Mental well-being and depression among university students in Palestine under the war

BACKGROUND: Since October 2023, the West Bank has experienced an "invisible war" characterized by intensified military raids, movement restrictions, and economic instability. While global attention focuses on the destruction in Gaza, the impact of these "attritional" war conditions on the mental health of West Bank university students remains under-researched. This study aims to assess the prevalence of depressive symptoms and mental well-being among this population and to model the bio-psychosocial determinants of these outcomes. METHODS: A quantitative cross-sectional study was conducted in November 2024 among university students (N = 497) across the North, Middle, and South West Bank. Data were collected using a digital survey comprising the Beck Depression Inventory-Short Form (BDI-SF), the Short Warwick-Edinburgh Mental Well-being Scale (SWEMWBS), and a customized bio-psychosocial stressor inventory. Partial Least Squares Structural Equation Modeling (PLS-SEM) was employed to analyze the relationships between environmental, familial, individual, social, and university factors and mental health outcomes. RESULTS: The results revealed a profound "Flourishing Gap": while 36% of students exhibited moderate-to-severe depressive symptoms, a staggering 93% failed to reach the threshold for high mental well-being, with only 7% classified as flourishing. Structural modeling explained 63% of the variance in depression and 40% in well-being. Individual factors were the strongest risk factor for depression (beta = 0.45), while Social factors served as the most significant protective buffer, strongly predicting higher well-being (beta = 0.73) and lower depression. University factors also positively influenced well-being (beta = 0.47). CONCLUSIONS: Palestinian university students are navigating a mental health crisis characterized not only by high depression but by a mass extinction of positive psychological functioning. However, the university environment and social support systems act as critical sanctuaries of resilience. Interventions must move beyond pathology to strengthen these collective social scaffolds and protect higher education institutions as essential psychosocial infrastructure.