Objectives This study aimed to compare and analyze the structural relationships among test stress, mental health, school adaptation, and school satisfaction of students from general high schools and specialized high schools, and to find ways to improve policies.
 Methods To this end, the Busan Education Longitudinal Study (BELS) data (6th year, 2021) was used for analysis, and test stress as an independent variable and mental health, school adaptation, and school satisfaction were selected as dependent variables. As for the characteristics of each variable, test stress and mental health are negative factors (-), and school adaptation and school satisfaction are classified as positive factors (+).
 Results The main research findings are as follows. First, the correlation between the variables examined in this study shows a negative correlation that the lower the mental health level, the higher the school adjustment and school satisfaction. On the other hand, school adaptation and school satisfaction have a very close relationship and show a high correlation. Second, in the causal effect analysis of the <research model (final)> established for this study, the coefficients of general and specialized high schools were found to be similar approximate values. First, the effect of test stress on mental health was higher in general high schools than in specialized high schools, which was a negative effect. The effect of test stress on school adjustment was higher in general high schools than in specialized high schools, but the direct effect was static, and indirect negative effects through mental health appeared to cancel each other out, and the total effect was slightly higher in specialized high schools. The effect of mental health on school adjustment was higher in general high schools than in specialized high schools, and a direct, static effect was found. The effect of school adaptation on school satisfaction was higher in specialized high schools than in general high schools, with the largest direct effect among the pathways set in the research model.
 Conclusions Therefore, increasing school satisfaction is to adapt well to school, which reduces test stress and improves mental health.