COVID-19 Emergency Rental Assistance Improved Mental Health Care And Psychotherapy Use Among Low-Income Renters

Housing insecurity, an important determinant of mental health, worsened during the COVID-19 pandemic in the US. The federal Emergency Rental Assistance (ERA) program sought to reduce housing insecurity among low-income renters. Using 2021-23 Household Pulse Survey data, we employed a quasi-experimental design to assess the effects of ERA on anxiety and depression symptoms and on mental health care use. We conducted causal mediation analyses to determine whether and how ERA affected these outcomes through indirect effects-by alleviating housing insecurity-or through direct effects, which freed up resources to seek care. ERA significantly reduced anxiety and depression symptoms through both indirect and direct effects. Among renters with anxiety or depression symptoms, it increased psychotherapy use through direct effects. Future rental assistance programs could strengthen these dual impacts by including features to improve both housing and health status-for example, by streamlining applications and expediting benefit delivery to provide resources that recipients can use to address urgent mental health needs even before full housing stability is achieved.