Helping Tenants with Mental Health Challenges Who Are at Risk of Eviction

Support at all stages of an eviction could help vulnerable tenants navigate the process, avoid being removed from their home, or if they are evicted, help them catch their footing.

In front of the Edward W. Brooke Courthouse, two people stand holding a banner reading "City Life/Vida Urbana." CLVU volunteer assist vulnerable tenants facing eviction in court unassisted.
Before the pandemic, Boston’s City Life/Vida Urbana deployed volunteers to housing court, where they assisted unaccompanied tenants, offering them guidance, information, and connections to legal aid or other supports. Photo courtesy of City Life/Vida Urbana

Eviction is without doubt a hugely distressing event. It can turn a person’s life upside down, disrupting work and child care routines, and bringing about economic fallout and even homelessness. Those life changes are incredibly stressful, and as evidence has shown, can significantly affect a person’s physical and mental health. For example, eviction during pregnancy can lead to adverse birth outcomes, which can have lifelong consequences.

Evictions are currently on the rise as pandemic-era moratoriums and rental assistance end. And while navigating through an eviction is surely stressful for anyone, people with mental health conditions face particular barriers and challenges at all stages of the process.

“When you get an eviction notice, it can exacerbate mental health symptoms. There’s a sense of loss of control, fear, worry, and uncertainty,” says Jaline Gilliam, a licensed clinical social worker who is the Los Angeles associate director for the Corporation for Supportive Housing. “If you struggle with mental health issues, it’s likely that your rights have been taken away or you’ve been institutionalized or you’ve witnessed that happen. So you’re triggered when you get papers or have to go into court, because you don’t trust the system—and rightfully so.”

Up to now, most discussions about mental illness and housing have focused on addressing chronic homelessness and creating supportive housing, rather than on helping those who are housed avoid or navigate an eviction, notes Merrill Rotter, a psychiatrist and associate clinical professor of psychiatry at Albert Einstein College of Medicine.

Rotter is a co-author of a recent report by the Center for Court Innovation (CCI) that analyzes the unique risks and challenges faced by those with mental illness throughout the eviction process. The initial aim of the report was to examine how housing courts could be better equipped with training and resources to improve the experience and outcomes for people with mental health conditions. But it evolved, Rotter says, into steps that could be taken by landlords and service providers to ward off evictions before they ever reach housing court.

“One of the things that became clear as we launched the project was that housing court is a critical and challenging juncture, but it is the last stop on the road. We saw that problem-solving approaches could be brought to bear at earlier stages as well,” Rotter says.

Heightened Risk for Eviction

Part of the problem for tenants with mental and behavioral health conditions is that the conditions themselves raise the risk of eviction, whether owing to problematic behaviors or to difficulty managing tasks like making timely rent payments or communicating with landlords.

“In general, behavioral health issues, including psychosis and substance use, are risk factors for eviction,” the CCI report notes.

Michael Ohler, director of resident services and homelessness prevention at Champlain Housing Trust (CHT), a northwestern Vermont land trust that operates 2,300 affordable housing units, sees this firsthand.

“Sometimes people engage in behaviors that jeopardize their tenancy—and those behaviors are a manifestation of their mental illness,” Ohler says.

Ohler’s 10 resident services team members function as “housing social workers,” he says, handling conflicts among neighbors or between residents and property managers and assisting in cases of substance use disorder, psychotic breaks, squalor, or hoarding.

The attention and support CHT’s residential services team offers often prevents eviction, but at the same time, CHT is the landlord and does at times initiate evictions. 

“We can’t penalize people for an illness, but we have to draw the line somewhere. It’s a tightrope walk at times,” says Ohler.

He ticks off a list of some situations that could lead to eviction: threatening neighbors; sabotaging others’ belongings; mental illness manifesting itself through racial slurs hurled at staff and neighbors; medical issues and depression leading to squalor that impacts a building via odors and health hazards.


“We have to keep in mind the community as well as individual residents,” he says. “That can be challenging. There are people whose housing we can’t save. Eviction is still a reality—our job is to reduce it.”

When a resident must leave, CHT support services don’t immediately cease.

“If we can’t save their tenancy, we also have the ability to work with people to help them have a soft landing elsewhere,” Ohler says.

Challenges in Navigating the Eviction Process

Once an eviction is in play, people with mental health challenges—from depression to substance use disorder to severe psychoses—may have greater difficulty understanding and responding to eviction notices, navigating housing court successfully, and following post-court directives that could help preserve their housing.

“They’re already feeling overwhelmed, and to add this additional stress could make them snap or withdraw or have a meltdown—any one of a number of dysfunctional reactions,” says David Mynott, who has been a housing court volunteer and hotline staffer with City Life/Vida Urbana, a tenant advocacy group in Boston. “They don’t understand what the attorney is saying, what the court process is. It exacerbates any issues they already have.”

[RELATED ARTICLE: Evicted—Navigating the Eviction Process and Its Lasting Impact]

Sergio Jimenez, a Brooklyn housing court judge, can cite numerous examples from a judge’s vantage point of how anxiety, depression, panic attacks, and more severe psychoses manifest themselves in the courtroom—and how difficult and time-consuming it is to deal with such problems on the spot.

“The eviction process is not necessarily an intuitive system. With folks who have problems reasoning, one example that I’ve heard dozens of times is, ‘I don’t owe this money—if I did, the owner would have brought me to court sooner.’ That’s a triggering phrase that suggests a problem understanding,” Jimenez says. Moreover, he adds, “In housing court, there’s no cap on cases. I have a very limited amount of time to troubleshoot situations of any sort, and it’s harder to get to the same place when there are mental health issues.”

Ten years ago, Amiyoko Shabazz’s family was in crisis when she fled an abusive environment in the Los Angeles area and moved with her three children through homelessness, then transitional housing, and finally into an apartment that ultimately became unaffordable.

“I got rushed out of transitional. [The transitional housing agency] got me a grant to help pay the rent, but every month it got less and less,” Shabazz says. “I remember trying to explain my situation, but there was no help. I remember letters on the door—rent overdue, grant money going down, eviction—which was just more stress. I would go to the office and explain, but there was nothing they could do. . . .  There were no supportive services. And I had all these undiagnosed mental health and emotional challenges going on. I had to figure all this out.”

To make matters worse, Shabazz is hard of hearing. In the courtroom, she recalls, on top of suffering extreme stress, she couldn’t make out what the judge was saying. In her recollection, she never had a chance to talk with the judge alone. “I could see mouths moving but couldn’t hear much. After the judgment was made, I could finally read it—he approved the eviction.”

Even though New York City and some other cities have enacted a right to counsel in housing court, the CCI report notes that a majority of tenants facing eviction remain unrepresented because of eligibility requirements or refusal of service. Another complicating factor is that some people, out of fear of stigmatization, may not identify themselves as having a mental or behavioral health condition that could entitle them to extra accommodations.

Preventing Eviction: What Role Can Housing and Service Providers Play?

The CCI report presents some overarching goals, such as advocating for funding of supportive housing, subsidies for tenants, and maintenance and expansion of public housing—but there are four strategies housing providers can employ now to make eviction less likely.

Embedded Support Services for Residents

The gold standard for housing stability for tenants with mental illness and behavioral health issues, many say, is permanent supportive housing—affordable housing paired with wraparound services, like counseling, case management, and education services. But even without permanent supportive housing’s fully incorporated services, evictions can be reduced through other resident supports.

For instance, only a small portion of Champlain Housing Trust’s units are permanent supportive housing, with supports provided by external agencies. When tenants in CHT’s non-permanent supportive housing experience mental health and substance use issues, the onsite resident services team takes a by-any-means-necessary approach to addressing problems.

“Someone’s having a psychotic break, and we just go,” Ohler says. “The embedded service model works because we can just show up—we don’t have to call another agency.” Noting that his staff can respond flexibly and nimbly, he describes one case in which a resident dealing with a paralyzing mental health crisis accumulated an untenable amount of dirty laundry that drew the attention of CHT’s property management. A resident services coordinator devoted a whole day to helping wash the clothes, and the tenancy was maintained.

Resources and Information for Residents

Ohler’s team uses community activities and newsletters to spread the word about mental health resources available in the community. In addition, resident surveys have been a helpful tool to gauge which resident needs are not being met.

Gilliam of the Corporation for Supportive Housing suggests that initial notices of eviction filings or court dates could be a vehicle to provide needed information to the tenant. “Why not have a system where right on the back of that eviction notice, there’s a list of resources? ‘Here are the legal aid resources, here’s the process to prepare, here’s what you need to bring,’” she says.

Landlord Training and Resource Guidance

Many landlords, especially smaller private landlords, may not feel they have time to devote to self-education on mental health issues, nor to wait things out with a disruptive or non-paying tenant. This is where organized training could be helpful.

The Corporation for Supportive Housing offers online training for housing providers on topics like mental health basics, addressing hoarding behaviors, and trauma-informed care, and it also offers regional programming.

“There are a lot of eviction prevention resources, but the landlord community is not quite tapped into that,” says Patricia Hernandez, Corporation for Supportive Housing’s director for metro New York, New Jersey, and Pennsylvania. “In New York City, we’re working to engage landlords on myth-busting and combating stigma around people who have mental illness and who are leaving incarceration. If landlords know there’s a community nonprofit that can assist, they’ll say, ‘Let me refer my tenant to them.’”

Ohler notes that when he worked previously with the Burlington Housing Authority, there was city funding for landlord education. “We would give them dinner, have a program. It was mainly about lead abatement, but we also talked about hoarding issues, or what to look for if a resident is slipping. So that’s effective, but you do have to make it attractive and easy for landlords. They are busy too.”

Paying Attention, Starting with ‘Why?’

In all sorts of housing, some tenancies could be preserved by simply asking “Why?” before starting an eviction.

“The first question in the problem-solving approach is, ‘Why is this person not paying rent? How can I understand that?’” says Rotter. “Hopefully a little education would help a landlord at least ask that question. It’s not on them to try to answer it, but the door opens when you ask the questions ‘Why? What’s going on here?’”

Gilliam tries to push back as much as possible on the idea that any eviction is inevitable. “What is the layered process before the person moves through eviction? Who’s at the table when they decide to file for eviction?” She says housing providers need to ask themselves, “Have we done everything possible before filing for eviction—connected them to mental health resources, connected them to a peer specialist, and all the available services? Is there something we could be doing differently to avoid eviction?”

In Court: Resource Referral, Clearer Processes, Mental Health Training

When tenants who are struggling with mental health issues do end up in housing court, the court experience could be improved in a variety of ways.

Clarifying Instructions, Processes, and Rights for Tenants

Following her eviction, subsequent tailspin into substance use, and time spent in recovery, Shabazz eventually found case management and supportive housing through the Downtown Women’s Center in Los Angeles. She participated in the Corporation for Supportive Housing’s Speak Up! advocacy training program and began helping others as a peer adviser. She has launched her own business providing anti-oppression and lived-experience consulting and facilitation for housing providers, staff, and case managers.

“Today I can recognize that I had serious mental health issues. I had depression and PTSD, and my hearing loss was more severe than I had known. My children got help, they got therapy—the one who didn’t get help was me,” she says. “I was bound to crash and burn.”

Shabazz cites several improvements that might have helped prevent her eviction: For starters, the agency that set her up in the unaffordable housing unit could have reduced or helped more with the rent while she was looking for full-time work—not a simple task as a single mother of three kids. Eviction papers could have been made easier to decipher: “They’re written in a language most people can’t understand. I understand things better now, but at that time I couldn’t. I needed eviction prevention support.” And if she were advising court personnel, she says, “I would tell them how the courtroom itself is a trigger. I would tell them about the support I didn’t get—hearing support, and someone to explain to me what was taking place and how it would affect me, and was there anything else I could do.”

Before the pandemic, Boston’s City Life/Vida Urbana deployed a handful of volunteers to housing court every week, where they tried to intercept as many unaccompanied tenants as they could and offer them guidance, information, and connections to legal aid or other supports.

For tenants who have access to technology, Gilliam would like to see more informational resources like the animated video featured on the website of the District of Columbia Courts’ Landlord & Tenant Branch that provides a short, straightforward walk-through of what to expect in an in-person hearing. “Those things are helpful,” she says.

Mental Health Training and Resource-Guiding for Court Personnel

Many advocates stressed the need for court personnel of all types to have mental health awareness and trauma-informed approaches.

“Someone might come across as agitated or upset, but if you’re trauma-informed, you’ll be able to take a step back and see they need additional support,” says Hernandez, who is also a licensed clinical social worker. “Training for court personnel to give a foundation for how to work with people in high-stress situations and how to connect them to community resources would be such a win-win.”

Judge Jimenez, understanding that lawyers do not typically have mental health expertise, has had his teams engage in training programs including Mental Health First Aid, devised by the National Council for Mental Wellbeing and offered by trainers across the U.S., including the Mental Health Association in New York State.

The authors of the CCI report recently convened a group of stakeholders from the legal, housing, government, and social service sectors to brainstorm on improved court processes.

“One of the things that came across is the need for a resource guide or resource networking for stakeholders in the court system,” says Ignacio Jaureguilorda, CCI’s director of poverty justice solutions and a co-author on the report. He describes a potential “bench guide” that would provide a judge or court attorney with an up-to-date list of resources for people with mental health issues who appear in court.

“Housing court is a very fast-paced environment. You have a lot of volume, you have a lot of people coming in,” Jaureguilorda says. “So having a structure where you can issue-spot where people need help and guide people towards resources goes a long way.”

Needed: Cross-Sector Communication and Collaboration

A key improvement in all stages of the eviction process would be increased awareness, communication, and coordination among the varied entities that touch the lives of tenants with mental health conditions.

“As a provider, until now, the eviction process was a black hole for me,” says Rotter. “If a client of mine got an early notice of noncompliance, I wouldn’t know what to tell them to do with it. So the more providers understand the process, the risks, the issues, and where to turn for help, the more we can support the client through the process.”

He adds, “A mentally ill tenant in court may actually have a case manager or a care coordinator who works within a community-based agency outside the courthouse. That case worker may have no clue about how the courthouse works and isn’t involved in that court system. There’s a disconnect between the legal trajectory and the clinical and social supports in the community.”

Jaureguilorda and Rotter would like to see evictions resolved and averted with a cross-sector problem-solving approach following some of the models CCI has created, such as the Harlem Community Justice Center, whose housing help center links tenants with legal and financial assistance, and the Red Hook Community Justice Center, which includes a courtroom with an innovative and wide array of resources available to the judge. These programs are not currently targeted specifically to people with mental health issues, but adding such a component, including peer counselors with first-hand experience, is one of the report’s recommendations.

What’s Next?

Rotter and Jaureguilorda are still processing the ideas shared during the recent brainstorming session with stakeholders. Next, they will organize a roundtable session to hear from people who can share their lived experience with eviction and mental health challenges, like Amiyoko Shabazz.

As for sweeping changes that would require new policies or funding, Rotter is optimistic that with increasing attention by health and housing sectors to the social determinants of health and the potential cost savings of preventive measures, funding to make the recommended changes may be easier to come by.

“We’re at an inflection point now, where the system as a whole is concerned more about these social determinants and how they’re costing money.” He cites initiatives in recent years such as Boston Medical Center’s investment in preserving affordable housing. “The cost of helping somebody be housed was saving them money in the back end, on their health care costs,” Rotter says. “And so my Pollyanna view here is, if we can help people see that there’s money to be saved by funding case management services that keep people housed, there may be dollars available to us.”

Sandra Larson is Shelterforce's health fellow.

1 COMMENT

  1. “Sergio Jimenez, a Brooklyn housing court judge, can cite numerous examples from a judge’s vantage point of how anxiety, depression, panic attacks, and more severe psychoses manifest themselves in the courtroom—and how difficult and time-consuming it is to deal with such problems on the spot.” Anxiety, depression, and panic attacks are not “more severe psychoses.” They are not psychosis at all.

    To list these very common human problems as “mental illness” is but another way of branding individuals. I challenge anyone reading this article, and the author and those included in it to examine a DSM V, the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, and not diagnose themselves as having a “mental illness.” I challenge any of the latter to withstand only the situation of being poor, without “mental illness.” I further challenge the latter to consider how bias as to variations in normal human behavior and emotions is causal in reactions by tenants.

    Savvy evicted tenants join with the opposition, as happened in the case of Shabbaz who accepted her “branding,” and, pulling forelock all the way, ultimately started her own business – that’s BUSINESS – as an advocate. As much as I can credit her for this, she also had to accept bearing psychiatric diagnoses, which she didn’t even know she had. This all began because she was not informed that an eviction would be pending. Why wasn’t she? But, she made the most of it, and again, I applaud her doing so as much as I think that no one should have to “kiss the enemy” in order to have shelter.

    As to Ohler’s take on the situation – Ohler of the Champlain Housing Trust – in December of 2021, the Trust purchased a Days Inn for $6 million. The Trust purchased a second, in one month’s time. How did they do it? According to an article in the independent newspaper, sevendaysvt, dated December 20, 2021, Chris Donnelly, the Director of Community Relations for the Trust, “…the trust would not have been able to purchase the hotels without the federal COVID-19 relief money that lawmakers and the governor’s office directed to housing projects this year.” And, “The housing trust paid $6 million for the property, and will use a $7.34 million grant for the purchase and renovation costs.”

    Like others, Champlain Housing Trust is not simply dabbling in affordable housing for the allegedly afflicted. They make investments. They have all manner of grants and other funding at their disposal. They will, I hazard to safely guess, get more monies through HUD and the like. It’s A-OK to be a profit-making entity, but playing up altruism, and without referencing actual motivation as a business? Well, there’s probably a term for that in the DSM V. Why, they even have in-house pseudo social workers. At least they make an attempt not to drop their tenants cold.

    But it’s not just this particular organization. “Health” insurance companies are offering case management and home visits through their own, subcontracted, but often wholly-owned “benefits.” The ruse of course is that the purpose is to enhance the health and welfare of insured members. Anyone who doesn’t believe there is enormous profit being made should also consult the DSM V.

    Then there is the now hard-wired link between “mental illness” and “behavioral disorders,” and “drug abuse.” Public sentiment, and programs have recently removed quite a bit of the stigma for the latter, at least in some circles. An individual stands a better chance of losing their stigma and gaining shelter and all manner of resources than someone branded with “mental illness,” which could be run-of-the-mill neuroses – as they used to be kindly and appropriately termed. And, PS – a neurosis is not a “behavioral disorder.”

    If an individual has sufficient funds to own a home, chances are they can be eccentric, have neuroses, and indulge in behaviors that are not branded as problematic.

    Referencing internet information about Champlain Housing Trust, (just an example used in this article), tenants behave badly, and police are frequent visitors. People know how they are perceived from the outside. People know when they are “other.” That’s not an excuse for being a bad tenant, but there is a culture related to living in low-income housing that is so very interwoven with every aspect of it that it is a wonder if any tenant escapes it – or escapes labelling and branding. But well-to-do apartment complex tenants don’t fare much better on the human kindness and rationality scale either. Do they.

    But I digressed. “Affordable housing” has become big business. Finding “client” material in every individual has become big business. And that’s what legislatures, and private developers, and altruistic-sounding organizations should at least acknowledge.

LEAVE A REPLY

Please enter your comment!
Please enter your name here

This site uses Akismet to reduce spam. Learn how your comment data is processed.