Lessons learnt from integrating mental health into sport-based adolescent sexual and reproductive health programmes in South Africa

Aim Mental health promotion and prevention programmes are a promising approach to addressing adolescent mental health, but little work has been done to integrate mental health into existing adolescent health programmes. Grassroot Soccer, with extensive experience in delivering sport-based adolescent sexual and reproductive health and rights programmes, has begun integrating mental health into its initiatives, re-designing, piloting, and assessing two evidence-based programmes in Alexandra, South Africa. This paper documents the process of adapting programme curricula and providing training on the new content; presents preliminary results from programme monitoring data; and shares challenges faced and addressed by Grassroot Soccer. Method The mental health integration process entailed stakeholder consultations, a participatory design workshop with young people, pre-testing, and programme refinement. Grassroot Soccer used a pragmatic mixed-methods approach, including programme monitoring data such as participant reach and retention, pre- and post-intervention questionnaires, and one focus group discussion with coaches (n = 8). Quantitative data were analysed using descriptive statistics, and key themes were documented through reports and memos. Outcomes Co-design with partners and young people clarified challenges facing adolescents, and review of the existing programme curriculum highlighted opportunities for mental health integration. Programme monitoring data showed early promise in enhancing adolescent mental health and sexual and reproductive health and rights knowledge. Facilitators highlighted the need for clear referral processes for adolescent participants requiring additional support, and emphasised the importance of supporting their own mental health. Additional insights include using supplemental print magazines to reinforce key topics, formalising facilitator mental health support, and further work on mental health measurement in integrated programmes. Conclusion Grassroot Soccer experiences demonstrate that integrated mental health and sexual and reproductive health and rights programmes can be feasibly delivered by young adult facilitators to address both domains. The authors recommend that government and programme stakeholders explore methods for integrating mental health content into existing programmes.