Mobilising community-managed organisations: A call to action to confront physical health inequities in people living with complex mental health challenges.

Australia is failing people with complex mental health challenges, who experience poorer physical health and a reduced life expectancy of 15-20 years. This inequity is driven largely by preventable physical illnesses, many linked to lifestyle-related behaviours including physical inactivity, poor nutrition, smoking and sleep disturbance. Evidence shows integrated physical health and lifestyle interventions are feasible and effective. Yet translation into routine care remains fragmented, with most initiatives failing to scale beyond pilots. As a cornerstone of Australia's mental health system, community-managed organisations (CMOs) are central providers of recovery-oriented and peer-led psychosocial care to adults with complex mental health challenges. This uniquely positions CMOs to tackle such physical health inequities, yet they are under-resourced and underfunded, and their capability remains insufficiently recognised within national health policy frameworks. This Perspective presents a case for harnessing the capacity and capability of CMOs as a pathway for system reform, enabling better access to interventions that improve health outcomes and minimise health disparities. We outline opportunities for structured models of intervention, integrated care pathways, workforce development and policy and research priorities - all critical levers to enable sustainable, equitable physical health outcomes. It is time to elevate CMOs within mainstream health policy and strategically invest in their capacity to lead a systemic response to the physical health inequities of people living with mental health challenges.