Mental health self-stigma moderates the effect of social support on depression, anxiety and stress among young adult Pacific Islanders.

Objectives: In the United States, Pacific Islanders have a high documented prevalence of depression, anxiety, and stress yet report low use of mental health services. Little is known about their risk and protective factors against psychological distress, such as self-stigma and social support. The aim of the current study was to investigate how perceived levels of social support and levels of self-stigma moderate mental health outcomes (depression, anxiety, and stress). Methods: A cross-sectional study was conducted in Southern California from May 2018 to June 2019 of 213 Pacific Islanders aged 18-35 years who had never been medically diagnosed with a severe mental condition. Each participant completed an online survey that assessed their demographics, mental health, perceptions of mental health, and perceived social support. The independent and synergistic effects of mental health self-stigma and social support on self-reported depression, anxiety, and stress were examined in a series of demographics-adjusted linear regression models. Results: Social support from family members exhibited a protective effect on all three outcomes. Social support from friends was associated with higher levels of depression, anxiety, and stress. Self-stigma acted as a moderator that either amplified the deleterious effects associated with social support from friends or altered the protective effect of support from family. Conclusions: Findings suggest that social support from friends may play a role in the presence of self-stigma through peer stigmatization of psychological distress. Family- and peer-centric interventions are needed to reduce self-stigma and improve mental health among young adult Pacific Islanders.