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First Step newsletter: Winter 2021

Although the tight lockdown has eased in Victoria, we are still navigating restrictions that mean we can’t connect with our family, friends and community the way we would like to. But now, more than ever, it’s important that we do connect.

It’s Men’s Health Week and the focus this year is on what it means to have a team, to stay connected and seek support early if something is wrong.

Aussie men make up the majority of premature deaths, have a lower life expectancy, a higher rate of suicide, and double the rate of heart disease, than women. There are a complex range of social and behavioural factors and barriers that influence this, which Dr Niall Quiery explores in his article, “Who’s on your team?”

Do you remember our International Harm Reduction Day Appeal? With your support we raised an impressive $49,340! This crucial funding means we can be there for people when they need us, to keep them safe, engaged and empowered to make better health choices.

We absolutely rely on the support of our community to do the work we do, to be the safe place people come to in their recovery journey. For some, it’s their only place.

We need your help to make sure we can keep connected, keep being a beacon of hope, and keep being the safe place for the 2,000 clients we see each year. As we approach the end of financial year, please consider making your tax deductible donation to First Step.

Patrick Lawrence
Chief Executive Officer

Who's on your team?

Did you know that the life expectancy for men is 4 years less than for women?

It is no surprise when you consider some of these facts:

•   Men are 32% less likely to visit a health professional
•   Men are less likely to seek therapy if they are feeling down, or anxious
•   Men experience higher rates of suicide and motor vehicle accidents
•   Men are more likely to drink excessively and smoke
•   Men are more prone to serious health conditions, such as heart attacks and diabetes

To turn this around, we need to understand why men don’t look after their health enough.

1. In many cultures, concepts about masculinity often make men feel pressured by societal expectations to appear strong, self-reliant and emotionally guarded.
2. Men take, and tolerate, more risks than women, so they present to the doctor later in the course of an illness.
3. Many men in their 30s stop exercising regularly, or participating in club sports, and instead become spectators. And in Australia, alcohol is frequently embedded in sports culture.
4. Men and women engage differently. Research has shown that women will volunteer information to a doctor, whereas men have to be asked.
5. Men often require prompting from a partner or friend to seek medical support.

At First Step, we dedicate a lot of time to forming relationships with each man. It’s a little bit like fishing – we put out a line and slowly reel them in, over time engaging at a deeper level!

We work hard to create a place where men feel comfortable and feel good that they came. We support them to set short, medium and long term goals that they want for themselves, that they can achieve incrementally. We address diet, exercise, self-esteem and healthy lifestyle choices. We support them – we accompany them.

We understand that the experiences of men differ to those of women, so we focus on engaging them in a different way. We encourage them to value their health so that they can live a fuller life, whether that be work, hobbies or meaningful connections with family and friends. And we encourage men to prioritise their health by staying connected and seeking support early if something is wrong, from a team of people who care about their wellbeing.

So, who’s on that team?

Obviously, we are. We help look after their physical and mental health and connect them to psycho-social services. But many of our clients have other people in their lives who want to see them get better. Trusted friends or family members to stay socially connected with. Teammates they can stay physically active with, colleagues they can eat healthy lunches with, or other people they meet along the journey.

This year, Men’s Health Week focuses on what it means to have a team. Who’s on your team?

Dr Niall Queiry
General Practitioner
First Step

It's never too late to change direction

The first time I drank to black out, I was 14.

By then, I was already bulimic.

As the only child of an emotionally distant single mother who failed to protect me from the men in her life, it was the only way I knew how to lock up the feelings and experiences that were happening to me.

I could not wait to escape home at 18 but was not prepared for life on my own. I found myself working night shifts in hospitality, using drugs to keep me awake, and drinking to black out.

I had no idea who I was. Each crowd I fell in with, I moulded and adapted myself to them, searching for acceptance and love. But inside, the anxiety would torment me, and I would muzzle it with alcohol and drugs.

Until I found out I was pregnant, and not long after, delivered my son at 26 weeks. This was a time of extreme stress and strain, but I managed myself without taking drugs or drinking, and I felt proud.

But it was not long until I relapsed.

In 2013, I met my husband. This was the first healthy, functional relationship I had ever had. I felt loved. But I also felt that I did not deserve it.

At the age of 43, I unexpectedly fell pregnant with twins. The pregnancy was complicated, and I delivered my girls at 29 weeks. This time, I did not cope and began drinking regularly.

I felt isolated and alone. My children were quite boisterous and difficult to manage, so we rarely went out. Every day was Groundhog Day and to escape this, my drinking escalated. I was self-medicating to cope.

Over the next two years, I accumulated a significant credit card debt which was primarily all spent on alcohol. Then the Department of Health stepped in, and I feared that I would lose my children.

I started to seek help – I went to AA meetings, spent 3.5 months in a rehabilitation facility and three stints in detox. But each time I would relapse. I couldn’t understand – I did everything they asked me to do. What was wrong with me? Why wasn’t it working?

Meanwhile, I was spiraling out of control. My husband was supportive, but did not know how to help me, or protect himself and the children. On one occasion I was admitted to emergency because I was suicidal, on another, with alcohol blood levels so high I was at risk of going into a coma.

I didn’t know what to do, but I was sure I could not return to residential rehab. I couldn’t quit my new job – it was stimulating me and allowing me to financially contribute to the family. And I couldn’t bear to be without my children for another 3.5 months. But I was putting them at risk, and I was going to lose my husband.

Then I found ResetLife at First Step.

ResetLife is a day program that allowed me to continue working and being with my children. It was the answer I was looking for.

Up until this point, I felt like I was carrying around an empty toolbox. ResetLife filled it up with tools that I could use in daily life. And I learnt that alcoholism is a disease that does not make logical or rational decisions.

If I had not learnt this, had not filled my toolbox, I would still be in the cycle of relapse.

Now when I am faced with challenges, I allow myself to feel emotions, to experience what is happening to me, with the knowledge that I know how to manage them, to move through them, and to implement practical steps. I use the tools that I learnt at ResetLife.

I want to be totally present and available for my children. To be the mother I wished I had. I want them to grow into happy, healthy, secure adults who make wise decisions. Who know that it’s never too late to change the direction their life is taking.

ResetLife educated me. That was this missing piece. It provided support to me and my husband and showed me that I can live a life of abstinence. I was able to make meaningful connections in a safe space whilst staying at home with my children and in my job. Now I have inner peace, gratitude and hope for the future. Hope that I can break the generational cycle of addiction. And hope that my family and I can lead full, happy and healthy lives.

This disease will not bring me down.

To protect my privacy, Emma is not my real name. But this is a picture my 5 year old daughter drew of our family.


People recover in the context of relationships

“People recover in the context of relationships” - we’ve all experienced this. When we go to the doctor, we don’t just want someone who knows how to use a stethoscope, we want a human being, preferably one who knows us well and cares about us.

This need is especially acute in people with complex mental health needs who have so often been disappointed by authority figures and ‘the system.’ During a consultation, the individual needs to know that they matter, and nothing says that better than a health professional that is there for the long haul, with no threat of a future cut-off date.

The mental health system is highly focussed on ‘episodes of care’ (if you’ve never heard that term then you’re lucky), at the end of which a person might be stepped up or stepped down, to another provider, in another organisation, or no provider at all.

However, we know full well that recovery from mental ill-health is non-linear. Good days and bad days, good months and bad months. The idea that someone should be constantly transitioning in, and then being pressured to transition out of care goes against what it means to have a healthy community.

At First Step, as much as is humanly possible, we maintain long-term, years-long therapeutic relationships with clients. There may be periods of high acuity (frequent support from a multi-disciplinary team) and periods of little or no contact.

Of course, we want people to recover and no longer need our services but wishing doesn’t make it so. We are concerned that some areas identified for considerable (federal) government spending such as the Adult Mental Health Hubs ($400M+) will only provide short or medium-term support, which will exclude complex clients and people with histories of trauma. It’s not good enough.

In the meantime, we’ll do what we do and try to make a fair bit of noise about it to inspire others and inform government models.



Towards reform: looking at how to provide effective care

We are proud to announce that First Step has been appointed as lead agency for the Victorian Department of Health Integrated Care Capability Pilot. This pilot will test the implementation of a Comprehensive Continuous Integrated System of Care (CCISC) across 10 organisations in greater Melbourne.

What are the implications of this?

For us at First Step, it means progress. Perhaps even better, it means hope.

That might sound dramatic, but for the 100,000+ people in Victoria each year that desperately seek treatment for complex mental health and addiction issues, this pilot is the first small step towards reform and improvement, in a system that has long struggled to provide effective care. The pilot extensively references findings from the recent Royal Commission into Victoria’s Mental Health System in its design – a very welcome sign of change.

The CCISC Pilot provides a framework with which to examine what happens each time our organisation(s) come in contact with a client, and then explores ways to improve each of those interactions. It draw’s deeply on the experience of people that currently use, or have used, ‘the system’.

That’s exciting because it means we have a better chance of providing services that truly meet the needs of people in our care. Services that foster a sense of hope for the future, and then actually deliver.

It is a collaboration of 10 organisations who will individually and collectively work through the challenges of this process, supported by the Department of Health and several significant industry experts. It represents an opportunity to streamline the way our services communicate with each other, reducing the risk of people ‘falling through the gaps’. If done right, it represents an immense opportunity to leverage the expertise of each other for our own organisational growth, specifically for the benefit of the people in our care.

This is a principle that we employ at First Step every moment of every day. We know how powerful it is when you get committed people collaborating on a challenging issue. Good things happen. Are we excited by the chance to employ that at an organisational level? Absolutely!

The very nature of a pilot is exploratory, and this one is no different. The pilot will commence in earnest in the coming weeks. There is much to learn and so we are gearing up.

For our clients, change can’t come soon enough.