Primary care patients were surveyed about emotional symptoms, treatment history, and treatment preferences. Four hundred and one patients completed questionnaires while waiting for appointments, and 271 (68%) mailed back additional materials. Many patients expressed a desire for help with the way they were feeling; understanding the cause of one's feelings was most commonly identified as likely to be helpful. Most preferred individual intervention. A range of attitudes and pragmatic concerns were barriers to seeking care. More patients said that they would likely to attend a fitness program than counseling, stress management, or healthy living classes. Distressed patients were more likely to say that they would seek medications and less likely to feel that they weren't the type to seek care or that they could work it out themselves. This work supports the need for continued patient education and for primary care-based mental health services that are responsive to patients' preferences.