Federal rental assistance during the COVID-19 pandemic improved mental health

Federal rental assistance during the COVID-19 pandemic improved mental health

Federal rental assistance provided during the COVID-19 pandemic has done much more than help people stay in their homes. It also improved her mental health.

A UC Riverside study was published this week in the journalHealth Mattersfound that the Emergency Rental Assistance (ERA) program created by Congress in 2021 to prevent evictions of low-income renters during the pandemic also improved mental health and increased appropriate use of mental health care.

“Using a national data set, we found that housing assistance helped low-income renters — who are among the most vulnerable populations — feel better and receive mental health treatment when needed,” said Wei Kang, an assistant professor at UCR’s School of Public Policy, who led the study. “This shows the importance of government programs in times of crisis.”

The federal government has allocated $46.55 billion for two ERA programs to provide direct assistance to low-income people struggling to pay rent due to pandemic-related financial hardship. Kang's analysis was based on data from the U.S. Census Bureau's Household Pulse Survey collected between 2021 and 2023. The survey includes questions about respondents' mental health status and whether they had recently sought medical help.

Kang compared survey responses from two groups: those who had received rental assistance and those who had applied but not yet received it. The latter served as a control group. Their results showed that symptoms of anxiety and depression decreased noticeably in rental assistance recipients and that they were slightly more likely to seek psychiatric help when symptoms occurred.

Almost 46% of help recipients reported anxiety symptoms in the two weeks before the survey - 9.1 percentage points fewer than those who had not yet received help. Likewise, 38% of recipients reported symptoms of depression, an 8.1 point improvement over the control group.

Although the increase in treatment rates was more modest, it was still statistically meaningful. Of those who reported symptoms of anxiety or depression and were waiting for help, only 16.2% said they had ever seen a psychologist for counseling or therapy in the past four weeks. Rates of need for care were higher among those who received help, increasing by 6.5 percentage points among those with anxiety symptoms and 7.9 percentage points among those with depression symptoms.

To understand how the program improved mental health, Kang used a statistical method called causal mediation analysis. This enabled her to distinguish between direct and indirect effects of rental assistance. The research found that the ERA program reduced psychological distress in two ways: first, by directly alleviating fear of eviction, and second, by freeing up financial resources for health needs.

The most immediate benefit was the reduction in housing insecurity. By helping tenants pay off past due balances and avoid the threat of eviction, the program eliminated a key source of stress, which in turn reduced anxiety and depression. The study found that this impact was particularly strong for anxiety-related symptoms, as renters no longer had to worry about losing their homes.

But the effect didn't stop there. With rent covered, many households could use their limited resources for other essentials, including co-pays for doctor's visits, prescription medications, and the transportation needed to reach mental health services. For those struggling to make ends meet, this shift in financial priorities proved crucial.

The results provide strong evidence that housing assistance is also a form of health care, Kang said. Financial stability programs can also serve as a lifeline for people suffering from emotional distress, particularly during times of national crisis.

The title of the paper is “COVID-19 Emergency Rental Assistance Improved Mental Health and Psychotherapy Use Among Low-Income Renters.” In addition to Kang, UCR co-authors include Qingfang Wang, professor of public policy; Tyler Hoffman, a research associate; and Bruce Link, distinguished professor of public policy and sociology.

The researchers argue that economic aid programs should be viewed not only as fiscal policy but also as tools to improve public health. They also suggest that future programs should be designed to take advantage of this dual impact—for example, by streamlining application processes and speeding delivery of assistance to ensure recipients can stabilize their housing and access the care they need sooner.

What's really interesting is that people in our field are often concerned about the unintended consequences of government programs - and that they will be bad, such as fraud or waste. But on the contrary, there are things here that might be called “unintended positive consequences” that go beyond the intended effect of helping people stay safely housed.”

Bruce Link, Distinguished Professor of Public Policy and Sociology, University of California – Riverside

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