The objectives of this study were to undertake a needs assessment of mental health services for asylum seekers and refugees in the London Borough of Haringey, to estimate accurate numbers of asylum seekers and refugees who need mental health services, and to understand their perspective on mental health needs and services. The mental health needs of asylum seekers and refugees in Haringey were determined through a needs assessment exercise, using epidemiological and corporate approaches. The representatives of the main asylum seeker communities in Haringey were interviewed to find out what the mental health needs of this group and their community are, and how best to provide services to them. Estimates of number of asylum seekers and refugees in Haringey ranged from 5000 to 35 000, with a current best-guess figure of 31000. The community representatives’ views suggested that the factors affecting mental health of asylum seekers and refugees were not directly under the remit of the National Health Service (NHS). They felt that practical issues like education, employment, and social inclusion should be addressed alongside provision of effective professional help like psychotherapy or pharmacotherapy. They also felt that language and cultural barriers were significant impediments to constructive engagement with mental health services for this group. Mental health needs of asylum seekers/refugees are broad based, with implications for public health, social services, primary care, and mental health services. Approaches to developing services for asylum seekers and refugees should be multidisciplinary, and community driven, addressing language and cultural barriers.