Last month marked 10 years since Britney Spears shaved her head. At the time, the world – myself included – collectively watched slack-jawed as one of our favourite childhood performers seemed to suffer a momentary breakdown. In the years since, the ‘I now understand Britney’s meltdown’ memes have been doing the rounds. But do we really understand?

I know I for sure have a lot more understanding of the kinds of pressures a life in the spotlight can bring, thanks in large to the behind the scenes look into the lives of celebrities due to new technologies like social media, a more mature and educated view of mental health, and the increasing number of people in the spotlight speaking out.

Kid Cudi, Kehlani, Selena Gomez and Professor Green have all recently spoken out on mental health.  Stormzy addressed the topic on his chart-topping debut album ‘Gang Signs And Prayer’. In the song Lay Me Bare he spits: ‘Like man’a get low sometimes, so low sometimes, Airplane mode on my phone sometimes, Sitting in my house with tears in my face, Can’t answer the door to my bro sometimes.’

In an interview which quickly went viral, Stormzy said: “If there’s anyone out there going through that, I think that for them to see that I went through it would help.” And he’s right. In particular when it comes to men, black men, and the hip hop community, the notion is more often than not that men don’t cry, men don’t feel, men don’t need help. For one of the most outwardly positive and successful artists in the UK to speak so openly and honestly sends the message that that is not in fact the case; that it’s okay to not be okay.

In the biggest ever study of its kind, Help Musicians UK found 71% of respondents had experienced anxiety and panic attacks and 67% had experienced depression. The charity suggested musicians may be up to three times more likely to suffer from mental health compared to the general population.

‘Some aspects of being an artist – such as touring – are counterproductive to what we imagine a healthy lifestyle to be,’ explained David Brudö, CEO and Co-Founder of personal development and mental wellbeing app Remente.

‘Being an artist is often like a kind of self-imposed torture,’ added Alastair Mordey, Programme Director at The Cabin Chiang Mai, a drug and alcohol rehabilitation facility. ‘Someone who is already more sensitive than the average person places themselves in the spotlight and is then subject to all the pressures that brings. In particular, the flying, lack of sleep, availability of drugs and alcohol, and the likelihood of leaning on drugs and alcohol due to lack of any other viable support structures is what does the damage.’ Results from Help Musician UK’s study found that is indeed likely the case.

And then, of course, there is the age-old theory that artists are already predisposed to emotional and mental health disorders by virtue of being creative people.

Last year was hailed as a ‘breakthrough year’ for mental health in music, in part due to the increased conversation around the topic. “We know that artists speaking out can have more of an impact than almost any amount of scholarly or academic material being printed,’ explained Music Support co-founder and iCAAD speaker Johan Sørensen.

Indeed, we have arguably come quite far in terms of breaking down the stigmas over the last 10 years, but there is still some way to go before mental health is viewed in the same way as physical wellbeing is.

According to Dubstep artist Benga, who was sectioned and diagnosed with bipolar disorder and schizophrenia that was brought on, he said, by drug use and the demands of touring, the stigma is still very much there. ‘This industry is all about perception: a lot of people wouldn’t want anybody to think they’re weak, or that they can’t do what they do, or that they’re not cool. Nobody wants to come clean, let alone an artist,’ he told The Guardian.

Indeed, in attempting to speak to several music artists for this article, the vast majority of artist PR’s and managers did not reply or said their artists did not feel comfortable speaking on the topic.

Add to that the persistent idea that money and fame can and should only ever breed happiness, and there’s often a wealth of misunderstanding surrounding artists and mental health. ‘This is one of my biggest frustrations around mental health awareness,’ said Rikesh Chauhan, an ambassador for CALM (Campaign Against Living Miserably), and a music artist who goes by RKZ.

‘You can live a perfectly wonderful life on paper, but still suffer from depression. You can be happy, and still have depression. It’s never as simple as meets the eye… I find it so upsetting when people essentially state a musician/celebrity isn’t “allowed” to be depressed because of their stature,’ he added.

And that stigma is one that’s apparent across the board. It’s far too easy to just dismiss the woes of anyone who is considered outwardly ‘successful’ in the traditional sense of the word, flippantly declaring that they can simply wipe their tears away with their money, meanwhile knowing full well that that’s not the case. Material wealth is not mental or physical wealth and money cannot buy love, or peace of mind.

Some argue that pressures on artists and their subsequent mental health has actually gotten worse over the last ten years, caused in part by social media. Alex, a singer/songwriter who goes by ADIV explained: “The internet has not only masked people’s problems but it’s made us think we are all doing better than we are… Before social media we saw only a handful of people, now we know everything about everyone, worsening the comparisons.’

Social media can also humanise artists, though. Fans endear with them and their wellbeing, and it creates a vital platform for conversation. When rapper Kid Cudi took to his Facebook in October to share that he had checked himself into rehab for depression and suicidal feelings, it birthed hashtag #YouGoodMan – a space to discuss race, masculinity, and depression, both in music and outside.

But while conversation is all well and good, how much *actual* support is there for musicians? According to Help Musician UK’s study, 54.8% surveyed felt there is a gap in the provision of services for musicians while 46.6% hoped to see a dedicated counselling service.

‘We’ve come a long way in the grand scheme of things, and I think the Britney incident was actually a catalyst for that,’ said RKZ. ‘[But] there’s [still] not as much support as there could be, and even when there is, it’s down to the individual to seek it, which they seldom do.’

As DJ Chris Cable put it: ‘I’d like to see some of the majors implement some kind of in-house support for their artists, even if it’s just someone they can chat to informally… I sometimes feel artist managers forget their clients are human beings. If there are any signs of burnout, excessive behaviour, etc, perhaps [they could] sit down with the artist and have that discussion.’

Indeed, the music industry as a whole should focus far more on prevention, as opposed to just attempting to clean up after the fact. The pressures on an artist: to reveal their hearts on a daily, to create music people actually like, to tour and pour at times literal blood, sweat and tears on stage and etc, will never really go away. And so better support policies must be put in place; better access to ‘round the clock mental health professionals, things such as safe tents at festivals and allowing for more open conversation.

Singer/songwriter Takura Tendayi, who has worked with the likes of Rihanna and Chase & Status argues that the problem is a lot more deep-rooted than just the music industry and their treatment and support, or lack thereof, of musicians. ‘There is support everywhere,’ he explains, ‘it’s the way society is towards mental health that’s the problem.’

And to a certain extent, he’s right. Indeed, mental health is still a huge stigma around the world. In a survey of 193 UN states, only about one third of countries allowed individuals with mental illness to vote, marry, inherit property, make a will or give rights for employment. Even more alarming, perhaps: in the past 25 years, rates of depression and anxiety amongst young adults have risen by 70%. Among our personal network of friends and colleagues, we will all experience some form of fallout from mental health issues within our lifetimes.

And so there’s no shying away from the topic. The support needs to come quick, it needs to come thick, and it needs to come from everywhere. ‘Employment based early-intervention needs to become the order of the day, not just in the art world, or the music industry but in any trade or profession’, says Alasdair Mordey.

‘Employers and colleagues should have the interest and the motivation to value human resources of any kind and see each individual as worthy of that support, instead of seeing them as replaceable, or perhaps just assuming it’s none of their business.’

Alarmingly, the world’s mostly mocking reaction to Kanye West’s recent troubles doesn’t go very far in suggesting that we’ve made much progress since Britney Spears and that now infamous incident ten years ago.

For as long as mental health is seen as some sort of choice, and a “pull yourself together” mentality foggy-ing the air around the topic, stigma will prevail and appropriate support evade us. Indeed, we are all fragile beings, and the artists of this world have always been the ones to reflect that back to us. What happens to them, what happens to our friends/family and etc is all of our business, and it’s about damn time we recognise that and start acting accordingly.