Penelitian ini bertujuan untuk mengidentifikasi dan menganalisis determinan yang berhubungan dengan kondisi kesehatan mental mahasiswa tingkat akhir program sarjana di Fakultas Ekonomi dan Bisnis Islam UIN Sumatera Utara pada tahun 2025. Penelitian ini menggunakan pendekatan kuantitatif dengan desain cross-sectional. Sampel penelitian berjumlah 278 responden yang dipilih melalui teknik purposive sampling. Pengumpulan data dilakukan menggunakan instrumen kuesioner terstandar dan dianalisis dengan uji chi-square. Hasil analisis menunjukkan bahwa mayoritas responden (68,0%) berada dalam kategori gangguan kesehatan mental berat, 21,2% mengalami gangguan ringan, dan hanya 10,8% tidak menunjukkan gejala gangguan mental. Seluruh variabel independen, yaitu tingkat resiliensi, strategi koping, dukungan sosial, tekanan finansial, dan tekanan akademik menunjukkan hubungan yang signifikan secara statistik terhadap kesehatan mental (p < 0,05). Mahasiswa dengan resiliensi rendah memiliki risiko lebih dari dua kali lipat mengalami gangguan mental berat dibandingkan yang beresiliensi tinggi (OR = 2,648; 95% CI: 2,404–2,879). Risiko gangguan mental juga lebih tinggi pada mahasiswa dengan strategi koping lemah (OR = 2,959), dukungan sosial rendah (OR = 2,908), tekanan finansial tinggi (OR = 1,947), dan tekanan akademik tinggi (OR = 1,601). Temuan ini menegaskan bahwa kondisi psikologis mahasiswa tingkat akhir dipengaruhi oleh interaksi berbagai faktor internal dan eksternal, serta menyoroti pentingnya intervensi holistik dalam upaya peningkatan kesejahteraan mental di lingkungan pendidikan tinggi Islam. This study aims to identify and analyze the determinants associated with the mental health condition of final-year undergraduate students at the Faculty of Islamic Economics and Business, UIN Sumatera Utara, in 2025. The research employed a quantitative approach with a cross-sectional design. The sample consisted of 278 respondents selected using a purposive sampling technique. Data were collected through standardized questionnaires and analyzed using the chi-square test. The results showed that the majority of respondents (68.0%) were categorized as experiencing severe mental health disorders, 21.2% experienced mild disorders, and only 10.8% showed no symptoms of mental health problems. All independent variables—namely resilience level, coping strategies, social support, financial pressure, and academic pressure—were statistically significantly associated with mental health status (p < 0.05). Students with low resilience were more than twice as likely to experience severe mental disorders compared to those with high resilience (OR = 2.648; 95% CI: 2.404–2.879). The risk was also higher among students with weak coping strategies (OR = 2.959), low social support (OR = 2.908), high financial pressure (OR = 1.947), and high academic pressure (OR = 1.601). These findings emphasize that the psychological condition of final-year students is influenced by the interplay of various internal and external factors and highlight the need for holistic interventions to improve mental well-being within Islamic higher education institutions.