As society looks back in regret at how poorly Britney Spears’s mental health crisis was covered in the media of 2007, artists like Chappell Roan and Ariana Grande have, openly and unapologetically, taken care of their need for mental health support and taken breaks from musical tours to recover. Even though the stigma of mental health has waned in recent years, artists’ mental health needs are still widely disregarded by ever-demanding music industry professionals and fans alike. The treatment for this industry-wide issue is a specialized mental health care that addresses the distinctive needs of musicians, support crew and more.
UK psychotherapist Tamsin Embleton stepped up to address this critical need, leading a mission to make this support accessible across the music industry. She founded the Music Industry Therapist Collective (MITC), a global group of specialized health clinicians in the UK and US, providing mental health support on tour, in person and online.
ABILITY Magazine’s Olivia Austin and Chet Cooper met with Embleton via Zoom to discuss how she moved from the music industry into psychotherapy as well as her new book, “Touring and Mental Health,” a guide and support manual for managing the strain of physical, emotional and psychological challenges of the music industry. Embleton discussed the unique and often unaddressed mental health needs of musicians and support staff in the rigorous and high-pressure touring environment. She also shared helpful realizations around mental health that can be used by anyone.
Olivia Austin: I understand you previously worked in the music business.
Tamsin Embleton: Yeah, I did. I started in music in the early 2000s, and I was primarily working in live booking venues and festivals and a little bit of artist management. I ended up in a recording studio called Metropolis (in the UK). Basically, a lot was changing in music then. There were a lot of big brands coming in. I used to be a punk back in the day. I had green, spiky hair and lots of facial piercings. The way some aspects of the industry were going with working with brands didn’t sit very well with my punk ideologies.
But also, I was in therapy myself. And I realized, through that work, that I wasn’t very good at making money from shows, which is quite important in promotion. It was an amazing show, but it never really made much money. But I was really good with people. I’d been working, on the side, in homeless shelters for a little while, and I had a sense that I wanted to work with people and was going through my own therapy process dealing with childhood stuff.
Then I spoke to my therapist, and she said, “Look, go for it. Let’s try something new.” That’s what I did. But I was inspired to try therapy, specifically, for the music business when I was on tour in 2010, and I was a tour managing a woman called Anna Calvi. She was on the road with Grinder Man, which is a Nick Cave & the Bad Seeds side project. We were in Germany having a meal after a show, and we were talking about therapy experiences. A little while later, when I was thinking about retraining to be a therapist, I remembered the conversation. I thought, “Someone out there is a Nick Cave’s therapist, and I think that’s a really interesting job to do.” I didn’t realize you could specialize in a specific industry. Yeah, so that’s what I did.
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Olivia: How is it to be a part of creating a healthier mindset for music creators?
Tamsin: It’s a big question, and it’s a great question because on a personal level, I find it really fulfilling. I love meeting people and helping them discover parts of themselves and helping them really reflect on their experience. But what our role is almost separate from the industry.
We’re on the sidelines and we are one of the only people in that artist circle that has no skin in the game. If they’re on stage or off stage, we just want them to be well. And it’s really important that artists have someone like that who is just saying, “Okay, and what was that like? So, when you were thrust into that scenario, or when your status really changed…” Working with an artist at the moment, who’s had this enormous status change recently, it’s a lot.
Suddenly, she has security. All of these things are changing. She doesn’t know how to manage that. But, also, she’s not allowed to walk down the road by herself anymore. This is a lot. And you need to have somebody where you can.—You need to have a place to vent and make sense of it. And so, I feel really privileged to be able to do that. It’s an honor, really.
But there is a little bit of tension, I would say, because, sometimes, what we want for the artist is in an ideal world for things to be paced and for things to happen. And the industry doesn’t work like that. When the interest is there, it’s all hands on deck and everyone around you wants you to take every opportunity and make them.—Maybe not every opportunity, they’re still discerning..—But they want to make the most of that opportunity. Sometimes we are seen as someone who’s either trying to sanitize the industry or maybe getting in the way of that. I think maybe the more modern management doesn’t feel like that because they know that we’re there in support and it alleviates the burden for them. Some of the things we’re doing in the industry on tour, for example, there’s not always budget set aside for it. Every other industry has health and welfare and occupational health and things like that. And touring is one of the last areas that really doesn’t still.
Olivia: We’ve heard popular artists, like Chappell Roan and Ariana Grande using their platform to talk about the importance of mental health and health support. An artist cancels a show, for example, because they’re not doing well. The audience response can be very intense and critical. Do you feel like there’s an impact on the audience when an artist is getting the support they need?
Tamsin: Yeah, because audiences want to have those moments of connection. It’s disappointing. And it’s “What do you do with that disappointment?” Sometimes we see a lot of compassion and loyalty from fans who are saying, No, this is okay. It’s good that they’re looking after themselves. We also see a mixed bag there. We see people getting angry like, Well, why couldn’t you just keep going? We see a mixture. I mean, there’re a lot of things that have changed over the past 20 years.
More recently, artists aren’t using euphemisms anymore. What we used to see in the press as “exhaustion” is now, actually, “No, I’ve had a breakdown.” or “I’ve relapsed.” or “I’ve been in crisis.” These things are being named. There’s more of a language in public discourse. But also, fans have much closer contact with artists through social media. Artists are encouraged to disclose a lot more, and there are multiple things that this can lead to. The public has more of an insider view into what’s happening for some artists that are disclosing that. They also have much more access. If they comment on photos or posts or something, then lots of artists do read that, and then they have to deal with what that’s like to have all of that amplified message, which can be a lot. It really can.
Olivia: Sounds like a whole other world of things to manage.
Tamsin: Right. And you’re not trained in how to manage that. No one says at the start, “Okay, so here’s what might happen. This is what it might be like. This is how it might affect you and your personal relationships.” You’re just expected to step into a world that is all-encompassing, that will always want more from you.
So, a lot of the reasons why artists burn out is that they feel like they can’t say no. They’re at the center of this machine, especially on tour, that is working walking around them. They know they’re responsible for, I don’t know, 50, 80, 120 people’s day rate (crew). It’s just everyone sees my job as so covetous. The artist gets the glory. It’s very difficult for everybody else on tour as well, but they have to deal with envy. They have to deal with people saying, “Oh, just be grateful for this.” Don’t complain. Don’t stick your head above the parapet, which is why it’s amazing that Chappell Roan and other artists are saying, Actually, this is hard. Let’s change things. Let’s look after people.
Olivia: Yes. It’s time.
Tamsin: Exactly. Long overdue.
Chet Cooper: How do you work? Do you do everything online? Do you have in-person? Can you explain your operation?
Tamsin: Absolutely, yeah. We do a mixture. Music Industry Therapists Collective operates like a nonprofit. We’re about to make that more official soon. But we are a collective of psychotherapists and psychologists that used to work in the music business. Essentially, it happened really organically about eight years ago. I started meeting other people. I thought, “You know what? We could have a collective voice here to advocate for what we’re seeing and to help the industry understand the process, the psychological processes of what’s happening.”
We’ve got therapists from California, across California, Nashville, New Jersey, New York, across the UK, across Europe, India, and now in Thailand. We work with people one-to-one. We work with bands and groups. Sometimes we work with artists and managers. At the moment, I’m doing some work with a British band. We were on tour and we’ve met them in rehearsals, doing workshops, group therapy. Then I’m meeting them for backstage therapy. And we’ve done that for a number of artists. Also, an online platform we’ve just developed, which is basically giving artists and crew access 24/7 to our therapist for single-session therapy because we’re just trying to make it as accessible as possible.—however people want to work—and trying to make sure that people aren’t left out.
The online platform has a fund that we’re building at the moment. If sessions aren’t, say a tour buys 10 sessions 20 sessions. If they’re not used within six months, it goes back into the fund. Then a tour that can’t afford the sessions will get a bundle for free. We’re trying to improve. There are a lot of barriers to getting help, and we’re trying to look at them and say, “Okay, how do we get around this? What else can we do?”
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Cooper: I wonder if there’s a way you can look at a strategy that connects ticket sales In some fashion, a small percentage goes into a fund.
Tamsin: I would love that.
There’s a great charity here called Music Venue Trust who have done similar. They’ve got a levy in the major venues. I can’t remember who signed up, but I imagine it’s Wembley and O2 and stuff. Then a small levy goes back into grassroots venues that are closing. One of the problems with healthcare is that nobody wants it to be part of their budget. Production managers and vendors’ costs are going up. Agents say, “Well, this shouldn’t be an artist’s cost.,” even though the artist is technically an employer. Everything’s gone through the fine-tooth comb with management. So essentially, nobody wants to pay. So, we are going to have to find some artists who do. We’re working with a few artists at the moment that have said, no, actually, this is so important. Let’s put it in. But yeah, this is quite new.
Olivia: Do you feel like it can make an artist’s work more more successful working with all of you?
Tamsin: Yes. I’m biased, but I’ve definitely seen resilience developing and people feeling better able to advocate for themselves and make healthy choices and know their boundaries and their limits. We’ve had a lovely quote recently, actually. I’ve trained a welfare officer who’s out on the road with Dua Lipa at the moment, one of our big British exports. That came about because the production director, Peter Abbott, had read the book, Putting Together Touring and Mental Health, and said, “How do we put this in action? I want people to feel safer on the road. I want them to feel like they can belong.” We now have this welfare officer who is a mediator. She’s a counselor. She’s a health coach and advocate. The results have been amazing. We’ve been surveying people, and Pete says, “Look, the show sounds better and looks better because we have a welfare officer out there. People are working better together. They’re collaborating. They feel safer. They’re less stressed.” Yes, it does have a knock-on effect to productivity, creativity, working together, all of that.
Cooper: The welfare officer is part of your collective?
Tamsin: Yeah, she’s a psychiatric nurse and also a production coordinator. She has a really unique skillset. Our thing is that we’ve all been in the music business prior to retraining, and that helps us build a rapport. Music industry can be a little bit “them and us”. They want you to know, have the language, and which kind of makes sense. It saves time. We know sometimes when people work with therapists who don’t have that understanding, the therapist might be distracted by aspects of fame or proximity to fame. They might not be focusing on the right things in the session, or they might just spend ages explaining how the industry works. Yeah, she’s part of our collective.
Cooper: Plus, she plays the drums, right? (laughs)
Tamsin: She probably does, actually. But an interesting skill set for Sasha, but I’ll make that suggestion.
Cooper: Really interesting collective you’ve put together. It’s such a unique industry. Our publication is celebrity-driven, so high-profile personalities, with mostly TV and movie stars. And what I’ve seen, some celebrities have a problem with friendship. They don’t know who an actual friend versus someone who is just clinging to the celebrity or trying to get some benefit because of fame. I’m sure you have to deal with that with your communications with your clients.
Tamsin: Yeah, we presented a panel on this, with Philip (Selway) from Radiohead in 2024, on the Psychological Impact of Fame, where we were talking all about that, the problems, the trust issues that can surface in relationships: the fact that everyone wants a piece of you. They want to benefit in some way. They want to be near that proximity to fame. They want it to rub off on them in some way.
I’ve done a bit of work with him previously, and I always notice when he enters the room because there’s a bit of a shift. Certainly, for somewhere with a lot of Radiohead fans, there’s a little bit of a shift, and people become a bit more self-conscious. Yeah. We’ve just written an article about that for a book by Eric Mazel. (Psychological Impact of Fame) It will be coming out next year, I think, all about artists in crisis, and our article is all about the impact of fame. It’s vast. There are many stages to it.
Cooper: Yeah. I experienced it for just a short period of time myself. I was publishing National Lampoon Magazine for a while. People thought I was producing the movies —all of the sudden I had these “new friends”, and it felt so strange. I can’t imagine a daily dose of that going on in your life. It’s so great to hear that there are things written about it. Can you go into a little bit more about what you produced in a really brief summary of psychological impact of fame and the issues around it?
Tamsin: Well, my part of it was talking about the different phases. There can be a sense of trying to make it, trying to maintain it.—All of that in these different stages. And then losing it. And what does that feel like? So, the early stage is trying to catch people’s attention, this real preoccupation with how to do that. But Relevance is a big theme in that. Fear of losing relevance. You’re only as big as your last hit. But the way that you relate to yourself and the way that you relate to other people can shift and change during these stages.
Olivia: I had a question about the writing process for musicians. It sounds like you’re there for these different stages. Do you support artists as they’re going through the process of songwriting or for songwriters or the stages before the tours themselves?
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Tamsin: Yeah, of course. Whatever is coming up for artists, whether it’s something in their personal life or their professional life, whether it’s an issue related to, say, writer’s block and not knowing what to say, how do you engage people again? If people have been very interested in something previously that you’ve written. There’s, of course, often a desire to maintain that interest, but also you want to say something that’s fresh and relevant. Maybe you’ve experienced some press that hasn’t been favorable. Sometimes that can really stay with people as well, especially if they’re perfectionists.
Then they have, essentially, the internalized voices of fans, of A&Rs (Artists and Repertoire representative at record labels), of their team, of themselves, of press. And they have to find an authentic voice within all of that. What is it they want to say? What is it they want to make? One of the problems can be that at the start of your career, you don’t have as much of that. So, you can really write from a place that is really expressing something from within, rather than it being interfered with by these external forces.
Once you’ve made something that works, other people want you to make.—Oh, yeah, go and do that again. Go and recreate that. And then you’re starting from a very different position because there’s already this pressure to make something or maintain something or to feed something, to feed somebody else’s desire of what you make. So, you have everybody else’s fantasies of who you are and what you represent to them, that you might feel compelled to meet rather than it being, “Okay, here’s where I am now. Here’s what I want to write about now.” There’s less freedom of expression.
Olivia: I’ve heard a lot of people talk about this idea of creativity coming from suffering. A lot of artists. And in the creative process, what we’re learning, and what I’m learning from even this conversation, is more and more that maybe it’s the opposite. Maybe it’s harder to access our authenticity. But I’d love to hear your thoughts on that.
Tamsin: It’s a really good question. And this is one of the myths that is in the industry that some artists will be up against when they start to have a profile. So, we have the myth of the tortured artist or maybe the 27 Club or something like that. Someone’s actually gone out and done the research and said, “Do artists tend to die or suffer more at age 27?” And that’s not the case. I think it’s a good question.
What I would say is that creativity can be a vehicle to transform and process feelings. It can be a way to express yourself. And through that expression, that can help to feel relief. It can help you to make sense of it. And in that way, it can be felt to be healing. But if you’re really, really unwell, you’re not making much, really. So, we see the arts being used in lots of treatment settings, precisely because it can help put words to stuff that’s very hard to articulate purely verbally or face-to-face, which can be intimidating sometimes or can have other dynamics in there. But if it’s you and a canvas or you and some musicians or some instruments rather, then yeah, that can be really helpful.
But what I will say is that, yes, it can be detrimental. I’ve worked with a few artists who’ve been very connected to this idea that authenticity means that they must be struggling and suffering, and so they keep themselves in a state of being high risk, let’s say, either taking particular drugs or putting themselves in risky situations. That may be enlivening in some way in the body. It might be recreating a traumatic experience they’ve had previously. We understand it in that context.
But if they’re really unwell, you stop being creative. If you’re very, very, very unwell, unfortunately, it can obviously lead to death, and no one’s creative in that place at all. We’re trying to help people understand the difference between the cathartic expression, transforming feelings and meaning-making, which is the essence of therapy as well as the essence of some creative pursuits, and keeping yourself in a place where you’re unwell and you’re recreating creating and reinforcing unhealthy patterns for yourself.
Chet: I’ve been an entrepreneur all my life and been successful in different forms. So, I, often will try to help individuals and I would talk about the school of Hard Knocks, that everyone should at least attend that to some degree. But I say at some point you have to graduate. All successful business people that I know have failed at least once. Just as you said, you don’t want to stay there. At that point, it’s detrimental to your existence.
Tamsin: I guess there can be other things that can happen, right? We also see people that are very successful, sometimes can come from a background of deprivation, and they can have a real drive. And there can be a lot of positives to that, that it’s helped them reach something. But we can also sometimes identify other aspects that might be less helpful and can sometimes get in the way, like craving a lot of external validation or a compulsion to overwork because it’s very difficult to stay with your feelings.
So, it’s trying to understand the role of what we do and what it means. Why are we in these patterns? Why are we behaving this way? What does this mean? How have I used this to my advantage? Or what thought patterns or patterns am I in, in general, that may not serve me in the long term? We see this a lot on tour, particularly with crew, where often this sense of perseverance and endurance.—And crew are often very hyper functioning in work scenarios. They have a lot of function there, but to the detriment of their physical and mental health.
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We’re saying, well, don’t mistake endurance for resilience because that’s different. Actually, resilience does give time for rest. And rest.—Like we know from the world of athleticism, rest is built into high performance. In music, it’s not. We’re trying to learn from that industry. If you’re training for the Olympics, let’s say, then there will be periods of rest that will be built into that. And that will be expected and a necessary part of thinking of how you’re going to put yourself through that scenario and how you’ll recover. In the music industry, there’s no recovery time. After one tour, you’ll be back in the studio and expected to churn something out.—Even though you’ve been playing the same hits in the same order.—So, you might not be feeling creatively fresh. Maybe you’re inspired from something you’ve learned from the road, but there’s not much like, “Let’s slow down. Who am I now? How has this changed me?” It’s very fast-paced. And there’s a sense that unless you seize these things, as I said earlier, they’ll somehow pass you by and they’ll go to someone else. Everyone’s frightened of that.
Chet: As you were talking, I was thinking about the severity of certain mental health issues. Does your collective also have psychiatrists?
Tamsin: Absolutely. In different territories, we work with different GPs and psychiatrists, and often people come to us who already have those teams. I work a lot with people who have been given diagnosis, like schizoaffective disorder, bipolar I and II, so-called personality disorders. These people have areas of very high function and areas of difficulty. Sometimes we’re working with the team around them, and often the team around them.—I don’t want to do the industry down too badly here because sometimes we’ve had referrals from management who have been much more supportive than the family of origin, let’s say, in instrumental and getting people help. We’ll make recommendations. I do consultation for record labels like Mute. I spoke with them last year with an artist who was, unfortunately, sectioned in the end. There’s a lot of unwellness in the industry, and there’s also a lot of well-meaning people in the industry who just don’t understand what they’re seeing. Sometimes it’s been characterized as, Oh, these artists, and they’re quite charismatic or they are eccentric or have these unusual quirks. We’re saying, “Well, yes, maybe.” But also this is a sign, and these signs together may indicate that this person has experienced hypomania or this or that. Actually, they might need a bit of help from you. We try and provide that guidance as to what to do, what’s best practice in that scenario.
Cooper: Our chat with Brian Wilson, who had schizoaffective disorder was interviewed by Dr. Friedman, who’s a psychiatrist and part of our team. And at the end of the interview, he told her he felt like he had just gone through a wonderful session. It’s the nature of the way she asked questions. He’s a good example of someone with a mental health issue, such a creative, such a genius.
Tamsin: Absolutely. You’ve made a really good point there. One of our therapists, who joined us from being a journalist, once approached me at a speaking event I was speaking at. He said, “Look, I feel this weight of responsibility because I know that my job is to get the scoop, to help people open up. But I have been aware in some interviews that sometimes, I’m touching upon something that’s very raw, and I’m wondering about my responsibility there, my duty of care there or what were the boundaries.” He ended up training to be a psychotherapist and joined us.
It was really good to hear him think about that because, sometimes, interviews can touch upon things that are: “Once it’s out there, you can’t take it back.” Everybody wants to talk about mental health. It’s a very hot topic at the moment, but sometimes I feel quite conflicted about that. I love talking about it, but I also feel quite protective of the people I work with and I want them to have something that’s still private. Especially if it’s unprocessed and they’re still working it out, it’s still affecting them. It’s different when it’s later down the line, and they can talk from a position of safety. Yeah.
Cooper: I have a bit of a problem. When we spend time producing an article, we spend time with it, seeing the person’s photos, editing and starting to feel like we know them. Of course, the person who did the interview spent an hour and moved on. So, I met Brian Wilson at a private event after our initial interview a year earlier. I’m feeling really comfortable with him. I’m sitting next to him. While laughing and saying whatever, I had done a quick tap on his knee while laughing and he quickly jerked his knee away. “Oh, shoot!” He doesn’t like to be touched. Not only does he have an issue with that, but he doesn’t really know me. It was awkward. I felt terrible, I could see his mood immediately change.
Tamsin: That’s a really natural thing because we become so familiar, don’t we? With people in the public eye. We do feel like we know them, and they do chime with parts of us. I was just listening to a record earlier that really reminded me of when I was 15, 16. It’s what we call a parasocial relationship, right? It’s a relationship where one person knows a lot about the other and develops an internal relationship to them. Of course, if you then meet that person, you’re going to feel that and it’s going to intensify. It’s really natural.
Chet: It makes so much sense. Yeah.
Tamsin: In that article that I wrote about the Psychological Impact of Fame. We talk a lot about parasocial relationships.
Olivia: What do you think we as fans or as audience members of these shows and listeners of the music? What do you think we can do to encourage supporting the artist and encourage a healthier mindset in the music industry?
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Tamsin: That’s a good question, and not one I’ve been asked before, actually. I hadn’t heard that kind of suggestion. What can the audience do?
I guess there’s something about appreciating that these are ordinary people in extraordinary circumstances. Artists, anyone in the public eye, have all of the usual stresses of life, and then they have some more ones that are very specific to their job role and their status and their being in the public eye.
And so, we can’t expect them to be superhuman. We can’t expect them to endure. There will be times where it’s hard for them and they need to take time off, just like any of us needs to take time off sometimes. So, I think a bit of compassion and understanding there. Sometimes, I’ve seen a demand from certain groups of fans for knowledge about an artist’s private life that really they’re not entitled to ask for. It’s whatever the artist decides to disclose about something, let that be enough. They can say that. Whatever they choose, they might just choose to say more later, they might not. And that’s okay. It’s up to them.
Chet: Do musicians have access to unions in the UK? Are there international unions?
Tamsin: Not international, as far as I’m aware. I’m not as clear on the United States. I know there are some unions for crew. In the UK, There’s the Musicians Union and there’s the Featured Artist Coalition, which is union-like, who are advocating for change, and whether that be about songwriting credits or it’s about living daily wages. We see in different countries, like the Nordic countries are always well thought of in terms of having living wages for artists and things like that, which we don’t have in the UK yet. I haven’t seen anything international, but I could be wrong.
I see the most impact when artists like Raye speak up for songwriters or artists like Chappell Roan, as you said earlier, use their platform and say: hang on, this is wild what I’ve been put through or what I’ve been expected to share or the intrusion, the various things that they’ve talked about. Again, It’s difficult, isn’t it? Because we’re expecting artists to advocate for themselves and to share what they’re personally going through. It’s a pity that there isn’t more health and safety and HR built in. All of these major record labels have that for their execs, that they don’t extend the same for artists, or care is usually issue-specific or short-term.
Lots of major record labels have in-house therapists now, but, often, the care is short-term. When artists get a bigger profile, they don’t necessarily go in-house for care then. It’s complicated, but the industry is always wrestling with “Who’s responsibility is it? Whose duty of care is it really?” Often people are like, “Well, it’s not really me.” That’s not within my remit. That’s not my job role. Then we see somebody else…There are so many high-profile of deaths.
Audiobook of Touring and Mental Health: the Music Industry Manual is downloadable here. 30% discount code: Ability30 for ABILITY readers. Also available on Audible, Spotify. etc. The physical book Amazon.
*Article about the psychological impact of fame co-authored by; Tamsin Embleton, Dr Susan Raeburn, Dr David Giles and Philip Selway, in a book called Artists in Crisis.
