JMIR Publications

ABSTRACT

Background:

The mental health and psychosocial support needs of adolescents and young adults (AYA) in KwaZulu-Natal (KZN), South Africa (SA), as in other parts of the world, are inadequately addressed. National policies to address mental health among AYA exist, such as the Integrated School Health Policy (ISHP) and the Screening, Identification, Assessment, and Support Policy (SIASP). However, implementation gaps persist, particularly in mental health screening, service access, and care coordination.

Objective:

This protocol paper describes the methods used to co-design strategies to enhance existing mental health and psychosocial support care models for AYA, leveraging resources from the Asenze study, a population-based prospective cohort in peri-rural KZN, SA. The study uses a Human-Centered Design (HCD) approach to engages young adults, caregivers, and mental health service providers with the aim of improving mental health for AYA by: (1) identifying needs and barriers, (2) developing context-relevant solutions, and (3) refining a co-designed implementation strategy.

Methods:

A three-phase HCD co-design process is being undertaken, which also uses quantitative and qualitative multi-methods. Participants include: 15 young adults recruited from the Asenze study who screened positive for common mental health conditions during adolescence or young adulthood, 13 caregivers recruited from the Asenze study, and 16 implementation partners from KZN, SA. Phase 1, Discover, includes: a systematic literature review to understand the landscape of evidence-based interventions to improve mental health outcomes among AYA in Sub-Saharan Africa, describing the current gaps and needs of AYA through analysis of data from the Asenze study, and HCD workshops with young adults, caregivers, and implementation partners to understand: existing mental health and psychosocial support services, mental health and psychosocial support needs of AYA, potential evidence-based intervention options and implementation strategies, as well as determinants of implementation. Phase 2, Design, includes: two separate HCD workshops with young adults and caregivers to co-develop a context-specific mental health and psychosocial support implementation strategy. Phase 3, Build, includes: two separate HCD workshops with the young adults and caregivers, to refine the co-designed implementation strategy, and a consultation workshop with implementation partners to review the feasibility and acceptability of the proposed implementation strategy. A qualitative thematic analysis approach is being used, which allows for inductive and iterative exploration of patterns emerging from the data collected during the HCD workshops.

Results:

The study was funded in 2024, and ethics approval received in March 2025. Enrolment was completed in April 2025, and data collection is being conducted between May 2025 and January 2026. Data analysis is currently underway, with initial results expected to be submitted for publication in early 2026.

Conclusions:

The study aims to produce a co-designed implementation strategy for providing mental health and psychosocial support to AYA that is adapted to the local context. Clinical Trial: Not Applicable.