Abstract Cultural competence, as a tool to overcome disparities in mental healthcare to ethnic minorities, is facing unprecedented challenges. Providers are turning to cultural competence as one of the few resources available for badly needed information and strategies for improving clinical care. This essay provides background information about this issue and addresses two broad questions. First, are cultural competence programs ready to meet the test? And second, what are the likely consequences if these programs don't adequately meet expectations? This article also reviews what is at stake for clients, health care providers, and advocates of cultural competency in using this paradigm to address the disparities crisis. Recommendations for future progress in this field are discussed.