Peer-Reviewed Paper from Grassroot Soccer Details How Integrating Mental Health and SRHR Is Key to Adolescent Well-Being

Across sub-Saharan Africa, millions of adolescents face overlapping risks – from depression and anxiety to HIV, gender-based violence, and unintended pregnancy. These challenges are deeply intertwined: poor mental health can increase vulnerability to risky sexual behaviors, while issues related to sexual and reproductive health and rights (SRHR) can worsen stress, trauma, and hopelessness. Yet, adolescent health programs often treat them in isolation.

In an increasingly resource-constrained environment, this separation is no longer viable. Integrating mental health and SRHR is not only cost-effective, but also impact-amplifying. When young people gain the tools to manage their emotions, navigate relationships, and make informed choices about their sexual and reproductive health, the benefits multiply across adolescent development outcomes. 

Grassroot Soccer is putting this approach into practice by integrating mental health support into its core sport-based adolescent health SKILLZ programs. A peer-reviewed paper just published in the South African Health Review details lessons learned from this process, which can benefit other organizations’ efforts to holistically support adolescents’ health and well-being.

In 2022, Grassroot Soccer began intentionally building mental health content into its SKILLZ Girl program for girls 15–19 and SKILLZ Guyz program for boys 15–19 at its Centre of Excellence in Alexandra, Johannesburg. This integration process involved co-creating session content with young people to build into the existing curricula; training Coaches on core mental health concepts such as stress, depression, and anxiety; and providing mental health support for the Coaches themselves.

Grassroot Soccer piloted the integrated curricula over two years in Alexandra. More than 4,200 adolescents participated in the programs, and pre- to post-program surveys showed meaningful gains in both mental health and SRHR knowledge among girls and boys alike. For example, girls showed a 14% improvement in knowing where to access contraception, and boys showed an 18% improvement in understanding that stress is a normal part of life.

Grassroot Soccer offers several recommendations for effectively integrating mental health into existing adolescent health programming:

• Seek collaboration with stakeholders across sectors (including direct service implementers, government, civil society, and private sector) to ensure programs are sustainable 
• Meaningfully involve young people in program design to enhance programs’ relevance
• Prioritize training and support for the program facilitators, including supporting their mental health and emotional well-being

Mental health and sexual health don’t exist in a vacuum; they shape each other. This paper shows that integrating mental health content into existing SRHR and HIV programs can improve young people’s knowledge, attitude, and skills in both areas. 

In today’s challenging global health landscape, where budgets are tightening but adolescent needs are growing, integrated models like SKILLZ demonstrate how one investment can generate multiple returns. Addressing mental and sexual health together is both smart programming and smart economics.

Grassroot Soccer is now scaling this integrated approach across Sub-Saharan Africa in 2025 and beyond, building a generation of youth who are mentally strong, sexually healthy, and socially empowered. Our hope is that our experiences detailed in this paper offer practical insights for others. To learn more about this work, contact Grassroot Soccer Research Manager Devyn Lee at [email protected].