To review the current status, directions and distortions in the field of culture and mental health, and their interface with politics.

Arising from the ruins of Adam Smith's shattered capitalist dream, shattered by the Great Depression, Keynesenian economics underpinned post-neoliberal thought and shaped politics, culture and science in ways few could have imagined.

Biomedical science did not remain immune, and mental health provided a soft target to political activists and reformers. Research evidence relating to ethnic variations in the prevalence, pathways to care and outcomes in schizophrenia, generated from epidemiological studies on migrant populations and a series of WHO-sponsored cross-cultural studies, has become enmeshed in the dialectic around alleged institutional racism in psychiatry, with deeply entrenched and highly adversarial posturing on both sides.

Examine research evidence linking schizophrenia and culture, and how the politics of post-neoliberalism impacts scientific inquiry, with illustrations from different countries, and attempt to identify islands of credible research and outline possible future directions.

Fragmented and often contradictory evidence in this area does not lend itself to coherent inferences, with the problem being compounded by allegations of institutional racism.

There are many unanswered questions:

• • Does cultural research improve clinical practice?

• • Or does it merely distract attention from core/ important secular issues?

• • Does it tend to demonise mainstream services and alienate ethnic minority patients?

• • Does what some term cultural gimmickry serve a hidden political agenda?

• • Has cultural research evidence lead to meaningful macro or micro-level interventions?