South Africa's adolescents are facing unprecedented mental health challenges in 2026. Understand the signs, the pressures they face, and learn how we can help them through empathy and connection in a digital world.
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A convergence of biological, societal, and economic factors is placing South Africa’s adolescents at higher risk of suicide, yet many adults may not be in tune with the signs of mental health crises in today’s younger generation.
Psychiatrist Dr Abongile Makuluma unpacks the pressures young people are facing in 2026 and provides insights into how life online may be changing how emotions are communicated.
“We have to take adolescent suicide risk more seriously, given the global rise in suicide rates and local factors, including higher trauma exposure and fewer mental health resources in South Africa,” Dr Makuluma says.
“Families and healthcare practitioners should be ever vigilant for subtle signs that children may be struggling. We need to understand that some adolescents don’t have the words to describe their feelings. With so much time spent on social media nowadays, many young people are losing the vocabulary to describe complex emotions and express feelings such as frustration or disappointment.
“There is a danger today that adolescents are increasingly reliant on a limited range of emojis online, depriving them of the ability to fully express themselves in words when accessing support for the numerous pressures our young people are facing,” she points out.
Socioeconomic issues may drive increased exposure to childhood trauma, leaving lasting psychological scars. On top of this, many adolescents face a higher prevalence of substance use in their communities, leading to peer pressure to participate in alcohol and drug use.
“With the legalisation of cannabis, it has become more visible and accessible to school children for whom it remains illegal – and this is for good reason, as the adolescent brain’s prefrontal cortex is still developing,” Dr Makuluma says, who practises at Netcare Akeso Milnerton.
Think of the prefrontal cortex as ‘the CEO of the brain,' the area responsible for planning, making executive decisions, problem-solving, and logic. Damage to this region of the brain during this critical period is associated with interpersonal difficulties or academic setbacks that can influence a person’s life well into adulthood.
“When this part of the brain is still developing and the young person is exposed to neurotoxic substances, such as alcohol or high-potency marijuana, these can contribute to the risk of major mood disorders or longer-term cognitive effects,” she says.
“During adolescence, rationalisation is not yet fully established. When faced with academic and personal stressors, ranging from bullying on social media to parental divorce and peer pressure, young people may not be equipped to find solutions, especially where there is a lack of support from adults in their lives.”
According to Dr Makuluma, the growing inability to express emotions effectively makes it even harder for adolescents in crisis to cope or reach out to their parents. Tragically, some seem to believe that death is the only way out of the situation they face.
“The preference for online engagement through social media means many young people these days no longer enjoy the real-life connections that would otherwise be the first line for children to reach for support or the vocabulary to understand how they are feeling and learn to self-regulate,” she says.
“Compared to previous generations, our young people often have less multigenerational support in the home, with fewer members of the extended family living together, and this has eroded a sense of stability for many adolescents at this pivotal time of transition.”
Dr Makuluma says the prevailing preference for a mainstream, academically focused curriculum is placing many young people under considerable academic stress. “Automation, high unemployment, and higher expectations from the job market are real concerns for the next generation, who are already contending with the youth unemployment crisis. We need to be in tune with the pressures teenagers are facing every day.”
She points out that there is no easy solution. “Multisectoral collaboration is required to address the major societal problem of adolescent and teenage suicide risk. This should equip parents with the support to teach their children skills in emotional regulation, recognise signs of concern, and access help when needed. Parents are also stressed and preoccupied with work, and it’s a reminder that we have to be present for our kids amid the pressures we all face.”
Social withdrawal, changes in eating or sleeping patterns, decline in academic performance, and acting out in ways that seem out of character can indicate a potential cause for concern and would often be noticeable to those closest to them, indicating the need for professional mental health support.
“With educational interventions, learning difficulties can be identified earlier and appropriate schooling initiated, or special academic concessions implemented, to assist young people. Teachers should be empowered to interpret when a learner is struggling, informed by the context of this generation.
“As adults, we need to take notice – whether you are a neighbour, a parent, an aunt or uncle, or a teacher, don’t turn a blind eye to signs of self-harm or weight loss. As community members, if we see substance use among minors, we have a responsibility to address these serious signs of mental health problems that could ultimately cost young people their lives,” Dr Makuluma says.