This exploratory study investigated the complexities of race and racial preferences in mental health as it relates to clinical decision making with African American clients. African Americans seeking mental health services face several unique barriers including the potential for racial bias, prejudice, discrimination, and racist norms that may inform a clinician's ability to accurately diagnose and provide the most appropriate treatment. This mixed methods study used an electronic survey to collect demographic and perceived effectiveness information, and asked mental health professionals to provide a detailed description of what has worked with African American clients during the assessment portion of treatment. After the completion of the survey, Greenwald, Mcghee and Schwartz's (1998) implicit associations test (IAT) collected the implicit racial preference of the participants. Semi-structured interviews further explored participant attitudes, perspective and beliefs of assessing African American clients. Two MANOVAs and a Chi-square were completed to analyze the data. Condensed implicit racial bias as identified by IAT score was found to be statistically significant with self-reported effectiveness of Mental Health Assessments with Black clients.