The research on external (social system) and internal (personal) attributions to mental health outcomes for African Americans is reviewed. Although many blacks have aspirations that they are unable to achieve, the motivational and mental health consequences of this situation are unclear. Several researchers have suggested that it is adaptive for African Americans to reduce striving effort and bring personal goals more in line with the objective realities of an unfair opportunity structure. Others have proposed that because an unjust system is to blame, the most appropriate response is to work collectively with other group members to make the system more open to opportunities for advancement. Epidemiologic research on the relationship of internal-external locus of control to mental disorder has generally found that being internal has positive mental health effects; while having an external orientation is detrimental. This paper addresses these issues by demonstrating that the psychiatric epidemiologic and the race consciousness literatures lead to opposite predictions about the relationship of external attributions (fatalism and system blame) to mental health. The article concludes with a series of issues which need to be addressed in order to advance our knowledge about social and psychological risk factors for psychiatric disorders in African Americans.