A growing body of research links the experience of racism to a variety of health and mental problems, with stress as the most direct link. The understanding of racism has become more complex in recent years, wherein investigators have shifted the focus away from overt forms of racism such as that associated with white supremacy to unintentional or "aversive" racism. Racism in mental health care is an ethical issue for psychiatrists and psychologists because it represents a very damaging force that is associated with mental health problems, and as such requires effective response. Racism and race related issues may enter the consulting room indirectly through the experiences of patients in the outside world, or, indeed, directly through the clinician's implicit and unintentional behavior. Both cases clinicians demand the awareness and responsiveness necessary to ensure that patients are not harmed. Conventional therapeutic approaches situate the locus of change in the individual yet racism is not a psychological problem as such. Recent work on racial microaggressions indicates that mental health professionals are prone to low level acts of racism that are of relevance only to the racially different patient; the clinician is unaware of such an act and as such not inclined to take corrective action. The Racial Identity Interaction model will be presented as a basis from which to understand the ethical impact of racism in the clinical context.