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Identity is a multilayered and multifaceted concept. This chapter describes the link between culture and expression of symptoms and distress, and how culture influences help-seeking and affects recovery and health inequalities. Using clinical examples from South Asian women, the chapter illustrates clinical management issues and what clinicians may find useful in dealing with the problems with which patients present. The literature on the role of culture in the development of mental illness and the promotion of mental health makes use of numerous terms to denote specific cultural, religious, ethnic and racial groups. The early literature on South Asian women refers to a higher suicide rate among young women of Indian origin, and greater levels of self-harm amongst South Asian women. Somatic idioms of distress are common. This chapter predicates on the clinician/therapist being able to enquire about unusual beliefs and forms of identity with which they are unfamiliar.