In Ghana, about 13% (~ 4 million) of the population suffers from a mental disorder, ranging from mild and moderate (7%) to severe forms (3%) of mental illness. However, treatment gap for mental disorders, including depression, remains unacceptably high: only about 2% of those diagnosed with a mental disorder receive treatment. This descriptive cross-sectional study investigated the levels of perceived need for mental health care in high school students with depression. Three hundred and thirty (330) students were recruited from the Salaga Senior High School (SHS) in the East Gonja Municipality, Ghana, using systematic sampling technique. The Patient Health Questionnaire (PHQ) 9 and the Perceived Need for Care Questionnaire (PNCQ) were used to collect data for the study. Data analysis was performed using Statistical Package for Social Sciences (SPSS) version 25. Male students formed the largest proportion of the study sample (54.8%). More than half of the respondents (55.8%) were in SHS 1 and the majority of them (79.4%) were residents in their school’s hostels. Moderately severe and severe forms of the disease were found in 15.2% and 9.1% of the respondents respectively. Overall, prevalence of depression was 57.9%. Approximately, only 1 in 5 students with depression had met needs for pharmacotherapy (19.4%) and counseling/psychotherapy (19.9%). The majority of students in the present study suffered from depression, yet, had high unmet needs for care. This finding suggests that a gap may exist between service need and engagement in high schools, hence, the need to scale-up mental health services and resources to SHS in Ghana.