Teachers in primary and secondary schools are frequently under pressure. Therefore, it is critical to understand the factors that affect their mental health. Autonomy was associated with mental health in the past. However, the mediating mechanism behind this relationship has received little attention. In this study, a chain mediation model was built to determine whether teaching efficacy and work satisfaction mediated the relationship between teacher autonomy and mental health. Our study enlisted the participation of 810 Chinese primary and secondary school teachers aged from 21 to 57 years old. They completed self-reporting measures of teacher autonomy, mental health, teaching efficacy, and job satisfaction. The results show that (1) teacher autonomy, teaching efficacy, job satisfaction, and mental health have strong positive relationships, (2) teaching efficacy and job satisfaction significantly mediate the relationship between autonomy and mental health, and (3) both teaching efficacy and job satisfaction play a chain-mediating role. The chain-mediating effect of teaching efficacy and job satisfaction plays an important role in promoting teachers’ mental health. Teachers with a high level of autonomy tend to have high teaching efficacy, high job satisfaction, and improved mental health.
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