Waves for Change is a mental health prevention programme combining surfing with evidence-based mind-body therapy for youth from adverse environments in South Africa. Through access to safe spaces, caring and consistent coaches, and weekly surf therapy sessions, annually 2 500 children learn the skills to cope with stress, regulate behaviour and build positive relationships. Surf therapy is delivered by young adult coaches from local communities who youth can relate to easily. The programme offers an accessible stigma-free blueprint for embedding interventions to address mental health.