Mental health self-labeling has garnered significant attention among journalists and physicians. One question is the extent to which self-labeling behavior is transmitted through social relationships. Yet, no study to date has examined the relationship between peer networks and mental health self-labeling. Drawing from prior research on social relationships and mental health, and using longitudinal data of college students from the NetHealth study (n = 402), this article examines how perceived support and actual social connections influence a student's likelihood of self-labeling. Evidence suggests that, conditional on distress severity, students reporting significant family social support are less likely to self-label with a mental illness. In addition, greater contact with others who self-label in local text and phone communication networks predicts self-labeling. Overall, both perceptions and observed social relationships play a role in mental illness self-labeling.