“With a normal job, if you're sick, you don't go in,” says Louis Carnell, aka producer Visionist, over the phone from his hometown of London. Carnell recently released a dark, tetchy electronic record called Safe chronicling the arc of a panic attack: the teetotal producer suffers anxiety so severe he once had to cancel an Australian tour. “As a DJ, if you’re on tour and can't turn up to a gig, you lose money,” he adds. “And you don’t just lose the money you're about to earn—you're probably gonna have to pay for flights.”

As well as emptying your wallet, chronic anxiety on the road can pose a grave psychiatric risk. In 2013, singer-songwriter Beth Jeans Houghton—now signed to Mute as glam outfit Du Blonde—was cooped up mid-tour in a Zurich hotel, obsessing about death. After five sleepless days, she suddenly panicked and called her tour manager; when he arrived, she had become paralyzed. “I looked at him and tried to say, ‘You need to get me an ambulance,’” Houghton remembers, speaking on the phone from her north London home. “And gibberish came out. I thought, I'm either dying or I'm going to spend the rest of my life in a mental institution.”

Luckily, her tour manager recognized the symptoms of a nervous breakdown, and spent seven hours cradling her to sleep. But it needn’t have got that far. “My label checks in with my tour manager to see how my voice is doing,” Houghton reasons, highlighting a disproportionate focus on physical health. “Maybe every six months they could have a meeting and check how we are, mentally.”

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A simple enough idea, but in practice, it’s compromised by the stigma that still exists around the subject of mental health. Mike Sniper, the owner of Brooklyn label Captured Tracks, stresses that he’s “definitely interested” in artists’ wellbeing, yet bristles at the thought of reaching out. “Certain artists, if I was to suggest a thing [concerning mental health], they or their managers would be upset,” he tells me over the phone from his New York office. “Like, ‘What gives you the right? Why would you think you're even able to do this?’” In Sniper’s eyes, the parties responsible are “management, bookers, promoters, venues, and artists who make the money on live performance.” After all, he claims, “nobody's forcing you to tour.” While technically true, the financial realities are often different.

“When you're in the middle of an album cycle, it feels like this inexorable process where you can't get out of it,” ex-Joanna Gruesome frontwoman Alanna McArdle says today from a Hackney café. “And because it's a small label—and I really love working with Sean [Price]—I thought, I can't fuck this up, because this is his money on the line.” After a short run of dates this February, McArdle—destabilized by sleepless nights, bipolar-induced mood swings, and the threat of costly show cancellations—realized she’d had enough. “Lately, my mental health problems have become a lot worse and I've gone through a pretty shitty time,” she wrote in a Facebook statement that June. “Thanks to everyone who ever put up with me on tour, and anyone who stopped any assholes from hurting other people at our shows.” With overwhelming love and support from fans, she parted ways with the group.