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As unbelievable as [White Dude Super Detective (WDSD)] characters are, they would become infinitely more so if their race or gender were changed. In The Mentalist, WDSD Patrick Jane once grifted clients as a fake psychic, but now works as a hard-to-control resource for the California Bureau of Investigations. What if the Jane character were a Latino ex-grifter? Would his arrogance and propensity for sneaking into suspect’s homes and accusing wealthy businessmen of impropriety read as quirky and charming? Would anyone believe that a police force would allow such behavior? Could the Scotland Yard of fantasy be down with a coke-addicted black Sherlock—no matter how clever?

The San Francisco police department abides Adrian Monk’s obsessive-compulsive disorder, as the FBI allows Perception’s Dr. Daniel Pierce to assist on cases, despite his unmedicated schizophrenia and paranoia, which results in hallucinations. Could a black woman be cast in those roles to the same effect? I submit, that even in the fictional worlds of literature and television, race and gender matter. Belief can only be suspended so far. And this archetype is reliant on power that comes with white maleness in American society.

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Since they usually come from the same type of background as most white Americans, many white therapists likely harbor negative and stereotypical views of African Americans, and thus of their African American patients. These negative stereotypes can affect the health care black Americans receive. In a survey of practicing psychiatrists, Doris Wilkinson found that “cultural conditioning to racial beliefs and attitudes  .  .  .   pervades therapeutic contexts in which minority women are clients.”

Racial stereotypes among medical practitioners often stem from hoary societal stereotypes and centuries-old myths, some of which may be linked to scientific racism and its notions of biological “races.” Physicians who accept any of these old stereotypes, even unconsciously, are likely to communicate some negative feelings in their verbal or nonverbal behavior, thereby causing many black patients to withhold the kind of self-disclosure that is necessary for effective psychotherapy. Doing so may cause them to be labeled as “noncompliant,” which is a further stigma provided by the mental health care profession.

Some researchers have found that, for African Americans, psychotherapy with a white caregiver often leads to “unhealthful consequences.” In addition, diagnostic tests themselves are sometimes racially biased and thereby elevate the observed rates of certain types of mental illness for black Americans.
<br Indeed, most diagnostic measures for mental illness, which are routinely used to assess the mental health of African Americans, have been validated only for whites. A white standard of “normal” is usually taught to, and used by, therapists. Yet, the subcultural norms for what is “normal” and “abnormal” behavior are sometimes different for blacks and whites.