Objective <p>Based on Conservation of Resources (COR) theory, this study aimed to examine the (in)congruence effect of psychological resilience and social support on mental health outcomes (anxiety, depression, perceived stress) among Macau’s gaming industry employees, and to explore targeted public health implications for Macau’s mental health support system.</p> Methods <p>A cross-sectional survey was conducted among in-service casino employees in Macau. Psychological resilience, perceived social support, anxiety, depression, and perceived stress were measured. Response surface analysis (RSA) was used to examine the congruence and incongruence effects of the two core mental resources.</p> Results <p>Congruently high levels of resilience and social support were associated with the lowest levels of anxiety, depression, and perceived stress, indicating a cumulative advantage of different mental resources. Under incongruent conditions, the protective roles of the two resources diverged: social support was more critical for depression, whereas resilience was more strongly associated with lower perceived stress. Marital status significantly moderated the (in)congruence effect on anxiety.</p> Conclusion <p>These findings highlight the complex (in)congruence effect of resilience and social support from a COR perspective. The results support the necessity of a mental health system that addresses the specific resource profiles of employees in the Macau gaming industry. The public health implications for the high-stress occupational populations are discussed.</p>