NYC free eviction Lawyer program Tied to drop in ER visits, but mental health visits Rise, study Finds

Research on first 10 ZIP codes of Right to Counsel shows 26 fewer ER visits per 10,000 residents, but substance use and mental health visits increased.

By LineZotpaper

Published21 October 2026

Read Time3 min

A new study published in the Journal of General Internal Medicine found that New York City's pioneering program providing free lawyers to low-income tenants facing eviction was associated with a significant drop in emergency room visits in the first neighborhoods where it rolled out. However, the study also found an unexpected increase in emergency department visits related to mental health and substance use disorders in those same areas.

Researchers from UCLA examined over 8 million emergency department visits by uninsured or Medicaid-covered New York City residents between January 2016 and February 2020, before the program went citywide and before the COVID-19 pandemic. In the first 10 ZIP codes where the Right to Counsel program launched in 2016, including parts of Brooklyn, Staten Island, Harlem and The Bronx, they found at least 26 fewer ER visits per 10,000 residents compared to areas without the program.

The decrease was most pronounced among children, with 32 fewer visits per 10,000 residents. "Particularly for vulnerable neighborhoods, this program might help tenants avoid ED visits," said Dr. Katherine Chen, lead author and assistant professor at UCLA's David Geffen School of Medicine. She cautioned that the team cannot definitively attribute the drop to the legal program, but called it a leading possible explanation.

The drop aligns with previous research linking evictions to poorer health. Danya Keene, an associate professor at Yale School of Public Health who was not involved in the study, said the finding makes sense given that right-to-counsel reduces evictions, which are "really harmful to health." A 2025 city report showed that about 81% of households with legal representation remained in their homes between 2018 and 2023.

However, the study also found that in the same neighborhoods, ER visits related to mental health and substance use disorders increased after the program began. "We thought that this program would help protect people from stress, and that those outcomes might go down," Chen said. Julia Fulton, a Brooklyn housing attorney who represents clients through the program, noted that the eviction process itself is "incredibly traumatic" regardless of the outcome. Many clients face issues beyond the housing case.

The researchers noted limitations: they lacked data on whether ER visitors were actually involved in eviction cases or using the free lawyers. Oksana Mironova, a housing policy analyst with the Community Service Society, said the study is helpful in pulling out "people's lived experiences beyond 'Do you get to keep your apartment or not?'"

The city has committed $14 million for Right to Counsel this fiscal year and $40 million annually in subsequent years. Rosalind Black, housing director at Legal Services NYC, called the funding a good start but said more is needed to realize the program's secondary benefits. Many tenants still appear in court without lawyers due to high caseloads and funding shortfalls.

Analysis

Why This Matters

Shows a concrete link between housing stability policy and health outcomes, potentially reducing healthcare costs and ER overcrowding.
Provides evidence for other cities considering similar right-to-counsel programs, with 25+ jurisdictions already following New York's lead.
The rise in mental health and substance use visits highlights the need for wraparound services beyond legal representation.

Background

New York City launched the nation's first Right to Counsel program as a pilot in 2016, providing free legal representation to low-income tenants facing eviction in Housing Court. The program began in 10 ZIP codes chosen based on factors like high eviction rates and shelter entries, then expanded in phases before going citywide in March 2020. Prior to the program, tenants often faced experienced landlord lawyers without legal help. Previous research has shown that evictions are associated with worsened health outcomes, including increased emergency department visits.

Key Perspectives

[Researchers (UCLA)]: Found a significant decrease in ER visits in the initial rollout areas, particularly among children, suggesting a protective health effect. They also observed an increase in mental health and substance use visits, which was unexpected and warrants further study. [Housing attorneys and advocates]: Emphasize that even with legal help, the eviction process is traumatic. They argue for increased funding to meet demand and to address clients' broader needs beyond housing. [City administration]: Has increased funding to $14 million this year and $40 million annually going forward, but advocates say this is still insufficient to cover all eligible tenants.

What to Watch

Future research examining whether the ER visit reduction persists in other phases of the program and how the mental health increase is addressed.
City Council budget decisions: whether additional funding is allocated for Right to Counsel and for supportive services like mental health care.
Whether other jurisdictions see similar patterns as they implement their own right-to-counsel programs.

Sources

ER Visits Dropped Where NYC Provided Free Eviction Lawyers, New Research Shows · THE CITY

Checked

12 claims in this story checked against 1 source: 11 supported.

Show each claim

SupportedNYC’s free eviction-lawyer program was associated with a drop in ER visits in the first neighborhoods where it rolled out.THE CITY: “In those first 10 ZIP codes, Chen and her team found there were at least 26 fewer visits to the emergency department per 10,000 residents.”
SupportedER visits related to mental health and substance use disorders increased in the first program areas after rollout.THE CITY: “In all of the areas where the right-to-counsel program first began, there was an increase in emergency department visits specifically related to substance use disorders and mental health concerns in the five-year period studied.”
SupportedThe first 10 ZIP codes had at least 26 fewer ER visits per 10,000 residents.THE CITY: “In those first 10 ZIP codes, Chen and her team found there were at least 26 fewer visits to the emergency department per 10,000 residents.”
SupportedThe study examined more than 8 million ER visits by uninsured or Medicaid-covered NYC residents from January 2016 to February 2020.THE CITY: “Chen and her team examined over 8 million emergency department visits between January 2016 and February 2020”
SupportedChen said, “Particularly for vulnerable neighborhoods, this program might help tenants avoid ED visits.”THE CITY: ““Particularly for vulnerable neighborhoods, this program might help tenants avoid ED visits, and so we will be doing future research to try to dig into that a little bit more deeply,” Dr. Katherine Chen”
SupportedChen said the team could not definitively attribute the ER drop to the legal program but called it a leading possible explanation.THE CITY: ““We can’t definitively say for sure it was definitely right to counsel that made people go to the ER less in those early ZIP codes, but that’s one leading, possible explanation.””
SupportedThe decrease was most pronounced among children, with 32 fewer visits per 10,000 residents.THE CITY: “The rates dropped most clearly among children, with a decrease of 32 visits per 10,0000.”
SupportedKeene said evictions are “really harmful to health.”THE CITY: ““Evictions are really harmful to health and are associated with increased ED visits, and so it makes sense that an intervention to mitigate evictions would have this effect,” said Keene”
Partly supportedA 2025 city report said about 81% of households with legal representation remained in their homes between 2018 and 2023.THE CITY: “A 2025 report showed that between 2018 and 2023, about 81% of households facing eviction with lawyers were able to remain in their homes.”
SupportedThe researchers lacked data on whether ER visitors were facing eviction or using the free lawyers.THE CITY: “The team, for instance, did not have information on whether the New Yorkers making emergency department visits were actually being evicted or relying on the free lawyers through the right to counsel program.”
SupportedThe city committed $14 million for Right to Counsel this fiscal year and $40 million annually in subsequent years.THE CITY: “The Mamdani administration, which has emphasized protecting tenants, committed to spending $14 million for right to counsel this fiscal year and $40 million annually in subsequent years.”
SupportedMore tenants have been appearing in court without lawyers because of funding shortages and high caseloads.THE CITY: “Still, in recent years a rising number of tenants facing eviction have gone to court on their own because of a lack of funding and high caseloads that make it hard for lawyers to meet demand.”