This article focuses on problems of cross-culture communication between patients and psychiatrists of varying socio-linguistic and foreign language backgrounds, in an in-patient psychiatric community facility. Issues of diagnosis, integration into the ward treatment program, and progress in the course of treatment can in some cases be traced to specific socio-linguistic problems, which have previously gone undiagnosed. The clinical impact of three types of communication breakdowns are evaluated: (1) overt language differences; (2) linguistic ambiguity; and (3) linguistic insecurity. A need exists for further research in identification and assessment of language insecurity, and for modification of therapeutic procedures to deal with inter-dialectic communication difficulties.