Emotional Support Animals: Benefits, Laws & Public Perception

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Emotional support animals (ESA) are becoming more common across the U.S. The majority of people who own pets for emotional support live with a mental condition, and an ESA helps ease stress and reduce levels of loneliness, anxiety, and/or depression. Lawmakers have recognized the role of ESAs and passed laws to support individuals who have ESAs.

To learn more, check out the infographic below created by Ohio University’s Online Master of Science in Nursing.

How nurses can manage the presence of assistance animals and ESAs.

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Understanding the Different Types of Assistance Animals

There are three types of assistance animals: Emotional support animals, service animals, and therapy dogs. What’s the difference between the three types?

Emotional Support Animals

Emotional support animals aren’t specially trained, although they must be toilet trained and well-behaved. They’re usually not allowed in shopping malls or restaurants and may be limited to residential dwellings. Owners must provide documentation for their animals to be allowed to live where pets are prohibited and must be accompanied by a legal prescription by a licensed mental health professional. Th animal itself can be a common domestic animal.

Service Animals

Service animals are usually dogs, although they can be miniature horses in specific cases. Service dogs are divided in five groups: guide dogs, hearing or signal dogs, seizure response dogs, psychiatric service dogs, or SSI dogs (that is, sensory signal dogs or social signal dogs).
These dogs are specially trained to perform specific tasks. These include wheelchair pulling, fetching items, guiding blind individuals, or alerting the owner to sounds.
Psychiatric service dogs are trained to detect the beginning of a psychiatric episode and support their owners, who may have one or more specified conditions. These conditions include major depression, anxiety, PTSD, motor skills disorders, and cognitive disorders. Service animals receive accommodations everywhere under the Americans with Disabilities Act (ADA).

Therapy Animals

Therapy animals assist counselors, physical therapists, and social workers. They aren’t guaranteed access under any laws.

Public Understanding of Assistance Animals

A survey conducted in 2017 found that 53.9% of people owned a dog as a pet. The survey also showed that 38% had friends or family who owned a service dog, and 38.4% had friends or family who owned an emotional support dog.
The survey also demonstrated that while some people have a firm understanding of what these special animals do, there is still some work to be done. That said, the animals are gaining public support. 51.4% of those polled strongly agreed with the statement, “I see nothing wrong with people having emotional support dogs if they think they are useful.” Only 6.7% somewhat or strongly disagreed with the same statement.

The Role of Emotional Support Animals

ESAs help individuals with many conditions and are protected under numerous laws. One key reason for this is due to the benefits an ESA can provide, as they can support individuals with depression, anxiety, and certain phobias by providing companionship and alleviating loneliness. They can even help child and adult witnesses testify in court.

Laws Supporting ESAs

The Fair Housing Amendments Act of 1988 (FHA) helped to define the concept of ESAs. The law classifies ESAs as assistance animals, and individuals with ESAs cannot be discriminated against when applying for housing. They also aren’t required to pay pet deposits nor are they limited by pet size or species. Furthermore, reasonable accommodations must be made, such as an exception to a “no pet” policy.

Rehabilitation Act

Under the Rehabilitation Act, individuals with a disability cannot be “excluded from or denied participation in services, programs, and activities” due to their disability. This act speaks to the right of ESA owners to reasonable accommodation from any program that receives federal assistance.

Obtaining an ESA

An individual must receive a letter from a mental health professional that’s written on letterhead and contains vital information like license type, license number, and issuing state. The letter must state that the individual is the professional’s patient and is being treated for a condition described by the Diagnostic and Statistical Manual (DSM of Mental Disorders Version IV or V. The letter also must state the individual is limited in performing at least one major activity due to the disability, and the ESA is prescribed as part of treatment.

Assistant Animals in the Health Care Workplace

Under the ADA, only two questions can be asked of owners with service animals to legally determine if an animal is a service animal. The first question is “Is this a service animal?”, and the second question is “What service/skill/task does the animal do?”

After obtaining these answers, nurses can either allow the animal to stay if it provides a disability-related aid or it follows employer guidelines to request the animal be removed. Nurses aren’t allowed to ask questions about the individual’s disability or to see proof of an animal’s training. However, a service animal can be prohibited if it may cause a safety concern, isn’t housebroken, or is behaving poorly.

There are a few guidelines nurses can use to treat patients with assistant animals. These include ensuring the animal is under the owner’s control and has their required immunizations, isolating the animal and owner if others are disturbed, and ensuring hospital policy doesn’t violate the rights of the disabled patient.

Health care professionals are responsible for ensuring all patients feel comfortable and supported – including those with assistance animals. ESAs are becoming more common, and nurses should be prepared to encounter more animals in the health care workplace.

Learn more about Ohio University’s Online Master of Science in Nursing.