The Western approach to understanding mental disorder, as indicated in the Diagnostic and Statistical Manual of Mental Disorders, is based on a bio-medical perspective which sees mental disorders as 'natural kinds' or discrete entities which manifest as dysfunction within individuals. Following from this is the view that its primary syndromes are ubiquitous worldwide, based on the assumption that this dysfunction is similar across diverse human populations. However, the cross-cultural literature reveals significant differences in the manifestation of these syndromes across ethnic groups, thereby challenging the universalist position. In response to this shortcoming, of the predominant contemporary conceptualisation of mental disorder, a constructivist understanding is offered which, it is argued, has a number of important advantages over the traditional view. In particular, a constructivist view can acknowledge the important role of social factors in the manifestation of mental disorder. And, importantly, it lends itself to a variety of alternative approaches to diagnosis and treatment which are culture-sensitive, and which therefore may prove advantageous in cross-cultural clinical contexts.