Aim: Mental health problems are prevalent among young people in Malaysia yet access to specialist mental health care is extremely limited. More context-specific research is needed to understand the factors affecting help-seeking in youth, when mental health problems typically have first onset. We aimed to explore the attitudes of vulnerable young Malaysians regarding mental health problems including unusual psychological experiences, help-seeking and mental health treatment. Methods: In the present study, nine young people (aged 16–23 years) from low-income backgrounds participated in a semi-structured interview about their perspectives on mental health problems, unusual psychological experiences and help-seeking. Results: Four themes were developed using thematic analysis. “Is it that they [have] family problems?” reflected participants' explanatory models of mental health problems. “Maybe in Malaysia” was concerned with perceptions of Malaysian culture as both encouraging of open sharing of problems and experiences, but also potentially stigmatizing. “You have to ask for help” emphasized the importance of mental health help-seeking despite potential stigma. “It depends on the person” addressed the challenges of engaging with psychological therapy. Conclusions: We conclude that young people in Malaysia may hold compassionate, non-stigmatizing views towards people experiencing mental health problems and a desire to increase their knowledge and understandings. Yet societal stigma is a perceived reputational risk that may affect mental health problem disclosure and help-seeking. We suggest that efforts to improve mental health literacy would be valued by young Malaysians and could support reduced stigma and earlier help-seeking.