Abstract Our goal is to highlight challenges clinicians encounter in achieving valid psychiatric diagnoses in linguistically and culturally diverse patients. These challenges often arise from language barriers, misinterpretation of nuanced expressions of distress, and a lack of consideration for the patient’s unique experiences and perspectives regarding their illness, leading to potential misdiagnoses. In this context, we explore the strategies to address these diagnostic issues. To illustrate these challenges, clinical examples of culturally diverse patients are presented. These cases offer insights into the cultural nuances of expressing distress and attributing illness to the external factors such as cosmic influences and spiritual afflictions, often employed as a way to conceal underlying causes. To achieve culturally appropriate diagnoses, clinicians need to be mindful of their patients’ cultural and spiritual beliefs, establish trust and rapport, and approach patient narratives with empathy. This empathetic approach allows clinicians to gain a deeper understanding of the patient’s cultural expressions of distress and their perspectives on illness attribution, often tied to supernatural influences. Importantly, effective communication is a key to uncovering the concealed causes of the patient’s condition.