Adolescence is a critical period of development characterized by significant psychological changes and challenges. In South Africa, universities serve as hubs for academic learning and research, but they also provide essential services to support students' mental health. The study employed a qualitative approach involving a comprehensive literature review, surveying university administrators, and interviews with student support staff. Data were analysed using thematic analysis to identify common themes and patterns of service utilization. A key finding was the underutilization of mental health services by students, particularly in rural universities where access barriers are more pronounced (45% reported no use). Despite growing awareness about adolescent mental health issues, there remains a substantial gap in accessing appropriate support services. Universities need to implement targeted interventions and policies to enhance service utilization. University administrators should prioritise the integration of mental health education into curricula and advocate for more accessible and culturally sensitive services. Collaboration with community-based organizations can also improve service provision. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.