We are in the midst of a deepening global adolescent mental health crisis. One in four adolescents are currently experiencing clinically relevant depression symptoms. In South Africa, due to the heavy burden of many social determinants for poor mental health - conflict, exposure to violence and trauma - 55% of youth are seen as medium-high risk for mental health problems. The problem has broad implications for other health challenges including losing ground in the fights against HIV, gender-based violence, and unwanted pregnancy. However less than one in 10 affected have access to care and where limited services do exist high levels of stigma reduce health seeking behaviours. The School of Hard Knocks addresses this urgent need by using a proven combination of psycho-social counselling from supportive adults and life skills through rugby coaching to challenge, engage, motivate and inspire vulnerable youth from violent communities, with data showing that they leave school with increased wellbeing, a sense of achievement and raised aspirations for their future.