Alcohol misuse is a national public health priority. Alongside the significant health problems that can result from heavy drinking, alcohol misuse also results in a variety of other negative outcomes, including social disorder and crime. It is estimated that alcohol misuse costs the NHS £2.7 billion in 2006-07. Emergency services, including ambulance services, together bear almost a third of these estimated costs. (1) 70% of Emergency Department (ED) attendances between 12 and 5am on weekend nights are alcohol-related. (2)

Street Pastors is an inter-denominational initiative aimed at tackling the effects of anti-social behaviour, including alcohol misuse, by engaging with people on the streets and in night-time venues. Volunteers from local churches patrol town centres in over 150 locations in the UK helping those who are lost, disorientated or unwell, calming potential conflict situations, and even handing out flip-flops to girls struggling in high heels.

Although it is difficult to attribute complex outcomes to single interventions, there has reportedly been a reduction in street crime in areas where the Street Pastors operate, as well as reductions in ambulance callouts, reducing the burden on EDs. The initiative has won a number of awards, and received praise from a range of sources including Boris Johnson, Mayor of London. (3)

The Street Pastors initiative is supported by Ascension Trust and each local group is co-ordinated by churches in the area. Street Pastors come from all walks of life and are supported during each patrol by a team of local prayer partners.

Diary of a Street Pastor

01.20: Back on the streets again after our halftime debrief and prayer time. We reprimanded our team leader for only providing biscuits; one of our two 83-year old women (known on the streets as 'The Legend') does do a wonderful lemon drizzle cake, but this was not one of her nights – pity. With it being the first night of a bank holiday, it is much busier than usual. Last week there had been a big confrontation outside Revs night club, with a lot of police and dogs, so we prayed for a peaceful evening. It is exceptionally rare for any SP to be assaulted, and we get good training on conflict avoidance.

01.25: My partner for this half is 'H', who is very experienced. She decides to go off the normal beaten track (explains that she feels we should) and sure enough we spot a group of black young men who are easy to engage with. As with so many, they are curious and baffled as to why we do this, what do we get out of it and so on. H asks me to answer this; I explain that we are volunteers from local churches and that we do it for nothing; this is completely outside their experience. One bizarrely mentions Paul and Ephesus, so H uses the opportunity to say that we do what Jesus would have done.

01.40: Back on our standard beat and I am preparing to walk past a young mixed-race man on his own but H senses we should stop and it turns out that he has had a bad evening. He has been visiting his brother with mental health problems, his mother has recently died of lung cancer, he is losing weight so is worried that he also has cancer, he only moved here recently, hasn't got a GP, he himself has mental health problems... I explain my medical background so that we can offer him practical suggestions. It seems opportune to offer him prayer, and he gladly accepts this. So I ask Father God to pour peace into his mind, into his body, into his heart; I do love praying with people, although it is only appropriate occasionally. We explain that our team is around every Friday and Saturday night if he wishes to chat to us on another occasion; we often get very positive feedback about previous encounters.

01.50: As we carry on up the High Street, I check with H whether it was OK to mention my work - she was very positive about it. It's really useful to bounce things off each other so that we can sharpen up and keep learning. One of the great things about this work is those you partner, 43 of us from 23 churches of widely different traditions; lots to discuss in-between contact with the 'customers'. We also often chat to club security staff, plus workers in the taxi firms and food outlets. 01.55: Standing at the bus stop where people congregate for the night bus. It's the night before a big Man United – Barcelona match, so three rather drunk men start quizzing us about football. Amazingly, I somehow knew that Barcelona had recently crushed Real Madrid 3-1, and we also talked about the Wembley Stadium. Rather wingingit, but a good chat. Here I am, three times their age, a foreigner to their culture, never done anything before beyond the Church, never striking up conversations with people on the Underground; but I loveit, and it isn't difficult to initiate conversations with these young people after all. Mind you, the twelve Saturdays of required training was very valuable, even though a major commitment, and made me realise that perhaps I could do it after all.

02.00: Twice now we have given out flip-flops to girls who have been partying so hard in their high heels that they are having to go home in bare feet. I personally kneel down to place the flip-flops (a revolting pink colour) on the ground for them, so that they don't need to bend down. A simple act of compassion, but the recipients often are profoundly affected. One of our team has told us that what motivates him is the opportunity to get in the dirt with Jesus.

02.15: H has just finished a long conversation initiated by a woman who is interested in what we do and clearly is happy to chat. Nothing particularly 'spiritual' comes up; which sometimes is the case for the whole evening. Still, even when we have not specifically shared the words of Christ, we are pervading his aroma, and people notice, much more than we usually recognise.

02.20: We have gone past Revs and start chatting with a group of black men who have just come out. They explain that the club does garage music on the first floor and junk music on the second. We admit ignorance to these (apparently my son's hip-hop is now so yesterday) so one of them plays us some from his mobile phone. So there we are, almost opposite the police station bopping around. Maybe the next time they encounter Street Pastors they will want to talk further...

02.30: As we walk up the High Street again there are two girls chatting to each other, and we are about to walk on when I sense that one has been crying, so we approach them. H discovers that she is feeling very ashamed for vomiting over her friend. I hand her a tissue from my pocket, and H gets out a plastic cup and bottled water from our rucksack which she appreciates for removing the taste of vomit. She now starts shivering, being scantily dressed like many of the clubbers, so its back to the rucksack for a space blanket, which H wraps round her. These Good Samaritan acts deeply affect these two women; like our biblical model we haven't said anything religious or prayed with them. Indeed, our motto is 'caring, listening, helping'.

02.50: A lot of people leaving the clubs now, men drunk and loud, women drunk and silly; very easy to judge the outside and miss connecting with the real person. Several police standing by; we have an excellent relationship with them (and the local council), and in spite of their cutbacks they still provide most of our funding. We have two-way radio contact with them and the bouncers at the clubs if needed.

03.20: We are now finishing, and relieved there wasn't any trouble outside Revs. The other group use their mobile to let us know that they need to escort a very drunk and vulnerable lady home, so we can't have our usual final debrief.

03.30: On my way home; in the kitchen there will be a lovely note from my wife plus a few nibbles. Although she says that there is no way that she could turn out until early morning, she is extremely supportive. I always get a roast before I go out because she is concerned about how I will survive the night; I tell her she is weak on physiology but excellent on psychology. Some time tomorrow I'll email this report to the friends who pray each time I go out – I couldn't do it without them either. Next session is in a fortnight, so I'll pray for lemon drizzle cake!

Andrew Miller is a retired physician who has been a Street Pastor in South London for a year.
For more information about Street Pastors projects in your area, including how to volunteer, visit www.streetpastors.co.uk