BACKGROUND: As part of an international survey of mental health advocacy groups, information pertinent to patients' concerns regarding their diagnosis and treatment was gathered from South African members of a depression and anxiety support group (n = 404). METHODS: Questionnaires developed by GAMIAN, an international consortium of advocacy groups, were mailed along with explanatory letters and self-addressed envelopes to South African members and members in nine other countries, for completion. Of 1,000 questionnaires mailed in South Africa, 40.4 % were returned. RESULTS: The sample comprised patient members with anxiety-only (39 %), depression-only (8 %), mixed anxiety-depression (26 %), and other diagnoses (27 %). While one-third of respondents reported onset of symptoms before the age of 20, most waited 3-5 years before seeking help. After making contact with the health system, respondents experienced further delays in obtaining a correct diagnosis. In many instances, respondents were poorly informed of diagnosis and treatment (25 %), and nearly half of all respondents discontinued treatment on account of side-effects. CONCLUSIONS: Attempts to improve awareness of mental illness, and better communication between physicians and their patients, might help to break down some of the barriers patients encounter when seeking help.