Accurate information is needed to facilitate health equity in underserved communities. This community-based participatory study asked residents about the meaning of mental health, their perceptions of community mental health needs, barriers to accessing mental health care, and acceptability of mental health services that are integrated in primary health clinics. Forty-five primarily African-American residents from urban communities participated in focus groups. Findings revealed high prevalence of substance abuse, depression, crime, and stigma about mental illness, with multiple access barriers. Participants were receptive to mental health care integrated in primary care, if others did not know they were receiving mental health care.