People from ethnic minorities are over-represented in secure psychiatric care, and have been reported to receive differential treatment from staff. It has been suggested that these people (especially Afro-Caribbean groups) suffer from prejudicial legal, criminal justice and psychiatric system. This text questions whether Western, white-oriented practice and systems of belief can, or should, be applied to service users from other cultural, racial, ethical or spiritual backgrounds. Contributors examine and explore the central and theoretic issues, such as culture, power, difference and participation and relate them to examples of practice, and to the improvement of future service provision.