Associations of Mental Health Literacy, Self-Stigma, and enabling conditions with student-perceived implementation of university mental health policies in Vietnam: a cross-sectional PLS-SEM study

Mental health concerns among university students have become a growing priority in higher education, yet limited evidence exists regarding how students perceive the implementation of university mental health policies and support systems. Drawing on the University Mental Health Charter framework and implementation science perspectives, this study examined the relationships among Mental Health Literacy (MHL), Self-Stigma, Enabling Conditions, and three domains of student-perceived mental health policy implementation: Learn, Live, and Support. A cross-sectional survey was conducted with 450 students from eight Vietnamese universities, and the data were analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM). The results indicated that MHL was positively associated with Enabling Conditions (β = 0.412, p < 0.001) and negatively associated with Self-Stigma (β = − 0.419, p < 0.001). Enabling Conditions were positively associated with Learn (β = 0.753, p < 0.001), Live (β = 0.914, p < 0.001), and Support (β = 0.871, p < 0.001). In contrast, Self-Stigma showed a significant negative association only with Support (β = − 0.056, p = 0.024). Mediation analysis revealed significant indirect relationships between MHL and Learn (β = 0.310, p < 0.001), Live (β = 0.376, p < 0.001), and Support (β = 0.359, p < 0.001) through Enabling Conditions. Self-Stigma demonstrated a more limited mediating role, with a significant indirect relationship observed only for Support (β = 0.023, p = 0.035). The model explained substantial variance in Learn (R 2 = 0.659), Live (R 2 = 0.879), and Support (R 2 = 0.806). Overall, the findings indicate that student-perceived implementation was statistically associated with both Mental Health Literacy and perceived institutional conditions, with Enabling Conditions showing the more prominent specific indirect associations. These findings identify institutional enabling conditions as a relevant area for further longitudinal research and institutional evaluation within a whole-university approach to student mental health.