As part of their work, the SAFMH National Youth Advocacy and Advisory Forum are encouraged to take up advocacy initiatives that are meaningful to them. Onthatile Tuta [Gauteng] wrote the below key ask document as part of her advocacy for youth-informed community-based mental health responses.
Onthatile said: “I chose to focus on Not in Education, Employment or Training (NEET) youth because they are one of the most excluded and overlooked groups in South Africa, despite facing a disproportionately high risk of mental health challenges and suicide. What stood out for me in the research was how deeply structural inequalities like poverty, inaccessible services, and social disconnection drive their distress, and how little current systems are doing to meet their specific needs. This highlighted the urgency of youth-informed, community-based mental health responses.”
SUMMARY
South Africa is facing an urgent and growing youth mental health crisis, particularly among young people who are Not in Employment, Education or Training (NEET) (Mudiriza & De Lannoy). This group-typically aged 15 to 24- is disconnected from formal economic and educational systems, rendering them especially vulnerable to social exclusion, economic insecurity, and psychological distress (Mudiriza & De Lannoy, 2023). Research shows that NEET youth face significantly higher rates of depression, anxiety, self-harm, and suicidal ideation than their peers who are employed or in school (Mhlaba et al., 2025).
Despite the scale of this challenge, current health and social service systems are not designed to respond to the unique needs of this population (De Lannoy, 2023). Youth mental health remains underfunded, under-prioritised, and difficult to access-particularly in underserved communities, where most NEET youth reside (De Lannoy, 2023).
This document outlines a set of recommendations for the Department of Health, in coordination with the Department of Employment and Labour, to lead a proactive, cross-sectoral response. The recommendations centre on community-based outreach, expansion of youth-friendly services and engaging NEET youth in co-designing interventions.
BACKGROUND: A YOUTH MENTAL HEALTH EMERGENCY
The NEET Crisis in South Africa
South Africa has one of the highest NEET rates in the world, with an estimated 3.37 million young people falling into this category (Stats SA, 2024). NEET status is not merely a reflection of joblessness or educational exclusion; -it is a symptom of deeper structural inequality, shaped by poverty, spatial disadvantage, and historic disinvestment in public infrastructure. Roughly 70% of NEET youth live in low-income households, where food insecurity, social isolation, and limited access to healthcare are parts of their daily life (Mudiriza & De Lannoy, 2023).
Mental Health Risks Among NEET – (and formerly NEET) Youth
Emerging evidence underscores the intense psychological burden associated with being NEET and formerly NEET.
The intersection of poverty, social disconnection and untreated mental health conditions places NEET youth at a heightened risk of suicide- particularly in underserved areas where formal care systems are inaccessible or non-existent (De Lannoy, 2023). Addressing this crisis requires urgent investment in community-level mental health services, targeted suicide prevention and improved systems to inform policy and measure progress.
Former NEET youth also face elevated mental health risks. A landmark study by Mhlaba et al. (2025) found that one in three NEET youth engaged in employment programmes reported suicidal thoughts or self-harming behaviours, while rates of depression and anxiety were especially high among those under 25. Crucially, the research showed that mental health challenges often persist even after exiting NEET status; This reinforces the need for early intervention and long-term psychosocial support for former NEET youth, too, perhaps as part of employment programme offerings and support (Mhlaba et al., 2025).
Key Asks
- Prioritise Community-Based Mental Health Outreach for NEET Youth
NEET youth are disproportionately concentrated in underserved communities where access to essential public services such as healthcare, education and transport is limited or non-existent (Mudiriza & De Lannoy, 2023). In these environments, formal mental health services are often inaccessible, increasing the risk of untreated psychological distress and suicide (Mudiriza & De Lannoy, 2019). A community-based, proactive outreach model is urgently needed to bridge this gap, to reduce stigma and support young people where they are (De Lannoy, 2019).
Recommended actions:
- Provincial Departments of Health to deploy mobile mental health units in high-need provinces (e.g.; Gauteng and the Eastern Cape) to provide free counselling, suicide risk assessments and referral services (Wits University, 2022)
- Provincial Departments of Health to establish community-based outreach hubs in trusted local spaces (-e.g. libraries, sports fields and youth centres)- through partnerships with municipalities, NGOs and youth-led organisations.
- Train community health workers in suicide prevention and psychological first aid, using tools such as WHO’s Mental Health Gap Action Programme (mhGAP) and the Youth Mental Health Toolkit, equipping them to deliver effective, low-resource care for mental, neurological and substance use (MNS) conditions (WHO, 2022).
- Expand Access to Free, Youth-Friendly Mental Health Services
NEET youth often face multiple barriers to accessing mental health care, including financial constraints, long travel distances, stigma and fear of discrimination (De Lannoy, 2019). Services must be youth-centred, trauma-informed and designed with accessibility and cultural relevance in mind.
Recommended actions:
- The National Department of Health to strengthen primary healthcare facilities in low-income communities to deliver age-appropriate, youth-sensitive mental health support, including screening, early intervention, and referrals.
- The Department of Health, the Department of Employment and Labour, and the Department of Women, Youth and Persons with Disabilities to launch a national public awareness campaign targeting NEET youth, to promote available free and confidential mental health services-such as helplines, digital platforms and drop-in clinics-through social media, radio and community networks.
- Actively Engage NEET Youth in Co-Designing Interventions
NEET youth are the experts of their own lived experiences, yet their voices are often absent from policies and programs meant to serve them (De Lannoy, 2019). To ensure interventions are relevant, accessible and effective, NEET youth must be included as active partners in designing, implementing and evaluating mental health initiatives (De Lannoy, 2019).
Recommended actions:
- Non-governmental organisations and community-based organisations to partner with youth-led organisations and community groups to co-create peer support programmes, awareness campaigns and safe spaces for mental health dialogue.
- Non-profit organisations and research councils to incorporate participatory research methods (e.g., focus groups and storytelling workshops) to capture NEET youth’s perspectives on barriers to care and preferred solutions.
- The Department of Women, Youth, and Persons with Disabilities to train policymakers and service providers in youth participatory approaches to ensure NEET youth are not merely consulted but empowered as decision-makers in programmes affecting their lives.
- Integrate Mental Health Support into Youth Employment Programmes for former NEET youth
Recent evidence (Mhlaba et al., 2025) highlights that one in three NEET youth participating in employment initiatives report suicidal thoughts or self-harm, underscoring that economic participation alone does not resolve underlying psychosocial distress. Without embedded mental health support, employment interventions risk overlooking a critical determinant of sustained wellbeing.
Recommended actions:
- The Department of Employment and Labour to integrate mental health support as a formal component of all youth employment and skills development programmes- especially those targeting former NEET youth.
- The Department of Employment and Labour to allocate budget for on-site or embedded mental health personnel (e.g.; registered counsellors, social workers, peer supporters) within funded employment initiatives.
- The Department of Employment and Labour to partner with mental health NGOs and universities to develop psychoeducational toolkits and training for programme staff on how to identify and respond to distress, especially among young people entering the workforce.
South Africa’s NEET youth are caught in a cycle of structural exclusion, poverty and unaddressed mental health challenges-placing them at exceptionally high risk of suicide and long-term psychosocial harm (Mudiriza & De Lannoy, 2023). The Department of Health, in partnership with the Department of Employment and Labour, must act swiftly to implement a community-based model of care that prioritises outreach, access, and prevention. By addressing the root causes and mental health needs of this vulnerable group, South Africa can take a critical step toward safeguarding its future generation.
References
- Mudiriza, G. and De Lannoy, A., 2023. Profile of young people not in employment, education or training (NEET) aged 15-24 years in South Africa: an annual update. Available at: WP 298: Profile of young people not in employment, education or training (NEET) aged 15-24 years in South Africa: an annual update
- Mhlaba, M., Mohitshane, T., Mnisi, N., Nevhufumba, E., Torres, G., Zech, F., Jooste, C., Vermeulen, B. and Ware, L.J, 2025. The health status of South African youth joining Youth Employment Initiatives: a health promotion opportunity. Health Promotion International, 40(3). Available at: The health status of South African youth joining Youth Employment Initiatives: a health promotion opportunity – PubMed
- Gariépy, G., Danna, S.M., Hawke, L., Henderson, J. and Iyer, S.N., 2022. The mental health of young people who are not in education, employment, or training: a systematic review and meta-analysis. Social psychiatry and psychiatric epidemiology, pp.1-15. Available at: The mental health of young people who are not in education, employment, or training: a systematic review and meta-analysis – PubMed
- De Lannoy, 2019. Towards a Basic Package of Support for Young People who are not in Employment, Education or Training (NEET) in South Africa. Available at: bps-summary-report-14-05-2020-for-web-1.pdf
- Statistics South Africa, 2024. Quarterly Labour Force Survey (QLFS) – Q4: 2023. Pretoria: Statistics South Africa. Available at: pdf
- Wits University. 2022. Mental health in SA is at shocking levels but people are not seeking help. Available at: https://www.wits.ac.za/news/latest-news/research-news/2022/2022-11/mental-health-in-sa-is-at-shocking-levels-but-people-are-not-seeking-help-.html
- World Health Organization, 2023. Mental Health Gap Action Programme (mhGAP) guideline for mental, neurological and substance use disorders. World Health Organization. Available at: Mental Health Gap Action Programme (mhGAP) guideline for mental, neurological and substance use disorders
