Abstract
<title>Abstract</title> <p> <bold>Background</bold> Suicide risk is a major public health concern among university healthcare students. Although depression, hopelessness, experiential avoidance, and psychological well-being have each been associated with suicidal behavior, their simultaneous contribution to suicide risk and the psychological mechanisms underlying these associations remain insufficiently understood. <bold>Methods</bold> A total of 319 university healthcare students (M = 21.62; SD = 3.67) completed the Plutchik Suicide Risk Scale, the Acceptance and Action Questionnaire-II, the Beck Hopelessness Scale, the Depression subscale of the Depression Anxiety Stress Scale-21 (DASS-21) and the Psychological Well-being Scale for Adults. Logistic regression was used to identify predictors of suicide risk, and parallel multiple mediation analysis was performed to examine whether hopelessness, experiential avoidance, and psychological well-being mediated the association between depression and suicide risk. <bold>Results</bold> Moderate hopelessness emerged as the strongest predictor of suicide risk (OR = 9.45), followed by moderate to severe depression (OR = 4.21), whereas adequate psychological well-being showed a protective effect (OR = 0.44). Experiential avoidance was only weakly associated with suicide risk. Hopelessness significantly mediated 42% of the association between depression and suicide risk, whereas experiential avoidance and psychological well-being were not significant mediators. <bold>Conclusions</bold> Hopelessness appears to be a key psychological mechanism linking depression to suicide risk and may represent a promising target for early identification and preventive interventions among university healthcare students. </p>