Helping fight addiction one step at a time

Patrick Lawrence took an unusual route to the not-for-profit sector, but now as CEO of mental health and addiction hub First Step, he is showing why everyone deserves every chance to turn their lives around. He is this week’s Changemaker.

Coming from a musical family, Lawrence started his career as a classical pianist and vocal coach.

But after coming across a local newspaper article about a small medical clinic, Lawrence made a fateful decision to volunteer and help people struggling with addiction issues. 

Now almost 20 years later, Lawrence is CEO of the organisation – First Step – which is a wrap-around addiction and mental health outpatient clinic with a fully integrated legal service. 

First Step aims to provide all the support that people need in one place from a unified team, so those who are struggling can make incremental whole-of-life improvements to turn their lives around. 

In this week’s Changemaker, Lawrence discusses his entry into the sector, outlines his vision as CEO, and explains how the COVID-19 crisis has affected his organisation.     

How did you come to be involved in the not-for-profit space?

I had a first career in the performing arts. I come from a musical family. So I did my undergraduate degree in piano performance at Melbourne University and then went overseas and spent several of the next years in Germany and Austria. And then in the United States, I did a master’s degree in classical piano. I was working with singers, so I was sort of in the opera space. Next I came back to Melbourne and continued doing that kind of work.

I then read an article in a local newspaper in the city of Port Phillip, about a small organisation that was a medical clinic – First Step. They were working with people with long-term addictions and detoxing people off heroin, with facilities to give them a chance to to get clean. And they were looking for volunteers including unskilled volunteers, and I thought, “oh, that’s interesting. If I don’t go today. I’ll never go.”

At that point they were detoxing 12 people at a time on mattresses on the floor, in the back room with a nurse and a doctor present. And they needed all sorts of things. They needed sandwiches being made for lunch and cleaning up messes and making beds. And so I got stuck into that and I was usually there a couple of days a week. Then they offered me a part-time role managing volunteers. 

I thought I could do it and keep playing the piano and keep doing those other things. And [then] a weird thing happened, in that every two weeks they gave me a set amount of money. As an artist I’d never experienced that before in my life. It was a bit of a revelation. And I got really interested in the work and I really transitioned over the next 10 years to be basically full-time in this space.

I stayed connected with First Step the whole time. That’s almost 19 years ago now. But I also went to work at the Asylum Seeker Resource Centre for 10 years. And my final role there was director of humanitarian services. That was a really informative time being at the absolute pointy end of people with histories of extraordinary trauma, many of whom had no access to our social welfare system that we pretty much take for granted. It was really quite heavy work. 

How did you end up leading First Step?

Well after 10 years, the CEO role came up at First Step and I’d still been doing a day a week there doing various different jobs. And I realised I had learned a lot at the ASRC, especially under [founder] Kon Karapanagiotidis.

I was at the ASRC as we grew from about 12 staff to about 100. It was very hard to leave, but it was time for a new challenge, so I came over to First Step as CEO and I’ve been in that role about three years.

What has your vision been in the role? Is there anything in particular you have tried to drive as CEO? 

I’ve worked a lot on really trying to understand the sector, trying to understand First Step’s pretty unique contribution to that sector and then trying to explain that in really plain language. We work with a lot of people with very complex mental health and addictions. So a great many of them grew up in out-of-home care, have histories of childhood homelessness, childhood illicit drug use and childhood incarceration. So there’s this long history of trauma. And what we find is that when you work with individuals like that, there are many areas of their life where they need support. And really the only sensible approach is to address all those areas with one team.

So at First Step we provide all the support that people want and need in one place from one team.

When you have all the people working in one place – so we’ve got GPs, psychologists, psychiatrists, lawyers, mental health nurses, care coordinators and art therapists all working in the building together – what you can then seek to achieve is incremental whole-of-life improvements. 

So you might experience an improvement in someone’s legal situation, and that helps with their mental health and that helps with their addiction. They then have a better chance of getting housing, and once housing is secure their mental health improves. If you imagine a bar chart with seven or eight elements, this means they’re all slowly moving up together. But if you’re only really working on one or two of those areas, the other areas will hold you down. How much can you expect someone’s mental health will improve if they’re homeless? 

So our core belief at First Step is that everybody deserves every chance to turn their lives around. And we think this multidisciplinary team and these incremental whole-of-life improvements are a way to achieve that.

How has the coronavirus affected your organisation? 

It’s not been as bad with our clients as you might think. We transitioned pretty easily from doing almost 100 per cent face-to-face work to doing phone and video conferencing work. And there’s no question that it’s not as good. But most of my staff rate face-to-face as 10 out of 10, and they generally give these other methods a seven or eight out of 10. And some of our clients find it more convenient. Sometimes it’s actually easier to get hold of people when you’re not making them leave their houses and come to the clinic. But now as the time has worn on a bit, we are certainly finding that social isolation is worse, depressive symptoms are higher, motivation to look after yourself is lower, and motivation to eat well, to sleep well, and to keep physically active is lower.

Our GPs have continued working from site all the time, even though they mostly still see clients remotely. And bit by bit the clinicians are trying to do more work from the clinic and get clients in and have eyes on them.

So the transition has been relatively seamless. But it’s starting to wear thin a bit.

A lot of the sector has struggled with fundraising shortages the last few months. How is First Step getting through it?

I think there’s a combination of two things. One is we need to face the harsh reality that these are difficult times. And at the same time we need to be innovative. As opposed to charities all being isolated, some of us are coming together for a [virtual fundraising challenge] in June, called Rock Around the World. There’s eight charities working together, which is very unusual. We’re collaborating, and the event that we’re trying to put together is emphasising inclusion and community as well. So we’re trying, I suppose, to embody what we want our clients to do as well, which is making the most of a difficult situation. And being as connected as you can to your existing supports and to find new ones. 

With self-isolation measures, a lot of people have been binging TV shows or reading something, or taking up new hobbies. What have you been up to during this time?

Look, I’ve got five kids. So I think my level of isolation has been a lot less than for a lot of people, because I see them all the time and I’m working from home. So we have breakfast together every day and morning tea together and lunch, and they’re all school-aged kids in primary school and high school. And I think having their positive influence to get on the trampoline, to go for a bike ride and get out of the house, has been really powerful for me as well. I mean, they are sucked into the screens as much as I am, so that’s sort of a constant battle. But being close to who you can be close to and counting your blessings is a big thing.