This chapter emphasises the role of social and economic inequalities in the production of both ethnic/racial differences in risk of mental illness, and in constructing the experience of ethnic/racial minorities in psychiatric care. It discusses the ethnic minority people's experiences of mental health services and the implications this has for healthcare provision and practice. Ethnic differences in risk of psychotic illnesses have been the primary focus of research in the mental health field, and most of this work has been based on studies of treatment rates. The chapter discusses non-health service-related factors: migration, genetics, culture, social and economic inequalities. One of the central problems with work on ethnicity and mental illness arises from the reliance of most work on data based on contact with treatment services. Generally, regardless of their ethnic background, people with mental health problems are critical of the services they receive.