According to the World Bank, China has the fastest aging population in human history. Strongly influenced by filial piety, there has been a culture of honoring an older person as a ‘treasure at home’ However due to various factors including rapid urbanization and associated policies, empty nest households are becoming more prevalent in Mainland China. In Hong Kong, traditional values are eroding, reinforced by a decline in the social status of older adults as a result of relatively low levels of education and lack of gainful employment. Moreover, social stigma and ‘face saving’ are prevalent in Chinese cultures. Mental illness is considered shameful. Negative stereotypes affect intervention models. This presentation examines the development of mental health services in China as well as the unique challenges faced by the different regions, including the paucity of community services in the Mainland and the sustainability of health/ community care in Hong Kong.