Child mental health in South Africa (SA)
As the world observes World Mental Health Day on Friday, 10 October, the South African Medical Research Council (SAMRC) highlights that mental health challenges remain a leading cause of illness and disability among young people, both globally and in South Africa.
A recent systematic review led by the SAMRC with input from international and local experts shows that approximately 10.1% of young people in SA have depressive disorders, while 6.7% have anxiety disorders, and 17.6% have Post-Traumatic Stress Disorder (PTSD). Worldwide, 8% of children and 15% of adolescents experience a mental disorder. Professor Carrie Brooke-Sumner, Specialist Scientist at the SAMRC Mental Health, Alcohol, Substance Use and Tobacco Research Unit (MASTRU), explains: “Young people are navigating a critical phase of human development during which they experience heightened vulnerability to environmental factors that shape their mental health. In South Africa, the environmental forces include exposure to the effects of poverty and violence.”
Most mental problems have their onset in adolescence or early adulthood. Disorders like phobias, problems with impulse control, learning disorders, and attention difficulties often begin before the age of 12. While problems such as depression, substance use, eating disorders, and self-harm typically emerge in adolescence or early adulthood.
Mental health problems do not have a single clearly defined cause. They are often the result of a complex interaction between genetic, biological, and environmental factors, which can make it difficult to plan prevention programmes.
Professor Jason Bantjes, MASTRU Director, whose research focuses on psychiatric epidemiology, with a particular interest in the well-being of adolescents and young adults, emphasises that: “The vast majority of young people with mental health problems do not seek help or receive care. Sometimes this is a result of resource constraints and a scarcity of health professionals who are properly trained to identify and treat childhood psychiatric conditions. But stigma and a lack of knowledge among teachers and parents can also contribute to children not getting the care they need.”
Early childhood experiences, exposure to violence and neglect, and poverty are among the environmental causes of mental health problems. Likewise, social isolation, bullying, and unrealistic academic pressure can contribute to harming the mental health of young people.
Exposure to substances also has harmful effects on the mental health of young people. A recent meta-analysis led by Dr Carrie Brooke-Sumner, also from the SAMRC, showed that a significant proportion of young people in South Africa are exposed to substances.
Dr Brooke-Sumner says, “Combining the best available data shows that in the past 12 months, approximately 33.17% of young people under the age of 18 years used alcohol, while 8.2% used cannabis.”
Early identification and treatment of children with mental health problems is vitally important. Left untreated, childhood mental disorders often persist into adulthood and have a serious adverse impact on physical and mental well-being.
Because of rapid scientific advances in the field of child mental health, effective treatments for mental disorders do exist. However, many people do not have access to these evidence-based treatments.
The need for reliable data
Reliable data on the prevalence of child mental health problems is urgently needed in SA to plan services and set priorities. Unfortunately, this data is not available, and most studies in this area are either poorly designed or are too small and unrepresentative to be helpful.
Prof Xanthe Hunt from Africa Health Research Institute comments: “Educational pathways into risk and poor mental health, as well as towards optimal development and thriving, are beginning to be better understood. But there is a lot of room for us to nuance our understanding of how learning and schools affect young people's mental health, and what kinds of things can be done to maximise positive impacts, reach children and youth where they are, and create psychosocially friendly educational systems.”
The SAMRC is working with the Stavros Niarchos Foundation (SNF) Global Centre for Child and Adolescent Mental Health at the Child Mind Institute to address the data gaps in youth mental health. In partnerships with the National Department of Health, Stellenbosch University, University of KwaZulu-Natal Natal and the SAMRC, the SNF Global Centre for Child and Adolescent Mental Health at the Child Mind Institute is undertaking a large nationally representative survey of child and adolescent mental health early next year. For the first time, a rigorous study will be conducted that uses a well-validated instrument with a large nationally representative sample of young people to provide us with reliable data about the prevalence of child and adolescent mental health conditions in the country.
Expert gathering in Cape Town, November 2025
The SAMRC is working closely with SNF Global Center for Child and Adolescent Mental Health at the Child Mind Institute to host an expert gathering in Cape Town on November 24-25, 2025.
This event will bring together young people, local and international experts, NGOs, and representatives from the National Department of Health and Department of Basic Education to discuss workable evidence-based solutions to address child and adolescent mental health in SA. Should you wish to attend as part of the media, RSVP with Jason.Bantjes@mrc.ac.za.