This qualitative pilot study explored the mental health needs of visible minority immigrants in St. John's--a small urban center in Atlantic Canada with limited ethnoracial diversity and ethnospecific infrastructure. The study examined the facilitators and barriers to maintaining immigrants' mental health and their perspectives on availability and access to support services and programs that support mental health. Our findings revealed several determinants of the mental health of visible minority immigrants: social support, income, employment, culture, physical environment, coping skills, gender, and availability, accessibility and cultural appropriateness of mental health services. We offer 18 recommendations framed by Health Canada determinants of health that may be of interest to decision-makers in government, health agencies and social services in similar small urban centers.