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What to Know About Emotional Support Animals

Emotional Support Animals are becoming more widely used to help individuals with mental health issues. They provide their partner assistance through constant companionship and connection. This relationship can help ease a person’s anxiety, depression or other mental health issues. Another benefit is that caring for an animal encourages a person struggling with depression or anxiety to maintain a schedule and participate in social activities.

Emotional Support Animals vs. Service Animals

However, Emotional Support Animals (ESAs) are not Service Animals. The Americans With Disabilities Act states that service animals are defined as “dogs that are individually trained to do work or perform tasks for people with disabilities.” A service dog, such as a guide dog, is trained for a specific job directly related to the person’s disability.

Some of these specially trained dogs include:

  • Psychiatric dogs: trained to detect and lessen the effects of psychiatric episodes

  • Autism assistance dogs: trained to help those with autism identify important alerts, like a smoke alarm or overstimulation

  • Guide dogs: trained to recognize seizures and stand guard or go for help during a seizure

This specific training is the key difference between a service dog and an emotional support animal. This distinction is critical.

Where Can They Go?

Service dogs are generally allowed in restaurants and the workplace, but emotional support animals are not automatically given access. ESAs are treated as pets, not service dogs, according to the Air Carrier Access Act.

However, emotional support animals are given some of the rights service dogs receive. For example, ESAs are given the same rights as service dogs regarding housing under the Fair Housing Act. Housing policies such as pet restrictions and deposits are waived for those with an ESA prescription.

Another distinction between Service Animals and Emotional support animals is that ESAs are not exclusively dogs. An ESA may be a cat, rabbit or even a duck or lizard.

Stricter Regulations

Unfortunately, many people have taken advantage of the opportunity to use these regulations to falsely identify their pets as emotional support animals and service animals. This has led to stricter criteria for ESA qualification.

In 2021, California Governor Gavin Newson signed an ESA law that addresses this misrepresentation.

ESA letters are subject to more stringent requirements under the new California emotional support animal law that took effect on January 1, 2022. To issue an ESA, the medical practitioner must:

  1. Hold an active license within the scope of the given treatment

  2. Complete a clinical evaluation

  3. Establish a patient-practitioner relationship at least 30 days before giving the patient an ESA letter

How to Decide if an Emotional Support Animal Can Aid Treatment

It’s been recommended that mental health professionals consider four separate components when considering a patient prescription for an emotional assistance animal.

  1. Patient Assessment: This evaluation determines whether or not a support animal will improve a patient’s mental health or help them live a better life not possible without the animal.

  2. Animal Assessment: This assessment aims to determine the animal's suitability as an ESA. Many types of animals may serve as ESAs, but some animals are more practical than others. A domestic cat or small dog may be more suitable than a horse or emu. Also, a patient may want their pet to qualify as an ESA but may have an ulterior motive for the request.

  3. Patient-Animal Interaction: The interaction between the patient and the prospective animal should also be evaluated. If the animal is well behaved and obeys the patient's commands showing a bond, it may be a good fit. In contrast, an animal that the patient has little control over would probably not make a good ESA candidate.

  4. Laws Pertaining to ESAs: It’s critical for the mental health practitioner and the patient to know the requirements for an ESA letter and the applicable laws and regulations. This knowledge can help in determining the suitability of a particular animal.

If an emotional support animal is believed to positively impact a patient, a prescription for an ESA may be a valuable part of treatment.

Suppose the patient doesn’t have a suitable pet. In that case, animal shelters and rescues are great resources for selecting a dog, cat or other emotional support animal that the patient can bond with and build a relationship with to improve the patient’s psychological health and daily life.

But again, before deciding if an emotional support animal is a beneficial addition to an individual patient’s treatment plan, mental healthcare practitioners and patients must first understand the laws and policies that apply to their particular situation before moving forward.


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