The stigma attached to mental health problems is well-known and attempts to diminish it have been made by both the Royal College of Psychiatrists and members of the Royal Family in recent times. It must also be a commonplace observation among professionals that this stigma is inclined to rub off.
Jean-Étienne Dominique Esquirol (1772–1840) was a favourite student of Philippe Pinel. He founded a private asylum and later succeeded Pinel at the Salpêtrière Hospital. He is credited with extending the humane reforms introduced in Paris to the French provinces, insisting on the importance of physician-led institutions, pioneering the formal teaching of psychiatry and emphasising the role of the state in providing mental healthcare. But this very successful man, René Semelaigne tells us in his book Les Grandes Aliénistes Français (1894), nursed a secret sadness:
‘Those whom he had taken under his care, or whose relatives he had treated, avoided him in public. To know a doctor who treated the mentally ill, to speak with him, seemed for many people an admission that they had had recourse to his ministrations. Esquirol's tender, sensitive heart suffered in this way. “Fatal profession,” he would write, “People do themselves credit by not recognising me; above all those whose secrets I hold, treat me as a pariah, and have need of darkness or to be behind closed doors in order to shake my hand.”’
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