What are youth refuge practice models and how effective are they in improving outcomes for youth experiencing homelessness? A systematic narrative review

Youth homelessness is a global problem. Preventing youth homelessness has many individual and societal benefits. Internationally, a key response to youth homelessness is the provision of a standard youth refuge model which includes short-term accommodation staffed by support workers who provide case management and referrals, with other varying health, hygiene and crisis services attached. However, it is unclear what is offered within these settings, and whether youth refuge improves any outcomes for youth experiencing homelessness. Homelessness services have also been increasingly encouraged to embed trauma-informed or psychologically informed practice models into service delivery. Like broader evaluations of the standard model, little is currently known about the extent to which these practice models are being implemented, how they are implemented, and whether they improve outcomes beyond standard models. Therefore, this systematic narrative review aimed to: (1) identify what services youth refuges provide, and which practice models are used; and (2) examine how effective youth refuge practice models are in improving health, behavioural, psychosocial, and/or housing outcomes for youth experiencing homelessness. Database and grey literature searches identified ten articles to be included. Seven articles evaluated a standard refuge model, two included strengths-based practice models, and one included an empowerment philosophy. No practice model offered evidence of its efficacy above what was offered by the standard refuge model, and limited detail about implementation of any model was found. Two cohorts emerged within refuge: (1) a younger cohort who could reconcile with family with therapeutic intervention; and (2) an older cohort who needed other options. Generally, results demonstrated short- to medium-term improvements in all health, wellbeing, and housing outcomes, with most gains reported in vocational status and improved family relations. Housing stability was a key contributing factor for outcome achievement. Most studies were of low methodological quality hence more rigorous, standardised, mixed-methods research is needed before conclusions about the efficacy of youth refuge and any practice models can be made.