São Tomé and Príncipe is a small island nation in West Africa with significant urban refugee populations. Studies on mental health support for these youth are limited, particularly focusing on telemedicine platforms. A mixed-methods study combining quantitative surveys with qualitative interviews. Data were collected from urban refugee youth aged 15-24 who used telemedicine platforms for mental health support between and . Engagement rates varied significantly, ranging from 60% to 85%, with higher engagement among younger participants (aged 15-17) compared to older participants (aged 18-24). Telemedicine platforms played a crucial role in engaging urban refugee youth and reducing depression symptoms. However, challenges such as internet access and language barriers need addressing for broader impact. Enhance digital literacy training for youth users to improve engagement rates, particularly among younger participants. Address infrastructure limitations by investing in broadband networks.