Research demonstrates that gambling support services often do not meet the needs of people seeking help for their gambling problems. In particular, the needs of cultural groups, and gender-specific needs of men and women are neglected. Understanding differences in help seeking behaviour can assist in developing early interventions to address gambling related problems and in developing effective strategies. This paper reviews the literature on help seeking by problem gamblers and their families, including barriers to and relevance of services through a gender and cultural lens. Research findings from international and New Zealand studies are examined, highlighting ways in which gender and culturally appropriate strategies can be implemented. Ways of changing barriers and social policies are proposed which may improve the responsiveness of services. Ultimately it may encourage health care access and utilisation for people and their families seeking help for problem gambling.