Based on Spaniol and Jung's stress and coping framework (1993), this study examined the difficulties and stresses experienced by carers with relatives suffering from schizophrenia in Hong Kong. The impact of these difficulties and stresses and of mastery as a coping resource on carers' mental health was also explored. Results show that carers experience most difficulties and stresses related to the management of negative symptoms such as refusal to perform household duties and neglect of personal hygiene, and less to handling positive symptoms such as bizarre behaviours and thoughts. It is also revealed that perceptions of stress associated with difficulties in the care of relatives with schizophrenia accounts for poorer mental health among carers. Lastly, carers with a strong sense of mastery have better mental health. Cultural issues such as 'family shame and face saving', 'family obligations and reciprocal expectations', 'external orientation to personal control' and the 'the Confucian work ethics' are put forward as explanations for these findings. Suggestions on culturally sensitive practices are made.