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Supporting youth mental health

According to the World Health Organisation, about half of all mental health conditions begin by 14 years of age, with most cases remaining unrecognised and untreated. The adolescence developmental stage is characterised by physical, emotional, and social change so it is important to protect young people at risk of adverse mental health outcomes, and to identify and provide support to those with mental health conditions.

The more risks that an adolescent is exposed to, the greater the likelihood that he or she will experience mental health challenges. In Eastern and Southern Africa, 79% of new HIV infections were among 10–19 year-old females (in 2017). An estimated 720 000 adolescents between the ages of 15-24 are living with HIV in South Africa. Young people are grappling with socio-economic determinants of disease that heightens their vulnerabilities to HIV.

In the context of HIV and AIDS, mental health issues are especially relevant: mental health problems have significant implications for the course and outcome of HIV infection, the early detection of mental health problems in HIV positive adolescents represent a key aspect of care.


The Covid-19 pandemic has exacerbated mental health issues for everyone, more so the mental health of young people with experiences of stressful events such as changes in lifestyle, the loss of friends and family members, social distancing and uncertainties associated with the sporadic opening of schools. All this is taking its toll on our young people.

In focus group discussions that we conducted with 30 adolescent girls and young women on our My Journey programme in the North West, Western Cape and Gauteng, it was clear that their mental health challenges were exacerbated by Covid-19. The girls reported personal experiences of gender-based violence, domestic violence, families as stressors, romantic relationships and social media as triggers. During the lockdown restrictions and isolation period, pre-existing traumas and experiences that were unresolved, resurfaced further impacting on their mental health. In our programmatic response aimed at keeping girls in school, decreasing HIV incidence, decreasing teenage pregnancy, gender-based violence and increasing economic opportunities, we could not achieve these aims by isolating the mental health of the beneficiaries.


Recognising this, the My Journey programme, funded by the Global Fund and implemented by NACOSA in Tshwane, Rustenburg and Klipfontein, provides mental health support to young women and the teams working directly with them as part of the package of care. NACOSA delivers these services through 11 implementing organisations, reaching 100,000 young women between 15 and 24.

July was mental health month and in 2021 the Mental Health Foundation declared ‘nature’ the theme for this year. According to the Mental Health Foundation:

“Nature’s unique ability to not only bring consolation in times of stress, but also increase our creativity, empathy and a sense of wonder is to be considered in our efforts to restore mental health well-being.”

During the focus group discussions, girls reported activities such as jogging, yoga, walking and chilling to have helped them cope better when they were feeling anxious, discouraged and experiencing depressive moods. However, South Africa has one of the highest levels of inequality in the world, and the young women on our programme are from low socio-economic backgrounds with the majority living in townships and informal settlements, where access to gardens and backyards is limited. The reality is, access to nature is a luxury.

However, in South African townships and under-developed areas, there are parks, community halls, community stadiums and open spaces that the local and national governments should refurbish and equip to make them youth-friendly. This will provide adolescents and young people space and the opportunity to enjoy nature and their environments, as ways to improve their mental health and well-being.

By Kgahliso Mangoale, Adolescent Girls and Young Women Programme Specialist