Effective communication is necessary for the provision of good quality health care as it enables a helpful process in being able to meet the service user’s needs. However, due to language and cultural differences many service users do not receive mental health services on a par with their English-speaking compatriots. Language differences can be excluding in terms of service users not being able to communicate needs, not being understood, and not being able to feel empowered in determining the type of services that are provided. Whilst many health care services are addressing issues of inequality and access for ethnic minority service users, there is a need for continuous process change if all communities are going to benefit from the health care provision that is available.