Background <p>Adolescent mental health (MH) is increasingly recognized as a critical component of sustainable development (SD); however, awareness and utilization of MH services among adolescents remain limited in many communities. This study aims to examine adolescents’ awareness of mental health issues and their perceptions of its role in sustainable development.</p> Methods <p>A cross-sectional survey design was employed to collect data from adolescents in six senior high schools located in the Eastern Region of Ghana. A total of 424 adolescents were sampled using both stratified and simple random sampling techniques. A self-developed questionnaire was utilized, and data were analyzed using IBM SPSS version 24.</p> Results <p>Adolescents reported high recognition of common MH issues (≈ 90% for depression/anxiety/stress) but lower recognition of schizophrenia (74%) and bipolar disorder (78%). A majority were unaware of adolescent-specific MH services (69%). No significant gender difference was observed in MH–SD perceptions after accounting for unequal variances (<i>p</i> = 0.10).</p> Conclusion <p>There is a need for targeted mental health education and policy interventions to enhance awareness, improve accessibility, and integrate mental health services within sustainable development frameworks and educational curricula. Addressing these gaps is essential for advancing adolescent well-being and promoting long-term social and economic progress.</p>