Most research about preferred sources of mental health assistance has been completed in the West. Mental health research with non-Western cultures is needed. Using data from the East Asian Social Survey (EASS), this study examined help-seeking preferences for individuals with low mental health in four countries – China, Japan, South Korea, and Taiwan. Preferences for kin versus non-kin support, use of alternative medicine, and professional mental health assistance were examined, as were between-country differences in support preferences. The results align with previous research in East Asian countries that found a strong preference for using kin support to address mental health concerns, followed by non-kin support (i.e., close friends and co-participants in religious institutions), alternative medicine, and professional mental health services, respectively. While there is a strong preference for family support, many East Asians are open to seeking formal or informal mental health support outside the family. There were some significant differences between countries, with South Koreans being more likely to seek non-kin support and professional support for mental health concerns than Chinese. These differences are discussed in the context of cultural and policy developments in East Asian countries.