CATCH IT EARLY OP-ED: Mental healthcare for young South Africans needs a wider front door

Youth mental health care in South Africa urgently needs to shift from a crisis-focused approach to early prevention and intervention measures. The strongest chances for preventing mental health issues arise during childhood and adolescence, when symptoms frequently emerge and can even co-occur, such as anxiety and depression alongside challenges affecting relationships, schooling, and daily functioning. Delays in recognizing and addressing these difficulties can allow distress and impairment to become more entrenched.

Currently, specialist child and adolescent mental health services are scarce and unevenly distributed in South Africa, while symptoms of depression and anxiety are common among young adolescents. Expanding specialist services is essential; however, the gap in treatment availability necessitates support available earlier and through a wider array of individuals and settings.

Schools play a significant role in this approach, as young people spend a significant portion of their lives there. Forming relationships with peers and adults, schools offer opportunities for mental health promotion, prevention, and early support when accompanied by appropriate training, supervision, and implementation considerations, along with links to further care when needed.

Task sharing is an increasingly important strategy for extending care reach. This involves training non-specialist mental health professionals to deliver evidence-based interventions within defined roles and with appropriate supervision. An example of this approach is the WHO and Unicef's Early Adolescent Skills for Emotions (EASE) programme, a seven-session group intervention for adolescents experiencing emotional distress, including anxiety and depression symptoms, delivered by trained non-specialists.

The program has been adapted for South Africa (EASE-SA) and evaluated across four public schools in the Western Cape, with participants reporting feasibility, acceptability, and perceived benefits for emotional wellbeing and relationships. Continued implementation, collaboration among departments, community organizations, and the integration of young people's perspectives are essential to ensure effective mental health support for young South Africans.