Vaissnavi Shukl
Today’s episode contains a discussion on mental health, which might be triggering or upsetting for some. If you or someone you know has struggled with their mental health, please seek medical help and reach out to a certified care provider.
Long before the idea of mental health was cemented as an essential part of one’s well being, those struggling with mental health were confined to spaces that primarily functioned on a punitive model. The patients were labelled as dangers to the society and isolated in asylums. That, of course, has changed over time. Today, we are in conversation with artist and activist James Leadbitter, who goes by the name vacuumcleaner and works with young people, health professionals and vulnerable adults to change how mental health is understood, treated and experienced. With the support of the Graham Foundation in the Advanced Study in the Fine Arts, we talk about what good mental health feels like, what it tastes, smells and sounds like. And if we could design our own safe space, what does it look like?

I am Vaissnavi Shukl and this is Architecture Off-Centre, a podcast where we discuss contemporary discourses that shape the built environment, but do not necessarily occupy the centre stage in our daily lives. We speak to radical designers, thinkers and change makers who are deeply engaged in redefining the way we live and interact with the world around us.
I want to talk about yourself and the t-shirt you’re wearing. I think that’s a good beginning.

James Leadbitter
Okay, so my name is James. I’m an artist and mental health activist living in LA and today I am wearing my Hana Madness t-shirt. Hana madness is an artist and mental health activist who lives in Jakarta, who I’ve worked with on a few different occasions, critically looking at mental health care in Indonesia, and she’s a very amazing, inspiring artist and activist who’s really pushing the boundaries have challenging stigma and discrimination in mainly in Java in Indonesia. But across the whole of Southeast Asia really.

Vaissnavi Shukl
You’ve done a fair bit of work on mental health and which is what we’re going to talk about today. But I wonder if you could just talk a little bit about the mental health care infrastructure that exists around you and that you also at some point in your life, if you want to talk about it experience firsthand.

James Leadbitter
Sure. In England, while in the UK, we have the National Health Service, so it’s health service that’s paid through taxation, but in terms of the history of mental health care in particularly in England, I think it dates back over 1000 years in terms of how people that have struggled with their mental health but also people with perhaps learning disabilities or other kinds of neurological differences have been confined within enclosed spaces. There’s a long history of, of enclosure that is quite a violent history, not quite as a very violent history. But in the kind of 1800s here we begin to see the emergence of, you know, old, large asylums, and that are the kind of foundation of mental health hospitals here. So those were large grand buildings often on the edges of cities. And that kind of comes back to this kind of very English notion of confinement, but also that like people would be put to work and that like labour and activities would be the trend with your mental health. And then fast forward to the kind of the 1900s with the emergence of the kind of state run health care system here. A lot of those spaces were taken over by the National Health Service, and that journey is gone on a few different ways from the kind of closure of those asylums and mental health care being moved into kind of general hospitals but never really moving away from a system of very hierarchical care and care being based on kind of punitive models. So whether that is you know, what we’ll call like the chemical straight-jacket. So the use of a lot of very strong medication, and not really much early intervention in healthcare, so we’re only really dealing with people when they’re in crisis, and we don’t have what we call parity of esteem. So the funding that goes into health, a lot more goes into physical health than into mental health. So in the UK, that kind of what they call the disease burden. Mental health is 26% of the disease burden of England, but only gets about 4% of the funding. So the kind of level of care that you might get in a state run mental health hospital in England is really poor, my experience backslider. So hospitals aren’t clean, they are very institutional, they’re very drab. You know, they are not therapeutic kind environments. And you know, I’ve spent time in hospitals with people that have also been in prisons and those prisoners, because they’re like, Well, this is worse than being in prison, but you’ve not done anything wrong. So that’s the kind of state that we’re in now. Now, things have changed a little bit over perhaps the last 13 years because we have the right wing government here in England and that you know, the health service has been massively defunded. So mental health care is, you know, significantly worse. It’s now in a situation where in the past, if you’re in classes, you could go into the hospital and the hospital wasn’t very good. Now, we’re in the position where if you’re in crisis, there is essentially nothing. We’re kind of heading towards an American model. Really.

Vaissnavi Shukl
I was gonna ask you this, but you mentioned it I actually because the definition I mean, the arcade definition of these facilities sounds very close to that of an incarceration infrastructure and the season before this, we were actually about crime, violence and justice. And we had an episode where we’re speaking about prisons, per se, and also something that was quite profound as I said, that chemical straight-jacket. I mean, again, historically, when you look at it, you find at least in popular culture, these representations of people being put in like physical straight jacket being restrained physically and now you’re seeing that somehow shifted into like, chemical straight jacketing, where you’re seeing the drugs have overtaken what the physical force has to do, and you’re trying to change the chemical balance of a person and change their behaviour. But that’s kind of what it’s doing. Right. Well, I mean, I think there’s some caveats to this conversation. I think we need to be really careful because I think it’s important that you know, I am not against medication, I think there are certain medications that can be really useful. So I think it’s really important that

James Leadbitter
like, people who take medication shouldn’t be hearing what I’m saying. I think that all medication is bad, but I think definitely a lot of medication are essentially tranquillisers. You know, a lot of medication for psychosis, or bipolar for anxiety. We’re essentially giving people large doses of tranquillisers. So, particularly within inpatient care, you know, you can be given large doses of Lorazepam or Haloperidol, which will essentially knock you out and sedate you for days, weeks and sometimes months. Yes, we are putting people in physical straight jackets but we are sedated to the point where you know you can become a zombie in a zombie state because you know, the mechs that you want are so strong so yeah, the forms of confinement have changed.

Vaissnavi Shukl
Now, I want to jump into Mad Love because that’s what we’re talking about today. And that is, of course, I don’t know, would you call it well, it’s a project. It’s not a piece. It’s not a performance, but it’s a project and that has been a direct reflection or a translation of your experience and how you thought all this energy and experience could be channelled into something a little more creative and then collectively work towards your I hope so at some level getting into policymaking or design of all these facilities so that it caters to the theories or be that wholesome therapeutic place that it needs to be as opposed to the kind of places that exist right now. Can you talk about Mad Love?

James Leadbitter
Yeah so Mad Love, is a designed asylum so you know, taking the word mad and love and kind of mashing them together? So and then I designed for asylum so that you know the word asylum in its origins means a safe place, but those safe places should be places of luxury because if you’re struggling with your mental health, you haven’t done anything wrong and to go back to your point about confinement and criminality like the protection laws. In the past, if you were mad, you were dangerous, but a little bit more enlightened nowadays. So yeah, like, well, you know, the question, really, of the project or the process was really, if we’re going to experience mental distress and if mental distress isn’t a bad thing, what kind of environment could that be experienced in a healthy way? Because I think people struggling with mental health have always been with us and will always be with us. So how can we support people on that journey in a positive way? And what kind of environments would you want to be in to experience what could be quite a painful and distressing thing at times, but could also be enlightening? It’s a journey like any other so, to me, that process began as an inpatient when I was in a hospital in London, and I had a friend come and visit me and she’d never been in a mental health hospital before. She was like, “Yo, this place is horrible. Like, I’m sorry, dude.” And I was like jokingly said, like, “Yeah, I could design something better than this”, and then hung out with her. But you know, a month later after the hospital and she was like, you know, you jokingly said that you can make a better mental health hospital than the one you were in. And I was like, Yay, yeah. And she was like, go on, off you go do it by now. So the idea sat with me about like, who has the knowledge to make healthier environments to experience mental distress? I’m not belittling what, you know, the knowledge and experience architects have but if you really want to understand what those care environments and their needs are, talk to the people that use them. And so that really began a process of me finding people who had had experiences of inpatient care, or were in inpatient care, and asking them a series of very simple questions. So questions like, you know, what does good mental health look like? What does it smell like? What does it taste like? What does it sound like? And what does it feel like to touch what is our sensory response to mental health care? What activities support mental health so what design functionality do we need putting into an environment and you know, if you could design your own asylum if you could design your own safe space, what would it be like? What would you have in it? And so that kind of just kind of snowballed as a process really from, you know, talking to a few people in some art spaces to being invited into hospitals in England to that spreading across into mainland Europe and then go into other places in around the world and things so far, we’ve listened to over 600 people and what they what they say and everybody says the same things.

Vaissnavi Shukl
What I’m very curious, we have to go what are those things if you were to like put it into just like bullet points.

James Leadbitter
Sure. I mean, in terms of the senses, you know, is obviously there’s a big focus on nature, but like, you know, what does good mental health smell like it smells like baked bread? It smells like my mother’s cooking. It smells like red wine.It smells like the sea. Or a forest. What does it look like? It’s the horizon. It’s a big sky. It’s being on top of a mountain and getting that sense of a VISTA. What does it sound like? It’s the sound of silence with a sounding heard song. You know a lot of people talking about music and music having that progression to memory. Its natural environment. And then you also get the left to left field ideas of like a man I spoke to who was like”Iit smells like petrol, because I used to fix cars with my dad. My dad passed recently and that’s like, you know, that smell is really evocative.” So you know, we experience design to our senses. So clinical environments often smell of cleaning products, and those products are not like they don’t smell of lavender, or the, you know, the sense of a bed that you lie in if you’re depressed. If that bed is like, I’ve never stayed in a five star hotel, but if it was like that kind of bed, how does that change our relationship with the environment that you’re in? So this isn’t really obvious. And then, you know, in terms of activities, we’ve had really beautiful ideas like, you know, I spoke to a quite a young person, he was under 18. And he said, “What I want in my perfect mental health hospital is a room of Faberge eggs, and a hammer.” People want a room of bubble wrap farms and so that you’re not in a dead end environment that you’re in a simulated environment where there are things to do and those things are, you know, connecting the mind body in a positive way. So things that seem really obvious. You know, it’s not rocket science.

Vaissnavi Shukl
It seems like a lot of it has to do I mean, all those recollections are things that people associated with, like, mental health seems to be directly connected to memory, it seems I think it’s it’s a it’s the way you described, it doesn’t sound like it’s utopian, that it could look like this, but it sounds like something they’ve already experienced, or like have an association with. Except the Faberge eggs.

James Leadbitter
But I think that’s true of a lot of design processes. Yeah, but I think ultimately what we’re boiling it down to is comfort and safety. Because if you are in a vulnerable position, like if you’re experiencing very intense emotions, that might be the first time that you’re experiencing them. Then if you know if your anxiety levels are through the roof, if you’re having no feelings, if you’re hearing voices, all of these things can be quite scary. So to feel safe, feels important and safety and memory and there’s an obvious connection there.

Vaissnavi Shukl
And what happened after you spoken to like 600 papers, and of course there’s design aspect of it as well, where you put together something.

James Leadbitter
Yeah, so we’ve I mean, we’ve, you know, obviously you know, taking all that knowledge and wisdom that we’ve had a huge privilege to, to listen to and to document we’ve tried to manifest that in different ways. So we’ve manifested that in the art world through making installations that kind of so working with architects to go okay, what ways can we demonstrate this work? So we kind of have made kind of conceptual architectural models that we’ve displayed at the Wellcome Collection, we’ve made kind of bigger installations that have kind of show design features. So that might be about different levels of height and how that changes your relationship to space or different textures. But then we’ve also been able to work with the health service here to implement it within inpatient care. So again, working with a hospital in Edinburgh, which was a children’s hospital, children’s mental health hospital, to work with the young people, their adults or their parents and carers of those young people and the staff, taking them on a similar kind of process and then and the architects being in the room and engaging in that process, that then those architects went away and designed that inpatient unit. So and then also, you know, big kind of community projects as well. So trying to think about what the community needs are so we were able to take over an empty shopping unit on a high street and changed into a big community space that took all that knowledge and manifested into different design features, and different activities as well. So we’re trying to kind of figure out how, how we can create models that inspire change really, and kind of map out the sharing of that knowledge in a kind of manifested way.

Vaissnavi Shukl
Now, since this is a podcast and we don’t have any visual aid, could you give us an audio tour of one of the installations and if I would walk through it, what would I see, what would I touch, what would I smell? What would I taste?

James Leadbitter
The kind of  a conceptual model that we moved from the Wellcome Collection, which was designed by Benjamin Klasky and James Christian from Projects Office. So that was what they called that kind of landscape for mental health. So it’s set in a valley and you enter through a pathway and you follow a pathway into the bottom of the valley and in that valley, the first thing that you enter is a town square. And so the idea of community in a town square in a common area of the commons, and in that area is like bunting kind of kind of a joyful kind of I imagine like the South of France, you know, square but the idea is that there’s always somebody there, that’s the place where you can always find someone so if you’re distressed or you need to talk you need to check in. That’s the environment and working off that Town Square are different environments. So there is an art studio there with a kill Lynette and you know, just like you just imagine the best art studio and it’s kind of brightly coloured. On the opposite side of that is a bakery. So this idea of you know, often like the kitchen is the heart of the home, and it’s where you know, the kitchen can be the place where you have the difficult conversations and food and association and cooking for each other being a really fairly good thing but also, you know, the smell of bread, the smell of salt, the smell of like making coffee for somebody in the morning. The smell of fresh fruit being a really essential need and then obviously linking to that bakery is what we call a market garden here in England. So smallholding land where, you know, you can put your hands in the earth that you can grow things and then that will lead down to sea front area because a lot of people talk about the smell of the sea being really important is kind of different natural lakes and viewing platforms and the space to fish it has a birdhouse in it so you can migratory birds being brought into that environment. And then the two valleys kind of serve different functions. So one side of the valley is the bedrooms people spoke a lot about in Star Wars and getting the third original Star Wars there’s Ewoks and they had these like tree top tree houses and that came up a lot this idea of like the joy of a child climbing a tree, bedrooms in tree tops. So it’s kind of that idea. But each one is modularly designed because a lot of people spoke about the need to have space that they can adapt to their needs. So like you can position the bed in this room where you want so it could be that the bed is against the window. So you can look out on the base hidden in the corner because you want a darker environment. So that’s a kind of modular approach to the design of those bedrooms. And they are kind of trees in a forest. So you’re walking along the path to get to your bedroom into any kind of forest environment. And then the other side of that kind of Valley is really thinking about therapeutic conversations and spirituality. Spirituality can be really important. So there are kind of you know, if that’s a valley leading up there are kind of enclosed spaces for quiet conversations. There was an observatory in there so there’s a space to gaze at the stars. There was kind of different kind of wider conversation spaces. We’re going to speak as a group that’s really about quietness, quiet conversation. And again, that thing of like zooming out from where you are, and I guess the other thing about that model is brightly coloured, like it’s bright pink, it’s there’s a lot of tail in it. There’s a lot of yellow and so colours are stimulating, they’re not dead end and they’re bringing, I don’t know like I’m here in the UK and I’m looking out at red brick houses. And it’s everything’s kind of uniform, but it’s got contrast and depth in it through bright colours because why not have joyful colours in life? It sounds like happiness, right? There’s something about Joe that’s really important. And I think there’s something about it that seems kind of counterintuitive to be in a joyful space when you’re new and you’re maybe struggling but bringing that joy in that laughter can be really, it can be so nourishing for the soul. So yeah, why not like cities.

Vaissnavi Shukl
I’m surprised nobody talked about puppies.

James Leadbitter
I forgot about the puppies in the kittens. I went with a group of very young children. They were really obsessed with baby rhinos. They wanted a hospital ward for the baby rhinos. Great.

Vaissnavi Shukl
But James I do want to talk about something a little more serious that you mentioned a couple of minutes ago and you talked about how there needs to be a certain involvement of people who you know, encountered or have experienced something to do with mental health or have been involved in a mental health care facility. And it’s it’s interesting that we’re having this conversation today because I recorded another episode just yesterday with with an academician based out of the US called David Gissen and he’s just written a book about ‘The Architecture of Disability’ and he talks about how architecture limits the discourse on disability to just the question of access that for architects it’s often just providing elevators and ramps and so he’s really criticising about how we need to go beyond that and really critique the relationship that disabled people have had through history with the different monuments and the different movements that have happened with city planning, urban design, so on and so forth. And i In the end, I mean, I’m leading up to that question, but I did ask him it’s like how do you how do you change it like what would it look like to change the discourse and he said, We need to have more people and he’s also somebody who’s who’s an amputee. So it’s like, we need to have more people like me who are part of the system who have a seat at the table when these decisions are being made people who are part of the faculty, people who encourage students with different able bodies to be actively be a part of the classroom and what you said kind of relates to what David was talking about yesterday, and you said, you need to have more people involved and people need to bring in their own personal experiences in order to design these places, or build these places which actually cater to them. Right. So it’s, it’s I wouldn’t say it’s like a participatory design process, but there needs to be some kind of a system in which you put you in a feedback loop so that you have more involvement in all these pieces of design rather than just architects will not necessarily have encountered these places. And then having a top down approach.

James Leadbitter
No, I think it’s I think, I think you need to go much further than that. Because actually, I’m not dismissing the knowledge that architects have or engineers have or psychiatry.

Vaissnavi Shukl
Sure. Sure. Sure. Yeah.

James Leadbitter
Yeah. I mean, of course, but those are not the only people. No, but I think actually like what, what we’re trying to propose through the model of punetech is actually caring environments for mental health should be designed and run by people with lived experience, because it’s actually a politics of liberation. And, you know, we have to address the question of power in this situation like who has power over distressed people? Often we talk about mental health care being done to us, it’s not a collaborative thing. So actually, what we’re trying to propose through this process, is the idea that actually, if we engage in deep listening, if we engage in empathy and kindness, and really listened to people with lived experience, will find that their knowledge is really powerful. And their understanding of how to design environments is incredible. And yes, they might not be able to make a building stand up and they might not have a nuanced understanding of different materiality and colour but actually it’s more than co-authorship. It’s about architects supporting mad people on our journeys, rather than us giving our ideas to architects because architecture is like art, you know, I’m an artist, so I include myself in this there’s a lot of ego. Right, white male ego, of course, but like it is ultimately, you know, space is a collaborative process. And mental health is really, really complex. And so the design required for mental health is infinitely complex and the idea that, you know, for disability design is really about more than access. You know, that’s a really expansive idea. It’s a beautiful idea, really expensive, but if we’re, everybody’s mental health is different. Everybody’s mind is different than the way that everybody experiences mental health is different. So how do you design an environment that caters for the vast experience of like, you know, there are 10 billion synapses in the human brain. That’s like an infinite possibility design. So what the other thing that we’ve really learned from this process is that it’s not about creating something that is fixed in time. It has to be adaptable and changeable to the needs of that specific person. And that and having a specific culture, wherever you might be in the world.

Vaissnavi Shukl
No, I mean, for sure. There’s no way I’m minimising the role of an architect. I work as an architect. And of course, you need a certain amount of like technical, some skills to make sure the building stands but really looking at the door like using this word a lot now but agency of people who have had a certain lived experience be an integral part of the project, and which is why it’s very nice to see how you’ve almost taken this anthropological process of speaking to people, sharing with people absorbing knowledge from people and then taking all of that learning all of this lived experiences into something that can be manifested into a physical space. I mean, of course, the process but also the idea behind doing rather than just like sending out like a selfie.

James Leadbitter
But I think also like I know I’m, I’ve been really privileged to do some quite basic permacultural tree training and in permaculture design processes. The first thing that you do is protracted observation, you observe an ecological system so that you understand when the sun lands on that bit of soil and how it behaves over a few years and when the water comes in. So that when you are planting and designing an ecological system, you have a deep understanding of how the natural environment and how it impacts that and I think that has real relevance for all kinds of different practice where actually rather than beginning with a blank piece of paper and a pen and drawing shapes or wherever you are really observing the thing that you’re engaging with and listening and engaging in a real deep, deep listening process. And hopefully, you know, from loads of really amazing things can emerge and better design emerges from

Vaissnavi Shukl
I’m  just wondering how do you imagine Mad Love growing from here? What’s next to you been in conversation? I mean, you did mention it’s it’s taken a life of its own and you’ve expanded in geography to other countries, other cities, but does it have the potential of being written into policy and not as a guidebook on this is how it should be designed and ABCD because that kind of defeats the whole purpose, but as a process, at least

James Leadbitter
For me personally,things with the project were really growing and then we, you know, like, I think a lot of people we had, we had the COVID pandemic and that really created a huge challenge for us because, you know, we weren’t able to, to be together in a room. And that really impacted us. And I think we’ve, you know, I’ve kind of taken a change in direction in terms of my work as an artist, in that I’ve had to focus on this. In England, there’s a really massive crisis going on with young people’s mental health, particularly after COVID because, you know, we, young people were just not considered in lockdown and that impact on them. So I’ve had to take a slightly different tact in terms of what I’m doing. But that knowledge is still existing. So I’m still doing a lot of presentations, design conferences and stuff, but I think one of the challenges really is how that utopian thinking that willfully optimistic thinking around processes gets translated into the mainstream and haven’t really been able to figure it out. Because when you begin to engage with big institutions like health service providers or with government policy, things become really beige really quickly. And as an artist, I’m really interested in the hedge lungs, you know, again, in an ecological system it’s where the hedges are where two systems meet up to find the most fertile area, so I haven’t really been pushing it over the last year and a bit. I don’t know how it ripples into other things to be honest.

Vaissnavi Shukl
But it’s a conversation you started and there’s much to be grateful for.

James Leadbitter
Yeah, I think like, you know, you’re someone an artist and an activist, but I’m not a policy person. And I think like, I believe in the power of arts to provoke and challenge you know, the has done that. I think there’s bigger questions around structural ableism. You know, mental health is a disability like any other and the questions of how we overcome structural ableism. Like any other form of like structural discrimination, there’s huge work to do around challenging the notion that just because you’re struggling with your mental health, you can’t make informed decisions or so. I don’t have a solution to that. Let me know.

Vaissnavi Shukl
I don’t think there is one. I mean, I only asked about policy because in my head the way I think about things, it’s just, if it’s if it’s written if you’d like to put it in writing it, hence yours, you know, its application and its replicability in some format and just to kind of increase its…

James Leadbitter
It’s really interesting, like I mean, I’m not, I’m not totally disagree with what you’re saying. But I think for me as an artist, I think policies can be where wonderful ideas go to die. Because I actually think it’s about because it is about process, like, you know, my love is a project but it’s really about really as a person process, and processes where wonderful things can happen. So I think a lot of the work I’m trying to do is about bringing a lot of people into a process and I don’t think that can be manifested totally in policy because that is also about days about lived experience. So and that is that is like that’s generational work to imagine what that might be like, but it’s something during the pandemic, I left London, and like a lot people moved out a big city and I now live by the sea in a seaside town here in England where there’s a lot of empty buildings and I’m beginning to kind of wander wonder now about this intersection between art design, activism, mutual care, and kind of when I walk on the scene is this big building and I’m late for it, but I don’t necessarily want to get tied down in Manila building in a space I’m the kind of person that likes to jump around.

Vaissnavi Shukl
Well, thank you so much for this conversation, and for your time and for sharing.

James Leadbitter
Oh, that’s okay. No problem. I hope it was useful and of interest to people.

Vaissnavi Shukl
Special thanks to Ayushi Thakur for the research and design support, and Kahaan Shah for the background score. For guests and topic suggestions, you can get in touch with us through instagram or our website through our website archoffcentre.com, both of which are ‘archoffcentre’. And thank you for listening.