PURPOSE: Most people with mental health problems do not use mental health services, resulting in poor psychiatric outcomes and greater illness burden. Although perceiving the need for mental health care was identified to be a key factor for service use, factors that explain differences in perceived need for mental health care are incompletely understood. The present paper investigates the role of illness representations in predicting perceived need for mental health care. METHODS: In a community sample of 202 persons currently distressed by symptoms related to mental illness, illness representations were assessed using the Brief Illness Perception Questionnaire and perceived need for mental health care was measured by the Self-Appraisal of Illness Questionnaire. Multiple linear regression models were used to determine the association between a person's illness representations and the level of perceived need for mental health care. RESULTS: Two illness representations were positively associated with perceived need for mental health care: the belief that treatment could improve the current mental health problem and the attribution of experienced symptoms to a mental health problem. Increased perceived need for care was related to current mental health service use. CONCLUSIONS: Interventions that aim to increase mental health service use could focus on people's attitudes toward mental health treatment and enable people to recognize symptoms as a mental illness.