Seeking Help for Mental Health Problems in Hong Kong: The Role of Family

Background and Purpose: Family members are oftentimes the first responders for emotional or mental problems rather than mental health professionals, particularly in Chinese societies where family is the primary care unit. Yet, we cannot simply assume that family will always be a source of appropriate help and support. Some families cannot effectively render help to their members because of dysfunctional or unhealthy family dynamics or processes. The structure and dynamics of family—supportive or inhibiting—therefore, will be crucial in determining members’ patterns of help seeking for emotional or mental problems.

We analyze data from a representative sample of Chinese adults in the Hong Kong Panel Study of Social Dynamics (HKPSSD) and attempt to answer the following questions: Where do Chinese residents in Hong Kong turn for help when they experience emotional or mental problems? Are family members the most preferred source of help? Who are more likely to rely on family members for help and support? What family characteristics are associated with being the preferred source of help for emotional or mental problems? And what family characteristics may deter people from seeking help from family members? How does family function as a risk or protective factor and influence other types of help sought? Particularly, what family characteristics may motivate or inhibit members from seeking help from professional mental health services and how?

Methods: Data come from the third wave of the HKPSSD—a representative household panel survey with 2,404 households, 5,160 adults, and 477 children interviewed in 2015. In addition to the standard household and individual questionnaires, we added questions in three new areas: mental health help seeking and service use in the past 12 months, perceived structural and cultural barriers to seeking professional help, and the McMaster Family Functioning Scale.

We excluded 571 cases with missing data on key variables, leaving a sample of 4,589 for the analysis. Descriptive statistics are estimated on socio-demographic characteristics, help seeking in the previous 12 months, and perceived barriers to seeking professional help. Multiple logistic regressions are applied to assess the associations of help seeking in the previous 12 months with general family functioning and family characteristics. Survey weights and clustering at the household level are taken into account throughout the analysis.

Results: Our results indicate that family is still the primary source of help sought for mental health problems. Stronger family functioning is particularly instrumental 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 mental health and medical professionals, and alternative services. A well-functioning family enhances certain structural and cultural barriers to seeking professional help, yet trust in professional mental health services is not diminished because of stronger family functioning.

Conclusions and Implications: The findings confirm that family can serve as a platform for mental illness prevention and service integration. Appropriate family support and service should be incorporated into mental health treatment according to clients’ differential family circumstances.