Mental Health Care Utilization Following Eviction Moratorium Expirations.

IMPORTANCE

Housing instability is associated with adverse mental health and increased health care use. Policies that reduce eviction risk may affect mental health-related health care utilization. Eviction moratoria enacted during the COVID-19 pandemic provide a natural experiment to examine these associations.

OBJECTIVE

To examine whether the lifting of eviction moratoria during the pandemic was associated with changes in mental health care utilization.

DESIGN, SETTING, AND

PARTICIPANTS

A synthetic difference-in-differences approach was used, with state-week level, nationwide data of all-payer records of individuals with a mental health diagnosis or medication prescription in March to August 2020 and June to December 2021. The data were analyzed from November 2024 to November 2025. Two phases of eviction moratorium expirations were analyzed. Phase 1 included staggered expiration of state eviction moratoria from March to August 2020; phase 2 assessed the expiration of the federal eviction moratorium in August 2021, when some states maintained their own state-level eviction moratoria after the federal expiration.

EXPOSURES: State-level or federal-level eviction moratorium expirations.

MAIN OUTCOMES AND MEASURES: Weekly, state-level counts of unique patients who had (1) any outpatient mental health visit, (2) any psychotropic medication prescription, (3) outpatient visits associated with mood-related disorders, (4) outpatient visits associated with serious mental illness (SMI), and (5) suicide-related visits.

RESULTS

Of 8 963 310 individuals, 62% were female, and the mean (SD) age was 42.8 (21.5) years. Expiration of moratoria was associated with statistically significant increases in the weekly number of patients who were prescribed a psychotropic medication (0.57% in phase 1 and 1.17% in phase 2) and the number of patients who received outpatient care for SMI (3.42% in phase 1 and 3.13% in phase 2). By contrast, no measurable changes were observed in the overall patient count for mental health-related outpatient visits, outpatient visits associated with mood-related conditions, or suicide-related visits.

CONCLUSIONS AND RELEVANCE: The results of this differences-in-differences study suggest that the expiration of eviction moratoria was associated with increases in the mean number of patients with psychotropic medication prescriptions and outpatient visits for SMI. These findings underscore the importance of housing for psychiatric treatments and highlight the broader health care implications of housing policy decisions.