Creating supportive environments

This page highlights the importance of positive staff attitudes and environments for providing physical healthcare to people who have serious mental illness (SMI). 


Some service users have negative experiences of mental health and physical health services. It affects their trust and creates reluctance to access services.

Service users experiencing mental health difficulties or distress often encounter negative attitudes or a lack of respect from staff (or both). This is more common when they belong to marginalised communities. In order to support an individual in taking more control of their mental and physical health and wellbeing, they need to be treated with respect and compassion. Empathy, compassion, good communication, strengths-based approaches that explore people’s inner resources to manage their condition, curiosity about the individual’s values and core beliefs, and care about someone’s whole life are important for supporting a positive approach to self-management.

Fundamentally, consistency, trust, being knowledgeable and kindness are important for both physical and mental healthcare, but particularly for people with mental health problems accessing physical healthcare. One unpleasant encounter, even with a receptionist, and I may not come back as the psychological effort and stress to return will be considerable.

– Service user feedback, Healthy Lives Project Report

Suggested solutions

  • Make adjustments to screening tools and clinical environments to deliver positive, creative and strengths-based approaches to physical health care – rather than only highlighting risks in physical health management.
  • Provide mental health awareness training for all staff to ensure a positive, welcoming and warm environment is created. It is important that the first point of contact, often reception staff, is trained to ensure a positive first experience for the individual.

Tools to support you

Healthy Lives Project report: We commissioned this report from the National Survivor User Network (NSUN). It offers insight into the physical healthcare experiences of people with serious mental illness.

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