Emergency Rental Assistance Reduced Housing Insecurity and Improved Mental Health

By Esther Y. Colón-Bermúdez, NLIHC Research Analyst 

Research published in Health Affairs, “COVID-19 Emergency Rental Assistance Improved Mental Health Care And Psychotherapy Use Among Low-Income Renters,” found that  emergency rental assistance significantly reduced recipients’ anxiety and depression symptoms during the COVID-19 pandemic by alleviating rent arrears, reducing the risk of eviction, and freeing up household resources for mental health care. These findings indicate that future emergency rental assistance programs should strive to deliver benefits quickly to support both housing stability and mental health. 

During the COVID-19 pandemic, Congress created the U.S. Treasury Department’s Emergency Rental Assistance (ERA) program to keep renters stably housed during the crisis. Most ERA funds were for direct financial assistance to tenants for rent, rental arrears, utilities, and other housing-related costs. The program targeted low-income households experiencing economic hardship during the pandemic and at risk of housing instability and homelessness. These renters already have elevated mental health care needs and often face barriers to care, and housing insecurity can intensify these challenges.  

The authors examined whether receipt of ERA funds reduced anxiety and depression among low-income renters and increased mental health care through psychotherapy or prescription medication. They evaluated whether ERA’s effect on mental health was indirect, meaning that alleviating housing insecurity and eviction risks can positively impact mental health, or direct, meaning that rental assistance frees up other household resources that can be spent on mental health care. The authors used Household Pulse Survey responses from   December 1, 2021 through May 8, 2023, to compare renters who reported receiving ERA with those who had applied for assistance but were still waiting for approval. Housing insecurity was measured as rent arrears and a combined measure of rent arrears and self-reported likelihood of eviction. Mental health was measured as recent frequency of anxiety or depression symptoms, and mental health care use was measured as past-month psychotherapy or medication use. 

ERA funds significantly reduced housing insecurity among renters. The probability of rent arrears was 34.6 percentage points lower for ERA recipients compared to tenants who were waiting for assistance. The combined measure of arrears and likelihood of eviction was 26.9 percentage points lower for ERA recipients. 

ERA also reduced anxiety and depression symptoms. The rate of anxiety was 9.1 percentage points lower for ERA recipients. The analysis attributed 38% of that reduction to the indirect effect of reduced rent arrears. The share of renters with symptoms of depression was 8.1 percentage points lower for ERA recipients. Thirty-two percent of that reduction could be attributed to the reduction in rent arrears. Using the combined measure of rent arrears and self-reported likelihood of eviction, the authors found that 55% of the reduction in anxiety and 56% of the reduction in depression among ERA recipients could be attributed to reductions in rent arrears and eviction risk, indicating the significant impact that arrears and fear of eviction have on tenants’ mental health. 

The remaining reductions in anxiety and depression were the result of rental assistance freeing up household resources for mental health care. Among renters reporting anxiety, the use of psychotherapy was 6.5 percentage points higher for ERA recipients. Among renters reporting depression, the use of psychotherapy was 7.9 percentage points higher for ERA recipients.  

These findings emphasize housing insecurity as a key determinant of mental health. Given the low baseline rate of mental health care among low-income renters, the observed increases in psychotherapy represent meaningful improvements. Policymakers should design emergency rental assistance programs that expedite rent and utility assistance as a means of increasing the use of mental health care and improving mental health. 

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