Student nurse progression and clinical performance (CPA) are influenced by mental health, which includes self-efficacy, social support, and learning environment. This research applied a cross-sectional design to determine the effect of these factors on CPA and examine the links between them with the aim of developing better nursing programs. Participants were 259 nursing students in the Hail Region of Saudi Arabia. Data were obtained through a self-administered online survey. Analyses revealed several significant associations between the studied constructs and study level, family income, gender, marital status, age, and program type. The study identified numerous contributors to CPA in students, including self-efficacy, social support, perception of the learning environment, and demographics. In particular, social support has emerged as a strong bulwark against CPA, with a positive learning environment that intensifies this protective impact. These results underscore the need to consider social and environmental dimensions, together with academic support systems, to promote student welfare and excellence in clinical work.