Purpose Mental health concerns among students in South African universities have grown more severe in recent years, influenced by inequalities in access, institutional cultures and wider socio-economic pressures. Despite this, dominant mental health responses in higher education remain predominantly top-down and often neglect students’ lived experiences and diverse cultural identities. This paper aims to deepen the understanding of how participatory methods can act as transformative approaches for reimagining mental health support in university settings. Design/methodology/approach The study draws on empirical reflections and Participatory Action Research (PAR) conducted at two South African universities. Through narrative interviews, photovoice, social media-based photovoice and engagement with culturally grounded support systems, the research examines how participation functions not merely as consultation but as co-creation of mental health practices. Findings The study concluded that participatory approaches enhance students’ sense of belonging, agency and resilience. Peer-led initiatives and culturally rooted practices, including communal forms of care, proved vital in addressing the limitations of traditional, individualised mental health frameworks. These participatory activities empowered students to articulate contextually relevant strategies and to challenge institutional cultures that inadvertently perpetuate exclusion. Practical implications The results indicate that universities should move beyond individualised, clinical models of mental health support and adopt participatory, culturally grounded approaches that involve students as co-creators of well-being initiatives. Such approaches have implications for institutional policy, student affairs practice and inclusive governance in higher education. Originality/value The paper demonstrates that involving students and other stakeholders in decision-making can shift campus mental health initiatives from a narrow focus on individual treatment towards broader, community-centred well-being. This aligns with national objectives for social justice and transformation in higher education and offers a more inclusive approach to mental health policy and practice.
Lebogang Khoza (Tue,) studied this question.