Mental Health Prescriptions Increased After Pandemic Eviction Rules Ended

New study results suggest that lifting eviction protections during the COVID-19 pandemic was associated with measurable increases in psychotropic medication prescriptions and outpatient visits for serious mental illness (SMI). These findings, published in JAMA Health Forum, may underscore the broader health system consequences of housing policy decisions.¹ The research adds to a growing body of evidence linking housing instability to elevated health care use, moving the conversation beyond self-reported symptoms to quantifiable changes in treatment contact.

Eviction Protections Associated With Shifts In Utilization

Researchers from Johns Hopkins Bloomberg School of Public Health used a synthetic difference-in-differences approach to analyze nationwide all-payer administrative claims data from more than 8.9 million individuals with a mental health diagnosis or psychotropic medication prescription during the pandemic period. The study examined 2 distinct phases: the staggered expiration of state-level eviction moratoria from March to August 2020, and the expiration of the federal moratorium in August 2021, after which 42 states did not maintain their own state-level protections.

Across both phases, moratorium expirations were associated with statistically significant increases in the weekly number of patients prescribed a psychotropic medication. The study found a 0.57% relative increase following state-level expirations and a 1.18% increase after the federal expiration, as well as a roughly 3.1% to 3.5% relative increase in outpatient visits for SMI. By contrast, overall mental health outpatient visits, outpatient care for mood-related conditions, and suicide-related encounters showed no statistically significant changes.

The findings were consistent across both phases, lending credibility to the study's core inference that the removal of eviction protections, not concurrent pandemic dynamics, was associated with the observed shifts in utilization.

Why SMI Patients May Be Disproportionately Affected

The authors propose several mechanisms through which housing instability could drive utilization increases, particularly among individuals with SMI. Prior research has shown that life stressors, including housing loss, are more likely to precipitate clinically observable psychiatric episodes in this population than in those with less severe conditions.¹ Individuals with SMI also face elevated risks of entering and remaining homeless, compounding the downstream effects of losing eviction protections.

The study notes that the uptick in SMI outpatient visits does not necessarily reflect worsening outcomes. It may also signal improved engagement with care, since housing instability can simultaneously worsen psychiatric symptoms and disrupt treatment continuity, making it difficult to disentangle whether the increase reflects crisis-driven care-seeking or sustained treatment contact.

Regarding the psychotropic medication finding, the authors suggest that pharmacological management may represent a relatively accessible pathway for both patients and clinicians to respond quickly to heightened stress. Unlike outpatient therapy, which requires navigating clinician shortages and logistical barriers, prescriptions can be maintained via telehealth, which expanded significantly during the pandemic period, or through brief outpatient visits even when patients are navigating housing disruption.

Implications for Managed Care and Health System Planning

Housing instability is broadly associated with higher emergency department (ED) utilization and inpatient admissions across multiple conditions.² Importantly, this and other social risks are not fixed and may evolve over time.

Mental health services were already strained heading into and throughout the pandemic, and the results suggest that lapses in housing protections can add incremental demand for medication management and specialized outpatient psychiatric care. Given that individuals with SMI are disproportionately enrolled in Medicaid and often have complex social needs that intersect with housing, the implications for Medicaid are especially robust.

As the authors noted, “these findings underscore the importance of housing for psychiatric treatments and highlight the broader health care implications of housing policy decisions.”

Limitations and What Remains Unknown

The study's authors acknowledge several important constraints. The analysis relied on administrative claims data, which capture health care encounters but not unmet need, informal coping, or the underlying prevalence or severity of mental health conditions. As a result, the findings reflect changes in observed interactions with the health care system and not direct evidence of changes in psychiatric status.

Additionally, the medication outcome counts patients who received at least 1 prescription, without accounting for dosage or treatment intensity. The observation windows were relatively short, limiting the ability to detect longer-term effects. Geographic variation in how states implemented moratoria, with some halting the full eviction process and others only pausing enforcement, may have introduced heterogeneity in the effective exposure.

Future research should examine whether the effects persist over longer time horizons, whether downstream inpatient or ED utilization increased in the months following moratorium expirations, and whether specific payer populations, particularly Medicaid enrollees, bore a disproportionate share of the increased demand.

References

1. Ge Y, Leifheit KM, Kennedy-Hendricks A, et al. Mental health care utilization following eviction moratorium expirations. JAMA Health Forum. 2026;7(5):e261212. doi:10.1001/jamahealthforum.2026.1212
2. McCrear S. Health-related social needs linked to higher ED use. AJMC^®. December 16, 2025. Accessed May 26, 2026. https://www.ajmc.com/view/health-related-social-needs-linked-to-higher-ed-use