Lived Experience in Mental Health: Are Organisations Ready?

As lived experience roles become more embedded across mental health services, organisations are encountering a new set of challenges — not technical, but cultural.

What began as a push to include lived experience voices is now evolving into something more complex: how to meaningfully integrate those roles into systems that were not originally designed for them.

Across the sector, similar questions are emerging.

What counts as lived experience?
How is lived experience expertise recognised?
And how do these roles sit alongside clinical and professional disciplines?

These are not straightforward questions — and they’re not easily resolved through training alone.

From Inclusion to Integration

The inclusion of lived experience roles has been a central recommendation of major reform processes, including the Royal Commission into Victoria’s Mental Health System, which called for the expansion and formal recognition of lived experience workforces.

The intent is clear: services should be shaped by people with direct experience of the system.

But implementation is proving more complex.

Research from the National Mental Health Commission highlights that while lived experience roles are growing, many organisations are still developing the structures needed to support them effectively.

Without that clarity, tension can emerge between:

• Lived experience and clinical perspectives
• Different understandings of expertise
• Expectations of roles and boundaries

This is where many services are now finding themselves — moving from inclusion to integration.

The Culture Challenge

What’s becoming clear is that this is not just a workforce issue. It is a culture issue.

Embedding lived experience roles requires organisations to rethink:

• How expertise is defined
• How decisions are made
• How teams work across different forms of knowledge

Guidance from the World Health Organisation reinforces this, noting that integrating lived experience into mental health systems requires structural and cultural change — not just workforce expansion.

It also raises questions about support — particularly for staff with lived experience who may be navigating both professional and personal challenges within the same environment.

Why This Matters for Engagement

For engagement professionals working in health, this shift has direct implications.

Lived experience is not just something to “engage with” externally.
It is becoming embedded within organisations themselves.

This aligns with broader co-design and consumer participation frameworks across Australia and New Zealand, which increasingly position lived experience as central to service design and delivery.

That changes the dynamic.

It requires:

• Greater clarity around roles and expectations
• More deliberate approaches to inclusion
• A stronger focus on how different perspectives are brought together

Because ultimately, the goal is not just participation — but influence.

The Takeaway

The sector is moving beyond the question of whether lived experience should be included.

The focus now is on how it is embedded — and whether organisations are ready for what that requires.

That shift is where the real work begins.