First step evaluation

Investigators: Dr Annette Peart,  Professor Victoria Manning

Funder: First Step

First Step delivers integrated, person-centred care for people with co-occurring substance use and mental health concerns, bringing together medical, mental health, substance use, and legal support in one service. A 20-month evaluation by Turning Point examined the model and its impact on clients.

A mixed-methods design was used, including client surveys (n=84), interviews with clients (n=24), staff (n=9), and stakeholders (n=12), and an outcomes co-design workshop. Interview findings highlighted meaningful client improvements across substance use, mental health, quality of life, relationships, and employment. Many clients reported reducing or ceasing substance use, while others stabilised use to manageable levels. Participants emphasised the value of First Step’s holistic approach, with the service responding to a broad range of health and social needs. A welcoming, non-judgmental environment and strong, trusting relationships with skilled staff were central to client experiences and outcomes.

The outcomes workshop identified key priority areas, including health and emotional wellbeing, recovery, quality of life, and social stability. A pilot of baseline and three-month outcome measures showed early indications of positive change across these domains. Suggested areas for development included strengthening inclusion for LGBTQ+ individuals and women, and expanding peer-led and group activities to further support client connection and engagement.