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In rural regions of China, the rural-to-urban migrant worker population and their left-behind children-60 million children who remain in home villages-have diversified the rural adolescence experience in terms of family life, compounding known mental health disparities. This study examined the impact of a comprehensive panel of home- and school-related variables on the prevalence of three common mental health complaints among rural adolescents. Data were collected using a self-formulated questionnaire administered to 1347 seventh grade students in a rural county of Hunan Province in Fall 2017. The prevalence of mental health symptoms was 10-18%. Bullying, loneliness, and stress from home and school environments were risk factors; good life satisfaction and willingness to reach out to adult and peer social networks were protective. Being a left-behind child was only significantly associated with depression symptoms, and notably, none of the other variables specific to left-behind children were found to be influential on mental health outcomes. These results suggest that the school-related factors included in our analysis accounted for a share of the risk typically explained by home-related factors alone. Schools may therefore be reliable settings for mental health programs in rural areas with ever more unpredictable home environments.