Sarah Hetrick: why connection counts in youth mental health

When Sarah Hetrick was 14 years old, she lost two classmates to suicide.

“I have hazy memories of being in a classroom and being told what had happened, and of the funerals,” she says. “It was bewildering and devastating.”

Although she didn’t realise it at the time, the experience would eventually lead to a career devoted to understanding how young people experience distress and what helps them through it.

Today, Sarah is a professor of youth mental health at the University, where she is co director of Te Ata Hāpara Centre for Suicide Prevention Research. They’re responsibilities she balances with work as a registered clinical psychologist. In September, she also became research director of Growing Up in New Zealand (GUiNZ), the country’s largest contemporary longitudinal cohort study of child development.

The theme of this year’s Mental Health Awareness Week is ‘Belonging Matters’, highlighting how opportunties to belong strengthen our well-being and communities.

Through decades of clinical and research experience, Sarah agrees that creating a strong sense of connection is vital for fostering youth mental health.

“Knowing there are people around who care, who will notice, who will support young people if they need it, that goes a really long way,” she says.

A belief in young people is also crucial. “They’re creative, open and have solutions. Adults often treat them as if they have nothing to say or contribute, but that is not the case,” she says.

“I think it’s about giving voice to those who have often not had a voice.” 

Combining clinical work and research

Growing up in Lower Hutt, Sarah was initially interested in law, which she began studying at the University of Auckland. But psychology soon captured her attention and ultimately changed her life’s course.

Undertaking her BA and MA in psychology in the 1990s, she was increasingly interested in mental health and human behaviour.

“It was only once I started studying psychology that I became deeply interested in suicide prevention,” she says.

Her pathway into academia, however, wasn’t direct.

After graduating, Sarah worked at the Health Research Council of New Zealand, where she was introduced to public health research. Later, she worked in one of the University-based Cochrane Systematic Review groups, developing expertise in systematic reviews and evidence synthesis.

At the same time, however, she remained determined to become a clinical psychologist. She completed a Postgraduate Certificate in Health Science in Child and Adolescent Psychiatry at the University, and later moved to Australia, where she undertook a Doctorate in Psychology (Clinical) at Monash University in Melbourne.

Sarah has since built a career that combines clinical work and research. The former, she says, gives her firsthand insights into the challenges faced by young people and their families; the latter allows her to investigate treatments, interventions and systems that make a difference.

Her time in Australia included a National Health and Medical Research Council training fellowship at pioneering youth mental health organisation Orygen, University of Melbourne, undertaking research into youth depression and suicide prevention. She also worked as a clinical psychologist for Headspace, Australia’s national youth mental health foundation.

“Rather than a clinical psychologist, I probably should have been a youth worker,” she says with a laugh. “I’ve just always enjoyed young people.”

She returned to New Zealand in 2017 to take up a role as an associate professor of youth mental health at the University’s Department of Psychological Medicine (through an Auckland Medical Research Foundation Douglas Goodfellow Repatriation Fellowship). She has continued combining research, clinical expertise and policy work ever since, including working within the Suicide Prevention Office at Manatū Hauora Ministry of Health, helping inform national approaches to suicide prevention. 

Making a difference

Sarah’s leadership in youth mental health research is recognised internationally. Much of her research focuses on evaluating interventions for young people experiencing mental distress, and examining the broader social and structural factors that influence well-being.

For example, in studies involving more than 950,000 young people she and colleagues examined how physical and natural environments influence mental health. The research showed better mental health outcomes when young people had less exposure to health-constraining features, such as alcohol outlets, and greater access to natural spaces, such as parks, forests, rivers and coastal areas.

One project Sarah is currently leading is the Trans-Tasman Internet-delivered Prevention of Youth Suicide trial. The project is evaluating three smartphone apps with 1,480 young people across New Zealand and Australia.

Two of these apps were developed in New Zealand: Bro Reach Out, a suicide-prevention chatbot co-designed with rangatahi Māori; and Tune In, a goal-setting app designed to strengthen well-being through small, achievable actions.

“We’ve co-designed those interventions with young people, acknowledging their lived experience and expertise,” she says.

The research has found that young people want technology to strengthen relationships rather than replace them. One result was the development of Bro Reach Out’s ‘Wall of Strength’ feature, which allows users to collect photos, messages and memories that reinforce connections with whānau and friends.
Early intervention remains another major focus of her work.

As a co-director of Te Ata Hāpara Centre for Suicide Prevention Research, Sarah helps lead a number of projects. These span self-harm and suicide prevention in schools and other educational settings; support for families caring for distressed young people; risk-assessment practices in clinical services; and support for schools and communities following a suicide. 

Growing up together

As the recently appointed research director of GUiNZ, she is leading the landmark study that has followed the lives of more than 6,000 children since 2009 and 2010. The study is now tracking the participants’ transition into adulthood.

“I am excited to lead Growing Up in New Zealand into its next chapter, as participants enter emerging adulthood – a pivotal life stage that will shape their future health, well being and opportunities,” she says.

The role also holds personal significance for the mother of Luca, 17, and Zara, 14.
“What makes this study particularly special for me is that my teenagers are the same age as the Growing Up in New Zealand participants, and I see firsthand both the opportunities and challenges facing young people today.

“I love watching that process unfold as young people begin to understand who they are, where they fit and what gives their lives meaning.”

And her research reinforces something she sees at home: “They do want their parents. It might not always seem like it, but they want us to be available when they need us.”

Staying connected can mean stepping into her children’s world.

“I’ve had to tolerate a bit of dubious music,” she says. “I took my daughter to a concert I wasn’t interested in at all, but I absolutely loved it. I’m now a huge fan.”

It can also be found in the routines of everyday family life. Sarah gets up early to make breakfast and pack lunches, valuing the conversations that happen before everyone heads in different directions. Breakfast is often the one time of day everyone is together, a chance to connect and check in.

Many years after the deaths of two classmates left a bewildered teenage Sarah searching for answers, she remains focused on helping young people feel connected, supported and valued.

“It’s the showing up daily, isn’t it? You consistently show up for your kids. You make them breakfast, pick them up and take them places. It’s those shared moments that really matter.”

- Caryn Wilkinson