Though most mental health care today occurs in community settings, including primary care, research on mental illness stigma tends to focus on hospitalization or severe mental illness. While stigma negatively impacts the health of those with a range of mental problems, relatively little research examines how providers work with clients to confront and manage mental illness stigma. Calling on 28 interviews with providers in a range of mental health care settings, this paper reveals providers’ roles in managing mental illness stigma. Findings reveal that mental illness stigma is an important factor in treatment across settings and severity and that providers play important roles in common client stigma management strategies. Data show two major sets of strategies of working with clients on stigma: normalization and brokering/buffering. Professional stigma management is a key mental health care practice and needs to be studied as such.

中文翻译：

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打破墙壁，架起桥梁：精神卫生保健中的专业污名管理

尽管当今大多数精神卫生保健都发生在社区环境中，包括初级保健，但有关精神病耻辱的研究往往集中在住院或严重精神疾病上。尽管耻辱感会对患有一系列精神疾病的人的健康产生负面影响，但相对较少的研究调查了服务提供者如何与客户合作应对和管理精神病耻辱感。通过在各种精神保健环境中对医疗服务提供者进行28次访谈，本文揭示了医疗服务提供者在管理精神疾病耻辱中的作用。调查结果表明，精神疾病的耻辱感是影响各种环境和严重程度的重要因素，而提供者在常见的客户耻辱感管理策略中发挥着重要作用。数据显示了在污名上与客户合作的两种主要策略：标准化和代理/缓冲。