A model of community youth mental health support services in the global South: A description and use of school-based services delivered by a non-governmental organisation in South Africa

Young people in low- and middle-income countries (LMICs), including South Africa, are disproportionately affected by multiple risk factors for developing mental health problems and there are numerous barriers to accessing mental health care. In such contexts non-governmental organisations (NGOs) play a key role in providing support. We report on the mental health care services provided by NGO Community Keepers in South Africa. Community Keepers (CK) offers psychosocial support to young people, parents, and teachers, during regular school hours, and free of charge. At the end of 2019, CK was based at 23 schools in 12 areas in the Western Cape Province, South Africa. In this paper we describe the model of service provision and present descriptive statistics from retrospective observational service data using routinely collected quantitative data from 2019, including details about referrals received, referral sources and reasons, and feedback received from children, parents, and teachers on the psychosocial support CK delivered. During 2019, 34 676 individuals accessed 18 169 psychosocial support sessions rendered by CK. The most common referral source of learners to CK was self-referrals (40.6%), and the main referral reasons were emotional (psychological) problems, behaviour problems, or family (community) problems. At termination of therapy 320 (79.2%) learners said they strongly agreed that they would recommend CK to someone at their school. At termination of therapy with learners, 95 (39.3%) teachers rated CK’s services as excellent , 139 (57.4%) teachers gave a rating of good , and 204 (79.7%) parents reported an improvement in their relationship with their children. CK is an example of how psychosocial support can be embedded in schools in a LMIC. CK’s multifaceted model of service delivery could be used by other school-based mental health care service providers in other LMICs to inform and/or refine the services that they wish to offer.