Animals can provide joy and companionship. Animals can also provide emotional support to people with mental health concerns. These animal companions are known as emotional support animals (ESAs), and they have been growing in popularity in recent years.
Definition
An emotional support animal is an animal companion that offers some type of benefit to an individual with some form of disability. The animal is intended to provide companionship and support that will help alleviate at least one aspect of the disability.
Dogs are the most common type of emotional support animal, but cats are quite common as well. Other types of animals, such as miniature horses, can also serve as ESAs.
For example, a peacock made headlines after it was denied from entering a United Airlines flight, despite the fact that its owner said that the animal was an emotional support animal. Some of the more unusual emotional support animals that have flown with their owners include a pig, a duck, a monkey, and a turkey. The vast majority of ESAs are not rare, exotic, or barnyard creatures.
Benefits
Why would an individual choose to use an emotional support animal? Research has long supported the idea that animals can provide significant mental health benefits. One research review found that owning a pet has positive effects on mental health by fostering emotional connectivity and helping people manage in times of crisis.
Some of the other benefits that emotional support animals may provide include:
Less anxiety. Simply petting an animal can create a relaxation response and elevate mood.
Trauma support. Pets can provide comfort to people who are dealing with difficult situations, including those who have experienced some type of trauma.
Improved physical health. Studies have found that emotional support animals help to lower blood pressure, decrease respiration rates, and improve the ability to cope with pain.
Fewer feelings of loneliness. Animals can provide companionship, which is especially important for people who live alone and experience symptoms of depression and anxiety.
Reciprocal care and love. Caring for an emotional support animal can also help give people a sense of purpose. Not only do animals provide unconditional love and companionship, but they also require care and love in return, which can be emotionally rewarding.
Research
It's easy to say that animals can help make people calmer, happier, and even more fulfilled. But are emotional support animals really that different from any beloved pet? So far, the research remains inconclusive. While some suggest that support animals may produce positive effects, support for the therapeutic effectiveness of emotional support animals tends to be scant.
For example, research has not been able to demonstrate that support animals provide significant benefits over what any regular pet would provide. According to a 2016 study published in the journal Professional Psychology: Research and Practice, it is not clear whether emotional support animals have any therapeutic effects beyond the positive benefits that animals provide in general.
“Little empirical data exists to support the conclusion that ESAs are effective in mitigating psychological disorders and related problems, and empirical research that does exist is inconsistent, sparse and emerging,” suggested psychologists Jeffrey Younggren and his colleagues in an article published by the American Psychological Association in 2016.
Further research may be needed to help demonstrate what impact emotional support animals might have and when ESAs may be the most beneficial.
Emotional vs. Service Animals
While emotional support animals and service animals share some similarities, there are important distinctions between the two. Emotional support animals are intended to provide companionship and support. Service animals, on the other hand, assist individuals with disabilities by performing specific tasks.
Service animals are those that have been specially trained to perform a service for a person with some form of disability. Such disabilities may be sensory, physical, intellectual, psychiatric, or mental in nature. Tasks that a service animal might perform include alerting a person about a sound, guiding a person along the street, pressing an elevator button, retrieving items, alerting others or standing guard if the individual is experiencing a seizure, or reminding the individual to take his or her medication.
Emotional support animals, on the other hand, are there to provide companionship aimed at alleviating distress or provide some other type of relief.
Titles II and III of the Americans with Disabilities Act specify that service animals must be dogs, although reasonable accommodations must be made to allow miniature horses to serve as service animals in cases where the animals have received training to perform specific tasks for the disabled person.
ESAs
Provide companionship and emotional support to individuals with disabilities
Do not require specialized training
Covered under the Federal Fair Housing Act
Service Animals
Assist individuals with disabilities with specific tasks (reminding someone to take their meds, alert others of a seizure, etc.)
Require specialized training
Covered under the Americans With Disabilities Act
It is also important to note that emotional support animals and psychiatric service animals are not the same things. Where an emotional support animal may provide benefits to people with mental illness, psychiatric service animals are specially trained to perform specific tasks for people with psychiatric conditions. This might include reminding the individual to take their medications or stop someone from engaging in self-harm.
Laws
Under the Federal Fair Housing Act, housing providers are required to make reasonable accommodations to allow individuals with disabilities to keep an assistant animal in their home. The U.S. Department of Housing and Urban Development (HUD) requires housing providers to make exceptions to "no pets" policies.
The two conditions required for such an exception:
The individual living with the animal must have some type of disability that significantly limits one or more major life activities.
The animal must provide some type of relief or assistance related to these identified disabilities.
HUD does not specify which disabilities qualify an individual for an exception. Rather, they state that the functions of an ESA include "providing emotional support to persons with disabilities who have a disability-related need for such support.”
An exception usually requires a verification letter from a mental health professional stating the individual's needs for an emotional support animal. Landlords may also require that people requesting accommodation also submit a verification form completed by a physician or therapist that confirms the disability.
The Fair Housing Act Under the FHA, landlords cannot legally:
Require tenants to pay additional fees for ESAs
Ask for information on the extent of the person's disability or request detailed medical records
Refuse to accommodate an emotional support animal
Require that the animal receive specific training
Require the owner to use a specific type of harness or identification collar for the animal
However, tenants are financially responsible if their animal causes any type of damage to persons or property.
While the Americans With Disabilities Act allows people to legally bring their service animals into public areas, emotional support animals are not covered by the law. Emotional support animals do not meet the definition of a service animal under the law, which requires that service animals be specifically trained to perform tasks to help the individual with the disability. Because of this, business and public spaces can deny the admission of emotional support animals.
Controversy
While there is some evidence pointing to the value of emotional support animals, not everyone agrees that they are always necessary. Some mental health experts have suggested that support animals may be overused.
The number of emotional support animals appears to be growing every year. United Airlines, one of the largest airline carriers in the US, reported a 75% increase in the number of emotional support animals flying on the airline between the years 2016 and 2017.
One study published in PLOS ONE found that the number of emotional support animals found in the state of California had increased 10-fold between 2002 and 2012.
Airlines, other businesses, and federal regulators are now considering additional rules regarding the use of ESAs, including:
Limiting the number of species that may be allowed to be used as support animals
Requiring owners to submit documentation in advance as to their use of an emotional support animal
Stating that the animal is housebroken and safe to be around other people
The increased demand for ESA's sometimes places therapists in a bind as well. More and more, patients request letters of documentation supporting their need for an emotional support animal from their psychologist, therapist, or doctor.
Why are so many people interested in having a support companion? Many experts attribute it to the fact that the law allows these individuals with disabilities to bring an emotional support animal on a plane at no additional cost. Normally, airlines require people to pay an extra fee to bring their pets on a flight, but with a letter stating that they need an emotional support animal, people can avoid this fee.
The Air Carrier Access act suggests that a wide variety of animals may be permitted to board flights as emotional support animals, although airlines are able to use their discretion in cases where animals are too heavy, large, or disrupting as well as those prohibited in other countries.
The problem is that the law is vague in defining exactly who needs an ESA. This has led to many people attempting to obtain letters supporting their need for an emotional support animal in order to travel with their pet without having to pay to bring the animal on board the flight.
People also occasionally obtain letters from physicians and psychologists in order to justify keeping an animal in their rental home or apartment. Because the Fair Housing Act requires landlords to allow renters to keep emotional support animals in their residence, tenants may sometimes have their pet designated as an emotional support animal to keep their pets in their homes.
Ethical Considerations
The vagueness of the law creates a quandary for many psychologists and therapists. Do they write a letter for a patient who may not truly have the need, or do they deny the request and risk losing the patient?
Some patients may become angry if a therapist or doctor denies their request for a documentation letter. This creates an ethical problem for therapists. Should they write a letter in order to ensure that a patient stays in treatment, even if they do not feel that a support animal is necessary?
Many experts believe that additional guidelines are needed to help psychologists, therapists, and physicians determine who needs emotional support animals.
In the absence of such guidelines, a number of online businesses have emerged that promise to deliver a diagnosis and provide an ESA documentation letter. Many of these sites promise to provide a diagnosis and letter of documentation in under 24 hours for less than $100.
This type of abuse of the law has led to many airlines requiring that an ESA documentation letter be submitted in advance of the flight along with the name and contact information of the mental health professional who provided the diagnosis.
For example, in June 2018, JetBlue announced that it would require passengers to submit additional proof that their emotional support animals were needed and properly trained. Representatives for the airline attributed the new rules to "dramatic increase in industry incidents involving emotional support animals that haven't been adequately trained to behave in a busy airport or the confined space of an aircraft.”
These rules include only accepting dogs, cats, and miniature horses as support animals and only allowing one animal per customer. Passengers are also required to submit a medical form completed by their care provider, a veterinary health form, and an animal behavior form.
Requirements vary from one airline to another, so passengers should check carefully to see what forms and documentation they may need to provide before boarding with their emotional support animal.
Eligibility
Emotional support animals may be helpful to those with certain mental health conditions such as depression or anxiety. If you feel that a support animal may help relieve your symptoms, talk to your doctor or therapist about some of the possible benefits and risks.
Having a pet requires an investment of time and effort, so it is important to be sure that you are prepared for the commitment and capable of caring for the animal. It may be helpful to talk about what you hope to gain from having an emotional support animal and discuss which type of animal might be right for your needs.
If you want an ESA in order to avoid paying an extra flight fee or pet deposit, consider the effect your actions may have on people who have genuine needs for a support animal.
An ESA can provide support and comfort that some individuals may need to cope with their disorder or disability. Obtaining an ESA documentation letter to avoid paying extra for your pet ultimately hurts the legitimacy of the many patients who have a real need for a support animal.
If you feel you have a legitimate need for an emotional support animal, talk to the doctor or therapist who is currently treating you. Don't buy a letter from a scammy online site that promises a dubious certification document to anyone willing to pay their fee.
A Word From Verywell
While research has yet to demonstrate the long-term effects of emotional support animals for alleviating the symptoms of psychological conditions, you may find a support animal a helpful and rewarding addition to your existing treatment plan. Whether you are dealing with stress, anxiety, trauma, or some other type of mental health condition, a pet can provide companionship and support. Talk to your care provider about whether an emotional support animal might be helpful for your individual situation.
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