One in four Australians with lived experience of mental ill-health report unfair treatment by a health professional when seeking help for a physical health problem, with this being even more common among people with complex mental health conditions. This unfair treatment manifests in specific ways, including a lack of holistic care, routine health checks, or preventative health measures; prescribing decisions made without considering a person's broader needs or concerns about side effects; in some instances denial of help or early discharge; and an overall lack of response to unmet physical health needs.
The Impacts of Mental Health Stigma on Physical Health
Overview
This implementation brief from The ALIVE National Centre for Mental Health Research Translation is the first in a five-part series examining stigma and its impacts. It outlines how mental health-related stigma affects access to and quality of physical health care, drawing on national survey data showing that one in four Australians with lived experience of mental ill-health report unfair treatment from health professionals when seeking help for physical health problems. The brief presents lived experience perspectives on these impacts and outlines pathways to scalability for individual providers, health organisations, and policy makers to reduce the impacts of stigma on physical health at scale.
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Key insights
This implementation brief, the first in a five-part series on stigma and its impacts, highlights how mental health-related stigma significantly affects the physical health care that people with lived experience of mental ill-health receive. Drawing on national survey data, it documents the scale and nature of stigma-related unfair treatment, presents lived experience perspectives on its effects, and outlines pathways to scalability for individual practitioners, health organisations, and policy makers to address this issue.
People with lived experience of mental ill-health report a range of negative effects of stigma that extend beyond individual interactions to shape their overall relationship with the health system. These impacts include expecting to be ignored, judged, dismissed, or questioned; experiencing self-stigma including shame or embarrassment; experiencing fragmented support for both physical and mental health; feeling unsafe and being discouraged from seeking healthcare; and experiencing an overall decline in physical health as a result.
Scaling solutions to reduce the impact of stigma on physical health requires addressing the evidence base for an approach, its relevance and benefit to those who use it, its cost-effectiveness compared to current practice, and its alignment with the values and norms of the setting in which it is implemented. The brief notes that few existing models meet all of these criteria, but outlines pathways to scalability across individual, organisational, and health systems levels that could support progress in the absence of models that are immediately ready to scale.
Reducing the impact of stigma on physical health requires coordinated action by individual healthcare providers, health organisations, and policy makers, with practical pathways identified at each level. At the individual level, recommendations include building trusting therapeutic relationships, recognising people as experts in their own experience, conducting sensitive wellbeing checks while avoiding diagnostic overshadowing, supporting decision-making, and inviting carers and families into care with consent. At the organisational level, recommendations include establishing a lived experience workforce including peer workers, embedding co-design, providing professional development in trauma-informed and recovery-oriented care, and implementing accountability measures for stigma and discrimination. At the health systems level, recommendations include building lived experience workforce capacity at leadership levels, establishing mandatory training and guidelines, integrating physical and mental health services, and providing equitable funding including for longer appointments.
Did this resource draw on transformative evidence?
Yes — The brief includes a dedicated "Lived-Experience Perspectives on the Impacts" section, drawing on national survey data from people with lived experience of mental ill-health (Our Turn to Speak survey and the National Survey of Mental Health-Related Stigma and Discrimination) to document the specific impacts of stigma on healthcare experiences.
Yes — The pathways to implementation across individual, organisational, and health systems levels reflect accumulated practice knowledge regarding trauma-informed care, co-design, supported decision-making, and workforce development, drawing on recommendations from the Our Turn to Speak survey findings and related sector guidance.
Yes — The brief is grounded in six referenced sources, including the National Survey of Mental Health-Related Stigma and Discrimination (2022), the National Stigma Report Card (2020), the National Stigma and Discrimination Reduction Strategy (2022), and a systematic review of tools for assessing scalability of innovations in health (2022).
How can this resource help me as a...?
Individual healthcare providers across physical and mental health settings are a primary audience, with specific guidance on building trusting relationships, avoiding diagnostic overshadowing, and engaging in supported decision-making with consumers.
Health service leaders and organisations are addressed directly, with recommendations on establishing lived experience workforces, embedding co-design, and implementing policies to address stigma and discrimination with accountability.
The brief calls for system-level action including funding models, mandatory training requirements, and integrated healthcare service models, making it directly relevant to health policy makers.
People with lived experience of mental ill-health are the population most directly affected by the issues this brief addresses, and their reported experiences form the evidentiary basis for the brief's recommendations.
The brief specifically recommends inviting carers, families, and support persons into healthcare with consent, making this relevant to carers supporting someone navigating both physical and mental health care.
The brief's emphasis on building and integrating the lived experience workforce, including at leadership levels, makes it directly relevant to this audience.