This paper examines selected expressions relating to the articulation of mental health challenges in three Akan speaking communities in Ghana, in the context of considering that language is reflective of human thought, and that human cultural practices and behavior emanate from people’s underlying appreciation of particular issues. Expressions of mental health challenges were extracted from a total of 37 one-on-one interviews and 12 focus group discussions. This paper notes that the expressions used fall into 3 categories: idioms and proverbs, non-figurative language and code mixed utterances. Overall, indirection permeates all the categories. Furthermore, the observation is that the expressions provide an indication of the manifestations and perceived causes of the illnesses, which are familial, spiritual or biomedical. There is a strong tendency towards an expectation of communal support for the mentally ill. An appreciation of the languages and cultures of local communities provides the basis for appropriate diagnosis, effective management of mental illness and efficient public health education. Keywords: Akan, Ghana, indirection, idioms, proverbs, mental health