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Research overview

The Foyer model for homeless youth: a systematic mapping review

The Housing Directorate in Norway (Husbanken) commissioned the unit for social welfare research in the Norwegian Institute of Public Health to map out all quantitative and qualitative evidence on the Foyer model. It is a package of accommodation and integrated support for young people age 16-24 in the transition to independent living and adulthood.

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  • Year: 01.2018
  • By: Folkehelseinstituttet
  • Authors Meneses-Echavez JF, Berg RC.

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Key message

The Housing Directorate in Norway (Husbanken) commissioned the unit for social welfare research in the Norwegian Institute of Public Health to map out all quantitative and qualitative evidence on the Foyer model. It is a package of accommodation and integrated support for young people age 16-24 in the transition to independent living and adulthood.

Methods

In May 2017, a research librarian searched in major databases for empirical research published between 1992-2017. We also undertook searches in reference lists and grey literature (i.e. non-formal, commercial channels). Two independent reviewers screened all retrieved records. We extracted data from the included studies, collated the data and performed descriptive analyses.

Results

We included 18 studies that addressed the Foyer model. This body of research had the following characteristics:

  • 56% of the studies were retrieved from grey literature sources and 72% were published as commissioned research reports.
  • 61% of the studies were cross-sectional, the rest were qualitative. We identified no controlled studies.
  • All the studies were done in either Australia or the United Kingdom (UK).
  • The provision of services in the foyers was homogeneous across studies.
  • There were three categories of studies:
    • Program evaluations (nine studies): the most common outcome measures were housing, education, employment, life-skills, and residents’ satisfaction with foyer services.
    • Experiences of being in a foyer (seven studies): most current and former foyer residents reported positive experiences.
    • Other (two studies): one description of mental health services in foyers, and one financial analysis of foyers.

Summary

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Background

Homelessness is a serious problem worldwide and the implementation of effective housing strategies is a priority in developed countries. A nationwide mapping study from November 2016 revealed that there are 3909 homeless people in Norway. This is a 36% decrease from the last mapping study done in 2012. The characteristics of the homeless population is multifaceted: Three quarters of homeless people in Norway are born in the country, one of four have children of dependent age, one of four suffer from a dual disorder of mental disorder and substance abuse, and 17% are young people under 25 years old.

It can be hard to escape homelessness. Social welfare schemes, particularly social benefits, is the most common mechanism of help. Another support service for young people is the Foyer model (program). The Foyer model is a package of accommodation and integrated support to young people aged between 16 and 24, who are homeless or at risk of becoming homeless. The model was developed in the United Kingdom (UK) in the 1990s and has since spread to several other countries, including Norway. Services provided in a foyer include housing, training and mentoring (including life skills), job seeking support, arts and social activities, and assistance with securing accommodation on exit from the foyer. However, the effects of the Foyer model remain unknown and empirical evidence about most aspects of it seems scarce.

Objective

To map out all quantitative and qualitative research on the Foyer model in young people who are homeless or at-risk of becoming homeless in the transition to independent living and adulthood.

Method

We conducted a systematic mapping review according to international standards. The framework proposed by Arksey and O’Malley, and Levac and colleagues’ recommendations on clarifying and enhancing each stage of the review, methodologically guided the systematic mapping review. The project team (reviewers) and commissioner (Husbanken) discussed and approved the research protocol.

We included all empirical research published in the years 1992 to 2017, irrespective of study design, that address the Foyer model in young people (15–25 years old) who are homeless or at-risk of homelessness.

To identify all relevant studies we searched 13 major databases, hand searched websites, the bibliographies of all included studies and any literature reviews on the Foyer model and other housing programs. We also contacted experts. Two independent reviewers screened the retrieved references and data extraction was double-checked. We grouped data extracted from the included studies according to their chief characteristics, performed descriptive analyses, and presented the results in text, tables, and graphs.

Results

We identified 18 studies about the Foyer model, most of which are commissioned research reports. Just over half of the included studies (56%) were retrieved from grey literature sources (i.e. non-formal, commercial channels). Nine studies (50%) used mixed research methods, while qualitative research and quantitative cross-sectional research methods were used in seven and two studies, respectively. We identified no controlled studies. All the studies were conducted in high-income countries, in either the UK (14 studies) or Australia (4 studies). Not all studies reported the number of study participants, but overall, about 2000 participants were included in the studies, most of whom were current of former residents of foyers. These young people had a similar pattern of support needs (e.g., being homeless for longer than one year, low educational achievements, illicit drug use, mental health problems, and rudimentary life skills).

All the foyers in the included studies offered a similar package of support services (i.e., housing, education assistance and training, job seeking and life skills). The included studies encompassed different research interests which we grouped into three categories: i) program evaluations (nine studies), ii) experiences of being in a foyer (seven studies), and iii) the last category (other) included one study about mental health services in UK foyers and one study about the financial situation of foyers.

The most common outcomes across the nine program evaluations were housing, education, employment and training, life-skills, and young people’s satisfaction with foyer services. Most of the data came from administrative sources. Only one study reported the use of a validated tool, the Health of the Nation Outcome Scales (HoNOS). In general, the results from the program evaluations suggested that the Foyer model met its goals in assisting young people who had been homeless in the transition to adulthood, especially when it came to housing, education and training, life-skills, and behavioral and mental health.

The seven studies addressing the experiences of being in a foyer showed that residents largely perceived that their lives were better by being in the foyer, chiefly because they received a stable and safe home. Yet, a few studies highlighted concerns with regard to social exclusion and restrictiveness of foyer policies.

Another study described how UK foyers respond to the mental health needs of their residents. The results showed that there were a range of mental health services, such as consultation with a general practitioner (most common), trainings for foyer staff, and consultation with an external agency. The last study, a financial analysis of foyers, reported that in Australia governmental funds were the main funding source for foyers while in the UK government grants were the main funding source.

Discussion

The current body of evidence about the Foyer model has been published mostly in grey literature sources, as commissioned research reports for governmental agencies, and exhibits a predominance of qualitative approaches. There seems to be a homogenous provision of services across foyers, characterized by housing, education assistance and training, job seeking assistance, life skills, and health services. This offer of services aligns with those offered in the foyer operating in Bodø, Norway.

Our findings may inform decision-makers of the current body of evidence on foyer services and serve as a basis for formulating and commissioning further research on the Foyer model. As highlighted also by the only other review on foyers, by Levin and colleagues, future research on the effects of the Foyer model should consider the lack of controlled studies and standardized and validated tools for outcome measurements. Integration of these methodological processes will lead to a strengthening of the body of evidence on the Foyer model.

The generalizability of our findings is limited since the included studies were conducted in only two high-income countries (Australia and the UK) and the deepness of our methodological synthesis is also constrained.

Conclusion

The body of evidence about the Foyer model consists of 18 studies that exhibit a predominance of qualitative research methods and has been published mostly in grey literature sources. Half of the studies included reported on program evaluations that suggested the foyer services appear to successfully help young people in the transition to independent adulthood. However, no controlled studies on the Foyer model have been published to date. In light of this, no judgements about the effectiveness of the model can be drawn from the present systematic mapping review. Further research on the Foyer model seems warranted.

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