---
title: "Why SA must invest in young people’s mental health sooner rather than later"
description: "Delaying accessible, preventative mental health and psychosocial support carries costs across education, employment, families, communities and the economy."
type: "NewsArticle"
publisher: "Daily Maverick"
site: "https://www.dailymaverick.co.za"
section: "OP-ED"
authors:
  - name: "Crick Lund"
    url: "https://www.dailymaverick.co.za/author/crick-lund/"
  - name: "Simone Peinke"
    url: "https://www.dailymaverick.co.za/author/simone-peinke/"
  - name: "Anya Hollands"
    url: "https://www.dailymaverick.co.za/author/anya-hollands/"
canonical_url: "https://www.dailymaverick.co.za/article/2026-10-26-why-sa-must-invest-in-young-peoples-mental-health-sooner-rather-than-later/"
published: "2026-10-26T19:22:15"
lang: "en-ZA"
word_count: 1078
---

# Why SA must invest in young people’s mental health sooner rather than later

> Delaying accessible, preventative mental health and psychosocial support carries costs across education, employment, families, communities and the economy.

By Crick Lund, Simone Peinke and Anya Hollands · Published 26 October 2026, 21:22 SAST

## Key points
- South Africa’s mental health system is missing a crucial opportunity: preventing young people’s distress before it becomes a crisis.
- Unaddressed mental, neurological and substance-use conditions cost the country about 4% of GDP annually, while fewer than one in 10 people needing care receive it.
- Early support in schools, communities and workplaces could deliver a “triple dividend” — improving lives now, strengthening adulthood and benefiting future generations.
- The answer is not simply more specialists, but a coordinated, supervised support network that connects frontline workers and institutions to professional care

## Content

South Africa needs to rethink how it invests in mental health. Preventing problems, beginning in adolescence, costs far less than treating someone whose mental health has already deteriorated – and that is before counting the cost to the economy of delayed action. Yet the country keeps missing opportunities to double down on preventing young people from sliding into crisis.

South Africa’s [Mental Health Investment Case](https://www.samrc.ac.za/sites/default/files/attachments/2024-11/Mental%20Health%20Investment%20Case_F.pdf), commissioned by the national Department of Health and [published in 2025](https://www.sciencedirect.com/science/article/pii/S2666560325001732?via%3Dihub), estimates that unaddressed mental, neurological and substance-use conditions could cost approximately 4% of GDP annually. By contrast, public spending on mental health is around R8-billion a year, [about 5% of the public health budget](https://academic.oup.com/heapol/article/34/9/706/5572608?login=false), and fewer than one in 10 people who need mental health care receive it.

The cost of poor mental health is being felt in disrupted education, lost opportunities, unemployment, exposure to violence, family strain, reduced productivity and narrowed prospects.

To understand the missed opportunity, think of mental health as a spectrum from thriving to struggling to being in crisis. Everyone sits somewhere on this spectrum, and their position shifts depending on whether they have access to support.

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Early support prevents deterioration. But far too many young people are not getting the right support early, which makes it more likely that their mental health will worsen. By the time they reach crisis point, distress may have already disrupted their education, work, relationships and sense of hope for the future.

Many of today’s workers and those preparing to join them are struggling with their mental health and are unsure where to seek help. A [2023 Unicef South Africa U-Report poll](https://www.unicef.org/southafrica/press-releases/60-cent-youth-needed-mental-health-support-over-past-year-u-report) makes the connection clear. Among respondents aged 15–24, 70% had needed help with their mental wellbeing the previous year. Only 63% of all respondents needing support sought it; not knowing where to go was the main barrier. Almost half (48%) were most anxious about building skills for future employment. Nearly 26,000 young people responded, with an [89% response rate](https://sa.ureport.in/opinion/6584/) to the opening question. While not nationally representative, the findings reveal the pressures respondents faced. This is an important account of what many young people are dealing with, and why accessible support cannot wait until difficulties escalate. It must start in adolescence.

[Media: "Chart: Fewer than one in 10 South Africans who need mental health care receive it"](https://charts.dailymaverick.co.za/chart/09b4c3665391c483a66f73c4)

### The triple dividend

Teenagers and young adults form identities, navigate relationships and make consequential education and work decisions, often amid poverty, unemployment, violence, discrimination and uncertainty. [Researchers argue](https://doi.org/10.1016/S2352-4642\(18\)30022-1) that adolescence extends from 10–24, beyond the conventional 10–19 range, reflecting continued biological and brain development alongside later completion of education, marriage and parenthood.

The brain remains highly responsive to experience and environment, making this a [crucial period](https://www.unicef.org/guatemala/media/381/file/The%20Adolescent%20brain.pdf) for developing social and emotional habits, identity and resilience. Intervention can strengthen positive developmental pathways before distress becomes more severe and expensive to address.

The [Lancet Commission on Adolescent Health and Wellbeing](https://doi.org/10.1016/S0140-6736\(16\)00579-1) describes a triple dividend for investing early in mental health: benefits today, into adulthood and for the next generation. Accessible mental health promotion and prevention includes [structured support](https://www.who.int/publications/i/item/9789240011854) to regulate emotions, solve problems, build supportive relationships and develop agency. These skills can protect mental health and reduce risk, supporting immediate wellbeing and future participation in education, work, family life and society.

The [World Health Organization](https://www.who.int/news-room/commentaries/detail/children-and-young-people-s-mental-health--the-case-for-action) (WHO) reports that one in seven adolescents experiences a mental health condition and estimates $24 returned over 80 years for every dollar invested in adolescent mental health. This global estimate illustrates the potential to improve lives and reduce long-term costs.

[South African research](https://doi.org/10.1016/j.ssmmh.2025.100560) estimates a $2.30 return per dollar invested in universal school-based social and emotional learning for adolescents, through productivity gains, health benefits and savings over 15 years. Well-designed investment can improve young people’s lives while reducing the social and economic costs carried by families and communities.

### Prevention can drive efficiency and impact

A health and education system focused entirely on responding to those already in crisis is costly and inequitable. [WHO’s optimal mix of services for mental health supports a continuum](https://www.mhinnovation.net/sites/default/files/content/document/The%20optimal%20mix%20of%20services%20for%20mental%20health.pdf), with widely accessible self-care and community support linked to primary and specialist care. Promotion and prevention must form part of this wider system.

[Professor Vikram Patel](https://ghsm.hms.harvard.edu/faculty-staff/vikram-patel), a global mental health expert at Harvard Medical School, demonstrates that earlier investment need not rely solely on more psychologists, psychiatrists and social workers. [Through task-sharing](https://www.who.int/news-room/commentaries/detail/from-isolation-to-inclusion---community-based-mental-health-care), trained and supervised community workers, school counsellors and other frontline providers can deliver structured psychosocial interventions, with referrals and specialist care for greater or persistent needs.

A [randomised trial](https://doi.org/10.1371/journal.pmed.1003778) in low-income New Delhi schools illustrates the potential. Trained, supervised lay counsellors without prior clinical qualifications delivered four to five brief sessions, helping young people identify a problem, consider options and try a practical solution. The intervention reduced psychosocial problems and mental health symptoms over 12 months. Although findings cannot simply be transplanted to South Africa, they demonstrate the potential for effective, affordable support in resource-constrained settings. The study shows why training, structure and supervision matter when expanding access.

This is not an argument for replacing professionals. It is an argument for building a wider, layered system around them: making the least-intensive support available to many, identifying difficulties early and escalating care when needed.

### Support must be built into young people’s pathways

Young people urgently need trusted support where they learn, work and connect. The departments of Basic Education and Higher Education and Training must embed psychosocial support in schools, colleges and skills programmes. Public employment programmes and employers should provide accessible support during placements and transitions into work. The Department of Sport, Arts and Culture should equip youth centres and community programmes to offer supportive spaces and connections to help. The Department of Health should link these settings with primary healthcare and specialist services, ensuring identified needs lead to timely care.

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This requires coordinated budgets and clear accountability. Government, funders and implementers should invest in a diverse, supervised community-based workforce, assigning responsibility for referral follow-up and continuity between services. They should measure wellbeing, participation, retention and progression alongside education and employment outcomes.

South Africa cannot afford to treat young people’s mental health as tomorrow’s problem. **DM**

*Professor Crick Lund is Professor of Global Mental Health and Development at King’s College London. Simone Peinke is the project lead of FETCH. Anya Hollands is the FETCH communications lead.*