https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6563823/

The service animal, usually a dog, is an animal that is specially trained to perform tasks for an individual with a disability. The disability can be psychiatric in nature, but the animal must be tasked trained to assist with that disability.

Some of these tasks include attending to an individual’s mobility and activities of daily living.

Helping to remind an individual to take their medication.

Assisting an individual during and /o after a seizure.

Supporting an individual with autism.

Applying sensory commands such as lying on the person or resting their head on the individual’s lap to help the individual regain behavioral control.

Service dog verification works via an honor system, which can be problematic, especially in the case of a psychiatric service dog where the disability may not be visible. In addition, their is no requirement for professional training. Under the Americans with Disabilities Act (ADA) individuals with disabilities, including those of a psychiatric nature, can bring their service animals into places where dogs may not be allowed. This does NOT include private clubs, religious organizations, or places of worship that ARE NOT open to the public.

Emotional Support Animals, or ESAs, DO NOT qualify as service animals under the ADA and are considered pets. They are no longer allowed in aircraft carrier cabins after the US Department of Transportation revised this act in December of 2020. They ARE still covered under the FAIR HOUSING Act.

Research has shown that service animals are able to help owners gain a greater degree of independence and participate in everyday outings that may otherwise had been a struggle. Overall, service animals are known to improve owners’ quality of life. ESAs, on the other hand are not evidence-based treatment for psychiatric disorders nor are they specifically trained to help with one. Pets however are known to benefit patients with mental conditions through the development of a strong bond and the contribution they make to emotional support in times of crisis.

Mental health professionals documentation?

A mental health professional can write a letter for a patient at their request, stating they have an emotional disability they are being treated for and the letter should be given to the patient to use as he / she /they deems fit. Patients should be encouraged to have the animal pass a standard basic obedience test as given by the AKC. You as a mental health professional can not vouch for the behavior of the animal.

If the letter is for documentation for a service animal, it can include how the animal helps alleviate symptoms of the patient’s condition. I strongly recommend referral to professional trainers that have a background in the mental health field so a coordinated treatment plan can be devised. The trainer is also able to write a letter stating how the animal is trained to assist.

Writing a letter for a patient confirming a dog is needed to assist with a disability does not make that animal a service animal. There are no current standards for conducting evaluations to determine the need for a service animal or ESA. This letter is your recommendation. If written, you should be able to defend your recommendation in a court of law. It is a crime to fraudulently certify an animal as a service animal in some jurisdictions, and such conduct could result in disciplinary action by your licensing board. There are cases where having an animal may be harmful or may worsen a psychiatric condition.

In summary, I am a strong advocate for canines in helping psychiatric patients both as ESA’s and psychiatric service dogs. I do believe there are certain situations where a dog is necessary for the most optimal functioning of a patient, especially where response to medication is only partially effective. In advocating for patients, animals must be tasked trained and should be able to pass basic obedience testing. If a patient has not been able to demonstrate this training, then a letter should not be written. The patient also must be responsible, and can care for the needs of the animal. In the case of an assistance animal helping a patient with dementia, arrangements need to be made for the care of the animal as well.