Occupational Balance and Meaning Mediate Higher Education Students’ Mental Health During War: A Structural Equation Modeling Analysis

The modifiable factors related to reduced mental health after exposure to traumatic threat included change in occupational patterns, occupational balance, and sense of belonging, which may all serve as goals for occupation-based interventions and contribute to better coping mechanisms with traumatic events. This study used a cross-sectional design and an online survey with self-reported data, which may limit the generalizability of the findings. Plain-Language Summary: Higher education students in Israel were exposed to traumatic events and changes in daily life because of war. This study aimed to understand their mental health, resilience, executive functions, environments, and changes in their occupational patterns and the complex interplay between these factors. An online survey showed a notable decline in the students' mental health status, with around 50% experiencing at least moderate levels of depression, anxiety, and stress. Changes in occupations, occupational meaning, and balance were also common. The study found that satisfaction with life, mental resilience, occupational balance, religious status, executive functions, and variability in occupational change all contributed directly to the students' mental health status. The findings suggest that modifiable factors such as occupational balance and belongingness could be addressed through interventions to enhance mental health and coping mechanisms of students facing trauma and stressful life events.