Family structure, adolescent mental health, and the role of advisors in the cultural and social context of South Korea

Prior research consistently reports differences in mental health outcomes among adolescents between intact and non-intact families, highlighting the need to address these disparities. This study aims to investigate the moderating effect of advisers (counselors, teachers, or friends) on the mental health of adolescents from non-intact families. We conducted a cross-sectional study using data from the 2017 Korea Youth Risk Behavior Web-Based Survey, a large, representative nationwide sample of adolescents. We included 61,572 middle and high school students living with at least one parent, categorizing them into five groups: biological parents, single parent (only father or mother), stepfather-biological mother, and biological father-stepmother. We assessed mental health outcomes (poor self-rated health status, self-rated unhappiness, depressive mood, suicidal consideration, suicidal planning, and suicidal attempt) using self-reported measures and evaluated the presence of advisers providing emotional support. Multivariate-adjusted logistic regression analyses were performed to examine associations between family structure and mental health outcomes, and to assess the moderating effect of advisers. Compared to adolescents living with both biological parents, those from non-intact families exhibited significantly higher odds of poor mental health outcomes. While adviser presence was associated with lower odds of adverse outcomes across most family structures, formal tests of interaction were not statistically significant. Our findings suggest that family structure is associated with adolescent mental health, and that adviser presence is generally linked to more favorable outcomes. Although formal interaction tests did not demonstrate statistically significant moderation, the consistent patterns observed across groups highlight the potential value of adviser support. These findings should be interpreted with caution, yet they underscore the importance of promoting access to trusted advisers as a practical strategy to support adolescents, particularly those from non-intact families.