Mental health disorders and substance abuse are major causes of disability worldwide [1] and the leading causes of years lived with disability (YLDs) among all disease groups [2]. In particular, young children and adolescents (aged between 10 and 24 years) are deeply affected by this problem [3], with as many as 20% developing serious common disorders, such as depression and anxiety, or other severe illnesses like bipolar disorder, schizophrenia and psychosis, as well as abuse of alcohol and other substances [4]. In sub-Saharan countries in Africa, key adverse conditions are known to increase the prevalence of mental illnesses and dramatically influence the abuse of legal and illegal drugs. Years of civil conflicts [5], gender-related prejudice, unemployment and poverty are major drivers that have contributed significantly to the rise of mental health diseases, hampering social development and decreasing the quality of life of children and adolescents [6, 7]. Moreover, childhood physical, emotional and sexual violence are also known to predispose children to mental health disorders [7, 8]. This article will discuss the prevalence of mental health disorders in the context of West and Central Africa (WCA), in particular their socioeconomic impact, the current efforts in mitigating such problems, and future foci in supporting children and adolescents in WCA.