'System hackers' needed for women leaving rehab

Women leaving rehab are often defeated by a maze of confusing systems and badly need long-term support and a ‘system navigator’, says University of Auckland PhD candidate Suzette Jackson.

Jackson has just submitted her PhD in social work focusing on a unique drug treatment programme designed for pregnant women and mothers of young children, based in Auckland and funded by Oranga Tamariki.

She says she found some encouraging signs and improvements to the six-month residential programme over the roughly two-year period of her research but has also identified significant gaps.

“What these women need after they leave the programme, is long term, relationship based support,” she says. “They need navigators – or ‘system hackers’ – who understand housing, WINZ, health, education, family violence and addiction, and can walk alongside them across multiple systems for years, not weeks; around five years would be ideal!”

The first-of-its-kind programme allows a small group of mothers dealing with multiple, complex issues, including substance abuse (predominantly methamphetamine), to live in pleasant, peaceful surroundings with their children while receiving treatment, which is a new experience for many, says Jackson.

“All these women are at the ‘apex of need’. Many have already been in the criminal justice system and suffered shocking intimate partner violence, as well as having children taken away from them on multiple occasions; and the majority are Māori.”
 

She says the women arrive with severe addiction and often in extreme poverty, with long histories of violence, housing insecurity and intergenerational trauma.

“One woman didn’t even have a toothbrush. Yet they are still deeply committed to being good mothers.”

As a registered social worker, someone with lived experience of drug addiction and who whakapapa’s Māori, Jackson says she wanted to approach her research from a te ao Māori perspective and integrate traditional weaving (harakeke) into her interview sessions.

Working with a Māori weaving teacher, Jackson designed six one day weaving wānanga, where she conducted in depth, conversational interviews with programme participants, focused on their lives before treatment, during the programme and after leaving.

“The weaving space was a ‘third space’,” she says. “The usual treatment rules didn’t apply. Women could swear, talk about staff, talk about violence and relationships. It was confidential, culturally grounded and, crucially, they loved it. They created taonga they could gift to their children or whānau and felt a real sense of pride.”

Jackson believes the reason the women responded so well was because she saw them as women first and mothers second, whereas our system views them predominantly as mothers and focuses on the children.

“If you properly resource and support the mother as a human being, you support the child – and often other children as well; their previous children, for example, who might not be living with them, and any future children. We’ve got it the wrong way round,” she says.

Other issues she noted included the fact that the women had very limited access to safe spaces within their usual treatment programmes to talk about partner violence and abuse, they often lacked safe accommodation to return to, and also how ‘surveilled’ they felt as mothers, both in general, and also within the programme itself.

This last, she says, made them afraid to be honest about their issues for fear of losing their children and constantly expecting to be judged and blamed as ‘bad mothers’.
 

She also became aware of what she believes is a serious lack of education about substance use and family violence in social work training, despite these issues being present “everywhere, in every service.”

Jackson says she saw success stories come from intensive, woman centred support, which not only led to stabilised recovery, but in some cases to children able to return from state care and mothers going on to a course of study. Some even returned as support workers to the same service that helped them.

Overall, says Jackson, it’s obviously a good thing that a designated service for mothers and children of this kind exists and has been evolving to better meet its participants’ needs.

However, her PhD makes a strong case for expanding residential treatment focused specifically on mothers as women first, as well as establishing a much longer support period after rehab and a designated ‘navigator’ to help with the complex systems that just seem overwhelming.

“There needs to be more support for women coming into services and then leaving them, to help them navigate the community and build their own mothering communities; and this requires support from services, and resourcing from the state.”

Publications
Jackson, S. (2025). Navigating mental health services as an (im)perfect service user.  Journal of Psychiatric and Mental Health Nursing

Jackson, S. C., & Chubb, L. A. (2025). ‘I can sleep at night’: examining the intersection of housing stability, addiction, and recovery among mothers who use drugs. Kōtuitui: New Zealand Journal of Social Sciences Online.