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In this paper, the authors attempt to understand how psychosocial and societal stressors result in mental health problems. A confidential, quantitative mental health interview was conducted among 150 MSM in Mumbai, India and the interview collected information on sociodemographics and assessed self-esteem, social support and DSM-IV psychiatric disorders using the Mini International Neuropsychiatric Interview (MINI). In multivariable models controlling for age, education, income, and sexual identity, participants reporting higher levels of self-esteem and greater levels of satisfaction with the social support they receive from family and friends were at lower risk of suicidality and major depression.