment, as well as four men and two women from the employed group. Within this context, five unemployed individuals suggested a collaborative entrepreneurial endeavor involving multiple partners, based on the project’s feasibility. This concept of collective entrepreneurship refers to economic activities undertaken by collaborating partners (Razafindrazaka & Fourcade, 2016). The underlying idea was to conceptualize the project as a hub for the development of collective skills, capitalizing on the experiences and knowledge of all involved. According to the initiators of this concept, this entrepreneurial strategy held the potential to mitigate the risk of failure by harnessing the power of positive synergy, which would facilitate the co-creation of effective solutions.

‘Investing in a project that resembles mine makes me dream. The state must think seriously about this possibility because young people do not have the financial means to undertake it.’

To address these issues effectively, a multifaceted approach is necessary. This includes educational reform, support for entrepreneurial ventures and improvements in working conditions to enhance the professional image of sports and its contribution to societal well-being.

Conclusion for S2

S2 highlights significant mental health challenges among both employed and unemployed sports science graduates in Tunisia. Key issues include high anxiety and low self-esteem, driven by environmental factors, a restrictive political and economic context and a negative social perception of the sports profession. Participants emphasized the need for curriculum reforms to enhance employability, particularly in the Gulf region and expressed interest in entrepreneurship as a solution to professional stagnation. These findings underscore that improving mental health among Tunisian graduates requires addressing broader socio-economic and political issues and creating supportive pathways for diverse career opportunities.

Discussion

The outcomes of both S1 and S2 highlight that the transition from unemployment to stable employment is not the sole determinant of the mental well-being of sports science graduates in Tunisia. This proves that achieving stable employment does not necessarily mitigate mental health concerns in a context marked by enduring political and socio-economic instability (Khelifi, 2022). Primary factors contributing to this phenomenon are rooted in political and socioeconomic conditions (Klai, 2021; Ash, 2023). Ellouze et al. (2017) documented a surge in suicides, particularly among young individuals, along with heightened levels of psychotic disorders compared to estimates from 2005. Damak et al. (2019) similarly observed a mild prevalence of suicidal risk (227%), which was more pronounced among women, the unemployed and those with lower incomes. These findings may signify a case of reverse causality, where poor mental health contributes to unemployment (Banerjee et al., 2017; Krug & Eberl, 2018). According to Auten and Fritz (2019), mental disorders can negatively influence business productivity through factors, such as absenteeism, incapacitation and disability. Certainly, the mental health ramifications of job loss may intensify over time (Thill et al., 2019).

The second prominent contributing factor was the unfavorable social perception of the profession, which in turn limited career prospects. Consequently, 83% of Tunisians do not take part in physical and sports activities, and this participation rate has remained constant since 2010 (NOS, 2010). This lack of participation is also due to the severe shortage of sports infrastructure, limited accessibility to existing facilities, their poor condition and unequal distribution (Sakli et al., 2021). A study by Ataçocuğu and Zelyurt (2017) corroborated the vulnerability of the sports sector in both public and private domains, creating conditions conducive to prolonged unemployment. Such perceptions of an unsatisfactory job situation can result in social and community issues, including poverty, family instability and inequality (Edgell et al., 2015). This situation is linked to employment quality, often deemed inadequate to meet life’s demands (Bryson et al., 2016), encompasses aspects related to working conditions and employee satisfaction (Erhel & Guergoat-Larivière, 2016).

This study observed no statistically significant gender differences in the relationship between employment status and mental health determinants. However, S1 identified a higher incidence of anxiety disorders and depression among employed women compared to their unemployed counterparts, except for three participants in S2 who reported benefits linked to increased leisure time. A critical factor influencing this mental health disparity appears to be work-life balance, which is crucial considering the rights gained and the significant role women have played in the modernization of Tunisia, both pre- and post-revolution (Ouanada, 2021). These gender-specific outcomes align with findings by Adhikari (2022), who reported notable differences in depression and anxiety levels between working mothers and those not in the workforce. A similar gender disparity is evident in economically developed nations. Gedikli et al. (2023) emphasized the considerable influence of gender, socio-economic context, social norms and labor market dynamics on well-being in these regions, especially among individuals facing long-term unemployment.

Additionally, our findings revealed no significant correlations with the level of educational attainment. While some literature suggests that higher education enhances employability and reduces the duration of unemployment (Graham et al., 2019), other studies have documented a moderate to exceedingly severe prevalence of depressive, anxiety and stress disorders among university graduates awaiting employment (Rafi et al., 2019). This vulnerability is exacerbated during economic downturns, as evidenced by Li and Toll (2021), underscoring the complex interplay between education, economic conditions and mental health.

Faced with this pervasive sense of discontent, some interviewees expressed a preference for seeking employment in Gulf countries due to the allure of financial incentives and promising career prospects (Saberi & Hamdan, 2019). Conversely, other interviewees suggested entrepreneurship as a more potent approach in terms of both social impact and cost-effectiveness (González-Serrano et al., 2019). These sporting ventures aim to address common economic needs while generating social value (Ratten, 2020; Pounder, 2019), contributing to the territorial vibrancy that fosters local development (Karamti & Abd-Mouleh, 2023). This trend aligns with Hanapi and Nordin (2014) observations, arguing that professional project implementation generates economic value and significantly reduces unemployment rates. Generally, entrepreneurship improves the well-being of entrepreneurs due to the advantages of autonomy and independence (Stephan et al., 2023). According to Ben Youssef Mnif’s study (2021), promoting entrepreneurship has positively impacted the mental well-being of Tunisian students, facilitating their professional integration. However, acquiring new employability skills at the university facilitates successful occupational integration (Sara & Sabil, 2022). In Tunisia, unfortunately, the various university reforms since 2011 have not solved the problem of graduate unemployment (Khelifi, 2022).

Additionally, certain studies have underlined the significance of temporary employment and re-employment in mitigating the adverse effects of unemployment on individuals’ psychological well-being by motivating and facilitating the transition to stable employment (Gebel & Voßemer, 2014). Simultaneously, other research has indicated that temporary employment opportunities that do not align with applicants’ skills and expectations may be more closely associated with psychiatric issues (Cassidy, 1994).

Consequently, Tunisia today faces significant challenges with brain drain, as highly skilled professionals leave due to poor salaries and working conditions, exacerbating socio-economic issues (El-Khawas, 2004; Docquier & Marfouk, 2006). This trend undermines national development and innovation. Our study’s findings align with previous research on unemployment’s mental health impact, supported by theoretical frameworks suggesting Tunisia’s instability amplifies these effects. This study contributes to theoretical knowledge by highlighting employment status’s specific impact on mental health in post-revolution Arab countries. Practically, it offers recommendations for policymakers to improve job quality, career development and entrepreneurship to mitigate brain drain.

Conclusion

The mixed-methods approach provided significant insights into the impact of employment status on the mental health of sports science graduates in post-revolution Tunisia. The results reveal that both unemployed and employed sports science graduates face considerable mental health challenges, influenced by the country’s socio-economic and political context. These findings underscore that transitioning from unemployment to stable employment alone does not guarantee mental well-being. Addressing the mental health issues of graduates necessitates comprehensive strategies that extend beyond merely reducing unemployment rates. Such strategies include improving working conditions, offering competitive wages, and providing robust career development opportunities, which are crucial yet challenging for countries in transition. Additionally, it is vital to reform curricula to align the skills of these professionals with international market demands, particularly in the Gulf States. Promoting entrepreneurial initiatives can also generate social and economic value, tackling career stagnation and mitigating the brain drain phenomenon, where highly skilled professionals leave the country in search of better opportunities.

This research enriches the global literature on mental health and employment and offers practical recommendations for policymakers in similar contexts, such as Egypt, Libya and Syria. However, the study has limitations, including the absence of a national database on young people’s career paths after graduation and data on the health of Tunisians, including mental health. These limitations hinder the retrospective assessment of the prevalence of mental illness. Future research should address these gaps, explore the long-term mental health outcomes of different employment statuses, and consider longitudinal studies to understand causality and the impact of targeted interventions. Furthermore, it is essential to verify these findings across different specialties and in other countries that have undergone similar political changes.

Authors statement

Chedlia Fitouri: Conceptualization, Methodology, Investigation, Data Curation, Formal Analysis, Visualization, Writing.

Sofiane Souissi: Methodology, Validation, Visualization, Review and Editing.

Ghazi Racil: Methodology, Validation, Visualization, Review and Editing.

Hejer Ben Jomaa: Data Curation, Formal analysis, Visualization, Review and Editing.

Karim Chamari: Conceptualization, Methodology, Validation, Review and Editing Supervision.

Acknowledgments

We would like to express our sincere gratitude to all participants who contributed to the completion of this study. This manuscript could not have been completed without their support and patience.

Disclosure statement

This research did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors. This absence of conflicts ensures the integrity and impartiality of the research.

Data availability statement

Aggregated and anonymized data supporting the findings of this study are presented in tables submitted in a separate editable file with suitable labeling. The authors, Chedlia Fitouri and Karim Chamari, each holding an ethics certificate (reference number: CEFMS 125/2022), collected and used the data exclusively for this study, ensuring ethical compliance and participant confidentiality. Data are openly available in a public repository that issues datasets with DOIs.

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Additional information

Notes on contributors

Chedlia Fitouri

Chedlia Fitouri, Ph.D. in Management Sciences from Tunis Manar University, Tunisia. She also holds a Master’s in Sport Management and a Bachelor’s in Sport Sciences. A former elite volleyball player and national coach, she has won multiple national, Arab, and African titles. Dr. Fitouri has served as an Assistant Professor at the Higher Institute of Sport and Physical Education of Ksar-Said, University of Manouba, where she also held the position of Head of Pedagogical and Technical Research and was twice elected to the Scientific Council of the University of Manouba. She is currently an Assistant Professor at Sohar University, coordinating the Department of Physical Education. She is a sport management trainer for the Tunisian Olympic Committee and football federations in Tunisia and Oman. With extensive experience leading international projects for the European Union, her research interests include sports sciences, with a focus on sport marketing, management, and entrepreneurship, integrating social, human, and political sciences within the sports context.

Sofiane Souissi

Sofiane Souissi, P.h.D. in Clinical and Sports Psychology. He is a clinical and sports psychologist specializing in performance enhancement, personal development, mental health, and the psychological well-being of athletes. He has extensive experience in the mental and psychological care of athletes. For over 18 years, he has gained extensive experience as a mental training specialist for numerous sports teams. Before joining Aspetar in 2013 as a researcher, he was head of the psychology unit at the Tunisian National Centre for Sports Medicine and Science. He has written several articles on concussions, executive functions, sleep, and mental health. In addition to clinical and sports psychology, he is particularly interested in neuropsychology.

Ghazi Racil

Ghazi Racil, Ph.D. in Exercise physiology. Currently works at exercise physiology and body composition. Ghazi does research in Diabetology, Nutrition and Dietetics and Nutritional Biochemistry. His current project is ‘perceived exertion and training in young obese.’ indeed he is working on motor skills in the young age and the effect of rhythm in performance development. Disciplines: Diabetology, Nutrition and Dietetics, Nutritional Biochemistry Skills and expertise: Lipid Metabolism, Metabolism, Body Composition, Physical Activity, Human Physiology, Exercise Science, Nutrition and Exercise Performance, Exercise Physiology, Leptin, Insulin.

Hejer Ben Jomaa Ben Hsouna

Hejer Ben Jomaa Ben Hsouna, Ph.D. in Pedagogy and Teacher Education. Assistant Professor, Higher Institute of Sports and Physical Education, University of La Manouba, Researcher at LR ECOTIDI (UR16ES10), Tunisia. Associate researcher at UMR EFTS, Toulouse Jean-Jaures University / GREDCAPS, Laurentian University, Ontario. Research interests: Didactics, Teaching and Learning, Clinical Didactics, Higher Education pedagogy, Professional Development, Physical Education and Sports, Gender studies.

Karim Chamari

Karim Chamari, PhD in Exercise Physiology (1990 to 1995 in Montpellier, France) University Full Professor. I have worked 18 years in Tunisia as Faculty (ISSEP Ksar-Saïd, Manouba University, Tunis) and Researcher (CNMSS, National Center of Sports Science and Medicine, Tunis) in parallel to being fitness coach in Professional Football (Club Africain 2002-2012 and Stade Tunisien teams 2012-2013). Then, I moved to Doha, Qatar, where I joined Aspetar (Orthopaedic and Sports Medicine Hospital, Doha Qatar 2013-2023) as Researcher in Sports Sciences with focus on Fasting and Ramadan studies. In 2015 I have served as Head of ASPREV (Aspetar) to work on Sports injury and Illness prevention in elite athletes. Presently working at Naufar, Wellness and Recovery Center, Doha, Qatar (2024- to date) as Deputy Director of Clinical Research. [email protected]

Notes

1 National Institute of Statistics, Tunisia. 2023. Employment and unemployment indicators, first quarter 2024. Indicateurs de l’emploi et du chômage, premier trimestre 2024 | INS (accessed 1 June 2024).