“Give them a reason to live”: exploring the prioritisation of adolescent and youth mental health policy in South Africa

Aim This study explores the factors underlying the prioritisation of adolescent and youth mental health policy in South Africa, or lack thereof, from the perspective of health policy actors and youth advocates. Methodology In-depth interviews were conducted with 34 key informants including researchers, civil society and government policy actors and a focus group with seven youth advocates, aged 18─24 years. Data were analysed thematically drawing on an adapted version of a policy prioritisation framework. Results The analysis revealed several barriers to prioritisation, including: a lack of policy community cohesion, inadequate leadership, insufficient collaboration with adolescents and young people and those with lived experience, evidence gaps, a fragmented policy landscape, and a lack of simple, scalable solutions. However, a number of opportunities were also identified: dedicated and passionate actors, new evidence, and contextual factors which have raised public awareness and provided opportunities for change, such as COVID-19 and the introduction of National Health Insurance. Conclusion Adolescent and youth mental health has not received the political attention necessary to ensure that action is taken to enhance and protect the mental health of young South Africans. More purposeful efforts to unite the adolescent mental health community and coordinate research, advocacy, policy and implementation efforts are needed to address these challenges. This research provides insight into the current state of adolescent and youth mental health policy in South Africa and potential actions to strengthen adolescent mental health policy development and implementation.