<p>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.</p>

<p>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.</p>

<p>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.</p>

<p>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.</p>