In an increasingly globalized world, migrants, refugees and asylum-seekers show higher than expected rates of mental illness. Migration and asylum occur for a number of personal and geopolitical reasons. Cultures and cultural identities strongly influence presentation, help-seeking and therapeutic alliance. Black and minority ethnic groups have higher than expected rates of psychiatric disorders, and their idioms of distress and pathways to care often vary compared with the majority population: thus, they need particular consideration in terms of their mental healthcare.