In the psychiatrist's shed - at Glastonbury

SEARCHING high and low for the psychiatrist on call at the Glastonbury Festival, I learned that he was waiting for a patient in the on-site welfare centre and that I could travel there by ambulance. The centre, housed in a wagon shed, is a temporary sanctuary for the bewildered, distressed and downright insane. The ambulance also contained Jo, who had been creating "a bit of a scene in the Samaritans tent" due to drug-induced psychosis. He explained that the whole festival "scum" were planning a mass knife attack on him.

Arriving at the shed I looked around for the psychiatrist, smiling sympathetically at a young man dressed in a psychedelic T-shirt and leather jacket, who I presumed was a recovering casualty. He returned my smile. "I've already dealt with three real crazies tonight, well and truly barking."

I realised that he was Karl Jansen, the senior registrar psychiatrist I'd been seeking. "No doubt about it," he continued, "if they'd been admitted to the Maudsley we would have sectioned them for at least four days, but things are done differently here."

The key word among the 10 volunteer psychiatrists, two psychiatric nurses and the welfare drug counsellors is informality. They come as much for the festival itself as for the work experience, although Glastonbury is an invaluable training-ground for psychiatrists. The majority of patients are suffering from amphetamine-induced paranoia, but drug-induced psychosis has much in common with schizophrenic behaviour.

"Whereas in hospital a psychiatrist is likely to encounter people who have been ill for a while and may therefore be a bit 'cold', here they are seeing cases in the raw," says Chris Lawson, the co-ordinator of the psychiatric team. "Being first on the case to someone who is at the peak of their psychosis is exciting for the psychiatrists." Indeed, the volunteers greeted each new case with such gleeful comments as "Brilliant! A classic case of pure psychosis."

Dr Jansen comforted a sobbing young woman. She wasn't on drugs, she explained, but she had stopped taking her Prozac prescription and now felt claustrophobic and despairing. Like most of the other patients, she had been abandoned by her friends for being a "downer", so Dr Jansen recommended she join the six other refugees spending the night in the wagon shed.

He took me to meet two of the "crazies" he'd been attending. "Hello, I'm the psychiatrist. How would you like me to help you?" he asked in a very loud voice. "Make them go away," was the mumbled answer from the shape hiding under a blanket. After listening sympathetically to more conspiracy tales, he produced a bag of the sedative Temazepam from his pocket.

Temazepam is popular among drug users. Earlier, Dr Jansen was trying to administer a tablet of it to a distressed boy when his girlfriend grabbed it and wolfed it down. Drug-seekers are the bane of the psychiatrist's shifts since they will put on elaborate emotional displays in order to get free drugs. When one such case arrived sobbing loudly, Dr Jansen and the psychiatric nurse drew to one side.

"Histrionic bullshit," said the psychiatrist.

"But if we give him a bit of Valium, d'you think he'll go away and never darken our door again?" asked the nurse. Instead they decided to stall for time; the man realised the game was up and made a speedy exit.

We were interrupted by an angry-looking man demanding that he be sectioned immediately. Sectioning a patient to a psychiatric hospital is a complicated process and can only take place if the patient is still in a psychotic state after 24 hours. This particular case, it was felt, did not merit the paperwork; the angry man got bored with waiting and wandered off.

As the relief psychiatrist arrived to begin her first shift, an ambulance delivered a naked man, swearing loudly. He had been running around the children's enclosure wielding a knife. For the first time in festival history, the team decided that it would be best to put the knife-wielder and three other violent psychotics under a police section.

In this environment, where Establishment values are often frowned upon, it is, ironically, the police who often end up being the only figures trusted by the psychotic. At least two severely paranoid people demanded the police arrest them and place them in safe custody.

By Monday night, with no psychiatric sections and an estimated 300 patients having recovered their sanity, the festival was deemed a psychiatric success. Next year may be different. The festival welfare services have had their grant withdrawn. "The Government is ploughing money into projects focusing on young people at risk from drugs, but they decide to withdraw money from a situation where the issue couldn't be more pertinent," says Penny Mellor, welfare services co-ordinator. "That's what I call crazy."