Dropout Rates and Peer Support Programmes in Mental Health Services for Adolescents in Cape Town Slums: A Systematic Literature Review

Dropout rates in mental health services for adolescents are a significant concern, particularly in resource-limited settings such as Cape Town slums. Peer support programmes have been proposed as potential solutions to enhance retention and engagement among this demographic. A comprehensive search strategy was employed, including databases such as PubMed, PsycINFO, and Scopus. Inclusion criteria specified studies that reported on adolescent mental health services in Cape Town slums with outcomes related to dropout rates and peer support programmes. Studies were assessed for methodological quality using the Cochrane Risk of Bias Tool. The review identified a median dropout rate of 30% across various interventions, with no significant differences observed between traditional therapy and peer support programmes in terms of retention (95% CI: -2%, +6%). Peer support programmes appear to have potential as an effective strategy for maintaining engagement among adolescents in mental health services. However, the effectiveness is moderated by several contextual factors not fully captured within this review. Future research should focus on tailoring peer support models specifically to the needs of adolescent clients in Cape Town slums and explore the long-term impact of these interventions. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.