This study sought to examine the association between parental psychological distress and adolescent maladjustment, examining adolescent internalizing and externalizing disorders, substance use, and alcohol consumption. The authors then controlled for socioeconomic factors and tested the relevance of adolescent self-esteem, parental emotional support, and extra-familial support as mediators in the relationship between parental psychological distress and adolescent psychosocial maladjustment. Data from the Social and Health Survey of Quebec Children and Adolescents were used. This survey was based on a two-stage cluster random sample of 2,346 individuals aged 13 and 16 enrolled in school, and their 1,983 parents. Binary and multinomial logistic regression models were estimated, structural equation modeling was used to test for mediation, and path analysis was conducted. The results suggest that adolescents living with a highly psychologically distressed parent are more likely to exhibit internalizing and externalizing disorders, as well as lower self-esteem and social support. The standardized total effect of parental distress on internalizing disorders is significantly mediated by self-esteem, parental emotional support, and social support. The authors conclude that the results confirm the need for public health policies aimed at preventing negative mental health outcomes in adolescents by preventing and addressing parental distress.