Access to somatic healthcare for people with lived experience of mental health conditions in Austria: A trialogic participatory action research study

People with lived experience of mental health conditions (PWLE) encounter significant obstacles when accessing somatic healthcare services, contributing to higher morbidity and reduced life expectancy compared to the general population. This research sought to identify the barriers and facilitators that PWLE face in accessing and using somatic healthcare in Austria, with the goal of co-creating strategies to address current challenges. Employing a participatory action research approach from the conceptualization and grant-writing stages and reflecting the principles of “mental health trialogue,” this study involved a steering committee composed of a person with lived experience, a family member of PWLE, and a healthcare professional. Based on World Café methodology, two co-creation workshops fostered open dialogue and collaboration among participants representing these three perspectives. Data were gathered through participant observation and systematic collection of workshop contributions, which were thematically analyzed. A total of 52 participants, with 27 in the first and 25 in the second workshop, contributed to the study. Six overarching themes were derived: (1) Awareness among healthcare professionals; (2) Accessibility and health facility design; (3) Structural diversity of services; (4) Lack of care coordination; (5) Bureaucracy and material support; and (6) Societal awareness. Findings underscore the need for systemic changes to address diagnostic overshadowing in somatic healthcare services, particularly through the design of more inclusive services and the expansion of networking between and within PWLE and their caregivers. Aiming to achieve health equity, this study provides specific policy and practice pathways to counter diagnostic overshadowing and ensure PWLEs’ somatic health needs are adequately addressed. • People with lived experience, informal and formal caregivers collaborated equally. • Diagnostic overshadowing is a pervasive issue requiring a systemic response. • Access barriers and facilitators to somatic healthcare were identified. • Interventions were trialogically co-created with stakeholder groups. • Based on these findings, actionable policy recommendations were made.