Stigma and Suicidality Among U.S. College Students: Differential Indirect Effects Across Racial and Ethnic Groups

Mental health stigma is associated with suicide-related outcomes, yet its mechanisms may differ across racial and ethnic groups. Using nationally representative data from the 2023–2024 Healthy Minds Study (N = 88,014; ages 18–29), this study examined whether personal stigma mediates the relationship between perceived stigma and suicide-related outcomes, and whether this pathway varies by race and ethnicity. Moderated mediation analyses (PROCESS Model 7) controlled for sex at birth, education, LGBTQ+ identity, and depressive symptoms. Perceived stigma significantly predicted higher personal stigma (B = 0.22, 95% CI [0.22, 0.23], p < .001). In turn, personal stigma was positively associated with suicidal ideation (logit B = 0.07, p < .001) but negatively associated with suicide attempts (logit B =−0.07, p = .02); no significant effect was found for suicide planning. Race and ethnicity moderated the association between perceived stigma and personal stigma, with stronger associations observed among Asian and Hispanic/Latinx participants than among White participants. Conditional indirect effects for suicidal ideation were significant across racial and ethnic groups, but the index of moderated mediation reached significance only for Asian participants. No moderated mediation was observed for suicide planning or suicide attempts. These findings contribute to the literature by clarifying the stage-specific and culturally contingent pathways through which stigma may shape suicidality among U.S. college students.