How Does Emotional Exhaustion Among Chinese College Students Affect Mental Health? A Mixed-Methods Study in Zhejiang, China

Longyuan JiangChengcheng FeiLefei FangYuan FangShujing DaiJiakun TianWei WuYuanqi XuMeili Zhang^*Haiyan Yu^*

• Wenzhou Medical University, Wenzhou, China

Based on social ecological theory, this study investigated the mechanisms by which emotional exhaustion impacts mental health problems in Chinese college students. We develop a three-tier framework that includes, at the macro level, the socio-cultural environment (characterized by involution culture and lying flat culture); at the meso level, organizational interaction factors (such as unmet survival needs, unmet relationship needs, academic pressure, and employment pressure); and at the micro level, individual cognitive-behavioral aspects (including ruminative thinking and maladaptive personal behavior). Emotional exhaustion is modeled as a mediating variable and mental health as the outcome. We collected 600 survey responses from students at 26 universities in Zhejiang Province, China. Partial least squares structural equation modeling (SEM) was used to test direct effects and mediating pathways between variables, and fuzzy-set qualitative comparative analysis (fsQCA) was applied to reveal complex configurations of conditions leading to mental health outcomes. The results show that involution culture, academic pressure, employment pressure, rumination, and maladaptive personal behavior each have significant positive effects on emotional exhaustion, whereas lying flat culture and relationship need show no significant effect. Emotional exhaustion, in turn, significantly exacerbates mental health problems as a mediator. Furthermore, the fsQCA results reveal three configurational paths driving high mental health risk. Research shows that emotional exhaustion among contemporary Chinese college students is no longer merely an individual psychological issue, but has evolved into a systemic problem, influenced by macro-cultural institutional pressure, which permeates into the field of mental health through social cognitive processes. Our conclusions provide a theoretical basis and empirical support for the multi-level strategy design of mental health intervention.