First Step House

A Comprehensive Approach to a Complex Problem

Jake Wilhelmsen | Photos by Kevin Kiernan Nov 14, 2019

He couldn’t hold down a job because he had an undiagnosed mental illness. He lost his apartment when he lost his job. He started using drugs while living on the street. Using drugs got him a criminal record, which made it even harder to get a job.

This isn’t just one person’s story but that of many. Talk to the people camping in Salt Lake City’s Pioneer Park or waiting in line for a meal at St. Vincent de Paul and most of their stories share at least a few of those threads. A home, a job, a network of support and good health are the pillars of a happy life. Knock one out and others are likely to follow.

Enter First Step House. The Salt Lake City organization is dedicated to helping people in the Salt Lake metro area — specifically those with behavioral health concerns — overcome those challenges, including substance-use disorders, homelessness and mental illness.

building with steps
bunk beds
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The Road to Recovery

“Our mission,” says Shawn McMillen, executive director of First Step House, “is to help people build lives of meaning, purpose and recovery.”

“These are chronic conditions,” McMillen says. “Chronic conditions are very responsive to interventions, but the trick is to sustain those treatment gains.” First Step House approaches behavioral health problems holistically, offering residential and outpatient substance-abuse treatment, case management for housing and employment, as well as long-term recovery support.    In 2018 it served 737 individuals, exceeding state and national benchmarks for treatment completion, housing stability and employment.

Case by Case

“Our job is not just to help people get well,” McMillen says. “That’s treatment. We want to help them stay well in the community. That’s case management.”

Case management may sound bureaucratic, but it’s the personal, daily work that makes treatment stick, McMillen says. “We’re very interested in what each person’s goals are. Their goal may be related to housing, but a landlord may see their criminal history and reject their application. The case manager can appeal that decision and ask for a joint meeting with the prospective tenant and landlord.”

The case manager can make a case to the landlord as to why the individual would make a good tenant, providing proof that the individual received treatment and resolved past criminal justice problems. The case manager can provide assurance that if the landlord decided to approve the tenant, the case manager would help navigate any issues in the future.

“The case manager then follows up to make sure the individual stays engaged, getting to their doctor and therapy appointments, getting discounted bus tokens, getting to the grocery store rather than just eating all their meals at 7-Eleven,” McMillen says.

man cooking in a large kitchen

Social Support and Networking

Case managers also provide social support.

“Many of the people we serve are estranged from their families, so our services are designed to provide that support, that social capital — the ability to network, to find a job, to find a house — and to connect them with a support group, a group of friends.” That could be anything from a 12-step recovery program to Clean and Sober Softball, the largest softball league in Salt Lake County with 90 teams mostly made up of alumni from treatment centers.

The road to recovery isn’t short and it isn’t straight. Each person has individual needs and individual goals, and First Step House meets them where they are and stays with them until they get where they’re going.

“We consider ourselves a health care provider,” McMillen says. “Just like most people have a primary care physician, we are this person’s health care provider for as long as they say we are, as often as they choose to visit. We are working with them indefinitely.”

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