<p>Grounded in stigma resistance theory, this ethnographic study identifies resistance strategies employed by patients and families within a Chinese psychiatric hospital, often in collaboration with institutional practices. While denial manifested as refusal to acknowledge diagnoses, distancing involved both social avoidance of peers and spatial negotiations. These strategies are characterized by subtle and personalized actions that receive limited attention. Although patients and families actively resist stigma, their efforts are constrained by the lack of supportive networks and the entrenched structural stigma within mental health systems, reinforcing the existing power dynamics within the facility. To meaningfully address and dismantle these entrenched structures, it is imperative to foster collaborative frameworks that bridge the perspectives of patients, families, and healthcare providers.</p>