---
title: "Mental healthcare for young South Africans needs a wider front door"
description: "Youth mental health care needs to move from a crisis response to early prevention and intervention. This could be achieved through expanding school-based ‘task sharing’ programmes like EASE-SA, where trained non-specialists deliver evidence-based emotional support to young adolescents."
type: "NewsArticle"
publisher: "Daily Maverick"
site: "https://www.dailymaverick.co.za"
section: "CATCH IT EARLY OP-ED"
authors:
  - name: "Bronwyne Coetzee"
    url: "https://www.dailymaverick.co.za/author/bronwyne-coetzee/"
  - name: "Katherine Sorsdahl"
    url: "https://www.dailymaverick.co.za/author/katherine-sorsdahl/"
  - name: "Claire van der Westhuizen"
    url: "https://www.dailymaverick.co.za/author/claire-van-der-westhuizen/"
canonical_url: "https://www.dailymaverick.co.za/article/2026-10-08-youth-mental-health/"
published: "2026-10-08T22:04:15"
lang: "en-ZA"
word_count: 954
---

# Mental healthcare for young South Africans needs a wider front door

> Youth mental health care needs to move from a crisis response to early prevention and intervention. This could be achieved through expanding school-based ‘task sharing’ programmes like EASE-SA, where trained non-specialists deliver evidence-based emotional support to young adolescents.

By Bronwyne Coetzee, Katherine Sorsdahl and Claire van der Westhuizen · Published 9 October 2026, 00:04 SAST

## Key points
- South Africa’s youth mental healthcare system must shift from crisis response to earlier prevention and intervention.
- With specialists scarce and unevenly distributed, schools could provide a crucial “wider front door” to support.
- The locally adapted EASE-SA programme trains supervised non-specialists to help adolescents manage anxiety, depression and emotional distress.
- Early evidence from Western Cape schools finds EASE-SA feasible and acceptable – but lasting impact will depend on strong links between schools, families, communities and health services.

## Content

Child mental health systems are still too often organised around crisis, even though the strongest opportunities for prevention come much earlier.[Mental health difficulties frequently emerge during childhood and adolescence](https://doi.org/10.1038/s41380-021-01161-7), and young people often experience more than one difficulty at the same time. Anxiety and depression, for example,[commonly co-occur in children and adolescents](https://doi.org/10.1097/PRA.0000000000000132), alongside challenges that can affect relationships, schooling and everyday functioning. Delays in recognising and responding to these difficulties can allow distress and impairment to become more entrenched.

This is one reason that recent international work has called for youth mental health systems to place much greater emphasis on[prevention and early intervention](https://pubmed.ncbi.nlm.nih.gov/39147461/). In South Africa, that challenge is especially pressing. Specialist child and adolescent mental health services remain[scarce and unevenly distributed](https://pubmed.ncbi.nlm.nih.gov/35078503), while[symptoms of depression and anxiety are common among young adolescents](https://pubmed.ncbi.nlm.nih.gov/38461564). Expanding specialist services remains essential, but the size of the treatment gap means that support also has to be available earlier and through a wider range of people and settings.

Schools have an important place within this response. Young people spend much of their lives there, relationships with peers and adults are formed there, and changes in behaviour, participation or wellbeing may first become visible there. Schools can create opportunities for[mental health promotion, prevention and early support](https://pubmed.ncbi.nlm.nih.gov/36684024), provided that this work is accompanied by[appropriate training, supervision and attention to implementation](https://pubmed.ncbi.nlm.nih.gov/32543016), with links to further care when needed.

### Extending the reach of care

One increasingly important approach is[task sharing](https://pubmed.ncbi.nlm.nih.gov/39300741). This involves training people who are not specialist mental health professionals to deliver specific evidence-based interventions within clearly defined roles and with[appropriate supervision](https://pubmed.ncbi.nlm.nih.gov/38050095). In settings where the demand for mental health support far exceeds the number of psychologists, psychiatrists and other specialists available, task sharing can extend the reach of care without expecting every difficulty to be managed by specialist services.

A useful example is the[World Health Organization (WHO) and Unicef’s Early Adolescent Skills for Emotions programme](https://www.who.int/publications/i/item/9789240082755), or EASE. It was developed for adolescents aged 10 to 14 experiencing emotional distress, including symptoms of anxiety and depression. The programme consists of seven group sessions for adolescents and three sessions for caregivers, and draws on cognitive behavioural approaches. Importantly, it was designed for delivery by trained and supervised non-specialist helpers. The WHO and Unicef have also developed a[formal training and supervision manual](https://www.who.int/publications/i/item/9789240113718) to support this model of delivery.

At the Alan J Flisher Centre for Public Mental Health (CPMH) researchers have adapted EASE for South Africa and have been working with stakeholders to deliver EASE in primary schools. Indeed, Mirriam Mkhize, Katherine Sorsdahl and Claire van der Westhuizen have led the local adaptation of EASE for adolescents and caregivers in the Western Cape. Earlier work in this population[identified substantial symptoms of anxiety and depression among young adolescents,](https://pubmed.ncbi.nlm.nih.gov/38461564) reinforcing the need for age-appropriate and accessible forms of support.

The South African adaptation, EASE-SA, has since been evaluated across four public schools in the Western Cape. A recent study found that adolescents, caregivers, facilitators and school stakeholders generally regarded the programme as[feasible and acceptable in school settings](https://www.sciencedirect.com/science/article/pii/S2666560326001027). Participants also described using the skills they had learnt in everyday life and reported perceived benefits for emotional wellbeing and relationships.

This work is now moving into implementation, where partnership becomes essential. The CPMH team has been working closely with the Western Cape departments of Social Development, Education and Health, as well as several community organisations. These links and collaborative efforts are essential for offering EASE-SA in schools and other community settings where young people spend time, supporting those delivering EASE, and referring adolescents for additional support and mental healthcare services, as needed.

The value of this network of services and collaborators cannot be overstated, since it is also vital for helping young people access mental healthcare services should they need them, and for focusing on prevention of mental health difficulties. Programmes such as EASE and related interventions can prevent young people with symptoms from developing a diagnosable mental health condition, but can also help prevent symptoms emerging by strengthening skills such as managing emotions, problem solving and coping.

There is also good reason to involve young people and communities in adapting or refining these programmes, as the CPMH team did in adapting EASE for South Africa. Our work has argued consistently for[contextually responsive, locally developed approaches](https://pubmed.ncbi.nlm.nih.gov/39644172/) that involve young people, schools and communities in their design and evaluation. At CPMH, our Youth Development Team is a group of young people who advise our staff and give input on our current (and future) interventions and research.

That emphasis also speaks directly to the theme of this year’s World Mental Health Day (10 October),[“Lived experiences heard: real voices, real change”](https://www.who.int/campaigns/world-mental-health-day/2026). Listening to young people and families has to shape how services are designed, adapted and delivered. It should influence what support looks like, who provides it and how young people move between different levels of care.

Mental healthcare for young people needs a wider front door. Schools can form one important part of that entrance, especially when they are linked to community organisations, families, researchers and health services. Ideally, we hope for a system in which young people can encounter meaningful support earlier, close to where they live and learn, and move easily to further care when they need it. **DM**

*Bronwyne Coetzee is associate professor in the Department of Psychology at Stellenbosch University and co-director of the Alan J Flisher Centre for Public Mental Health at the University of Cape Town. Katherine Sorsdahl is professor and co-director of the centre. Claire van der Westhuizen is associate professor and deputy director of the centre.*