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The recognition of the importance of addressing cultural issues in psychotherapy and counseling has been increasing. The present paper seeks to contribute to the specification of multicultural competencies in the fields of counseling and clinical psychology, based on clients’ perspectives. In particular, its objectives were to explore the experiences of individuals of ethnic minority groups regarding their access to the Portuguese healthcare system and to identify the multicultural competencies of the clinicians (as perceived by the clients) which would be required to improve culturally sensitive treatments.

The sample included 40 adults from different ethnic minority groups in Portugal – a total of 30 women and ten men – with a mean age of 34. Participants took part in one of eight focus groups, which were conducted using a semi‐structured interview plan.

Content analysis revealed that, generally, participants had experienced discrimination in the healthcare system, and that mental healthcare was perceived as mixed (both positive and negative). Furthermore, participants identified specific aspects of multicultural awareness, knowledge, and skills required of clinicians to provide culturally sensitive treatments, providing support for the tridimensional model of multicultural competencies.

Implications are discussed for ethical guidelines and clinical training of counselors, clinical psychologists, and other social and health professionals in Europe.

The paper addresses diversity, multi‐culturalism and mental health. It reports qualitative data from a larger project on multi‐cultural counselling competencies in Portugal which sought to meet the needs identified by specific minority groups by developing integrative, responsive and culturally sensitive treatments. A qualitative study is presented, with the aim of exploring the representations of mental health and illness held by ethnic minority groups in Portugal, as well as their specific needs and obstacles encountered in their interactions with health professionals. Semi‐structured interviews were conducted, and the results indicate that the meanings of health and mental health varied. Meanings of psychological health were related to general well‐being. Help‐seeking behaviours were associated with providing and receiving family and social support, mainly among participants of African descent. Although the great majority of participants had had no experience of counselling or psychotherapy, they expected psychologists to be multiculturally sensitive, as well as knowledgeable about diversity and multi‐culturalism. Implications for development of mental health services for minority clients are discussed.