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Family members, rather than mental health professionals, are often the first responders for emotional or mental problems, particularly in Chinese societies where family is regarded as the primary care unit. Using data from the third wave of a representative sample of Chinese adults in the Hong Kong Panel Study of Social Dynamics, we investigate how family, and particularly family functioning, is associated with individual mental health help seeking and perceived barriers to professional service use, and how the associations vary across different generations of immigrants and between individuals with high versus low psychological distress.

Our results demonstrate that family is still the primary source of help sought for mental health problems. Stronger family functioning is particularly significant for second-generation immigrants when they consider seeking help from immediate family members. Seeking professional help is uncommon, and stronger family functioning is associated with a lower probability of seeking help from general health professionals and alternative services.

A well-functioning family is related to certain structural and cultural barriers to seeking professional help, yet trust in professional mental health services does not diminish along with stronger family functioning, even among the high psychological distress subgroup. The findings indicate that family can facilitate mental illness prevention and service integration. It is recommended that appropriate family support and services be incorporated into mental health treatment according to clients' differential family circumstances.

Abstract Family members, rather than mental health professionals, are often the first responders for emotional or mental problems, particularly in Chinese societies where family is regarded as the primary care unit. Publication types Research Support, Non-U.