Book excerpt: 'Black and minority ethnic communities lack confidence in mental health services', according to the National Service Framework for Mental Health published by the Department of Health in 1999. Cultural Diversity, Mental Health and Psychiatry examines how and why this situation has come about, and makes specific practical, often surprising, suggestions for changing the status quo. In his latest and most critical analysis, Suman Fernando reflects on the current situation in light of his own personal experience, academic research and anecdotal reports. He weaves together themes of immense importance for the future of psychiatry and mental health services in a multi-cultural setting, exploring: * the nature of racism and its permeation into mental health services * the inside story of the struggle against racism in statutory and voluntary sectors of the mental health system * the history of psychiatry and the role of spirituality, holistic thinking, psychotherapy and Asian traditions of medicine. Trainees, practitioners, and managers of mental health services will profit from the practical application of Fernando's latest ideas, and students and academics will benefit from his theoretical guidance.