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Is there an epidemic of emotional support animals?

By Cynthia K. Chandler February 6, 2019

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On June 6, 2017, ABC News reported that a man had been severely injured on a Delta Air Lines flight after being attacked by another passenger’s emotional support dog. The dog had been sitting in its owner’s lap in a center seat. The dog reportedly growled before the attack, prompting the man to ask the owner if the dog was going to bite him. The victim received multiple bites to the face, became covered in blood, and was removed from the plane and transported to the hospital. The dog’s owner was in the military and said he had been issued the dog for emotional support.

On Oct. 29, 2017, USA Today described an incident in which a service dog, a yellow Labrador retriever, was sitting calmly in an elevator next to its owner, who was in a wheelchair. Then another woman entered the elevator carrying a toy poodle in her purse. Just as the elevator door closed, the poodle jumped out of the woman’s purse and bit the service dog on the snout, causing blood to drip on the elevator floor. After this occurred, the woman first declared that her poodle was a service dog. She then changed her story and said the poodle was an emotional support dog. Finally, she admitted the poodle was a pet that she had just wanted to bring into the building with her.

On Feb. 22, 2018, The Washington Post reported that an emotional support dog on a Southwest Airlines flight bit a 6-year old girl in the face during boarding. The flight was delayed for takeoff while paramedics examined the child and declared her healthy enough to continue with the flight. The dog and its owner were left behind.

There are important lessons we should take away from these reports, the first being that dogs bite. Or, to be more accurate, dogs without the proper temperament and training to be out in public may bite. Second, people often are not objective about their pets’ behavior and, because of this, may put other people and other dogs at risk for injury. And third, some people, such as the woman with the toy poodle on the elevator, may not be honest about their need for an emotional support animal.

Confusion around emotional support animals

The Fair Housing Act that established the right for an emotional support animal to live with its owner in pet-restricted housing does not provide any right for the pet to accompany the person anywhere else. The Air Carrier Access Act established the right for an emotional support animal to accompany its owner during air travel. As a public safety issue, it is extremely important to understand these two pieces of legislation and what an emotional support animal is exactly.

First of all, an emotional support animal is not a service animal. Therefore, rights related to emotional support animals are not covered by the Americans with Disabilities Act. Currently, there is no official oversight regarding the qualifications of a pet to be an emotional support animal. There is currently no requirement for a pet to be evaluated by a qualified animal evaluator to be called an emotional support animal. The pet’s owner is the one who decides that the pet is an emotional support animal. The Fair Housing Act regulation about emotional support animals stipulates that these animals do not have to be trained, certified or registered. It is my opinion that the absence of a requirement for proper training and evaluation of pets to be emotional support animals is a real public safety concern.

Opportunism and irresponsibility have gravitated to the realm of emotional support animals. Many services now exist, mostly in the form of websites, that charge a fee to pet owners to register their pets as emotional support animals. In reality, this type of registration means nothing because it does not signify that a particular pet possesses a temperament that makes it safe to be around, either in public or on a plane. Nor does this registration mean that the pet has any special aptitude or skill to serve in the role of an emotional support animal.

In my opinion, current commercial services that register pets as emotional support animals are mostly a scam. These services take people’s money for no legitimate purpose and mislead the public by implying that people and other animals are free from danger when around pets that are registered as emotional support animals. Presenting a pet as a registered emotional support animal is equivalent to promoting the falsehood that the pet possesses some special qualification.

Most of these website services will also sell a vest or some other type of uniform for a pet to wear in public that indicates the pet is registered as an emotional support animal. This can insinuate that the pet must be allowed in places other than the owner’s home or on an airplane (the only two places legislation actually designates that emotional support animals must be allowed). In essence, registration of a pet as an emotional support animal is worthless to everyone except the commercial enterprises that take money from the pet’s owners.

A significant lack of understanding also exists concerning the documentation required to establish a person’s need for an emotional support animal. Recently, a counselor forwarded me the official policy of a college in Florida that requires pets to be registered as emotional support animals before they can live with their owners in college housing. That policy is out of compliance with the Fair Housing Act, which does not require pets serving as emotional support animals to be registered as such. And, as a matter of course, the college’s policy is forcing people to participate in — that is, pay money for — a worthless scam known as emotional support animal registration (although the college is likely unaware of this fact). The college’s policy is further out of compliance with the Fair Housing Act because it requires health care and mental health care providers to name and describe a client’s diagnosis or disability when providing emotional support animal documentation. Naming or describing a person’s diagnosis or disability is not required by the Fair Housing Act.

The Fair Housing Act does require emotional support animal documentation to be provided by a licensed health care or mental health care provider, as well as for the recipient of the documentation to be under the care of the provider. The required documentation involves a few statements by a health care or mental health care provider, on an official prescription pad or letterhead, declaring that:

1) The person is under the provider’s care.

2) The person has a diagnosed disorder or disability. (Remember, there is no requirement to name or describe the diagnosis or disability.)

3) The person can benefit from having an emotional support animal to reduce or alleviate symptoms associated with the diagnosis or disability. (These symptoms do not need to be named or described; however, for readers’ information, common symptoms that the presence of an emotional support animal might reduce or alleviate include anxiety, depression, loneliness, and emotional or physical pain.)

Health care and mental health care providers should never specify a particular pet as an emotional support animal in supplied documentation. Why is that? One, health care and mental health care providers are unlikely to be qualified to evaluate animal behavior. And two, they would basically be endorsing that particular pet as an emotional support animal, thereby placing themselves at jeopardy for a lawsuit should the pet injure someone. By the way, the flawed college policy I mentioned earlier also erroneously required health care and mental health care providers to describe in their documentation the specific emotional support animal and its abilities. Once again, this is not in compliance with the Fair Housing Act.

Documenting need

Another major public safety issue is the documentation that health care and mental health care providers are now supplying to support the seemingly epidemic need for emotional support animals. Over the past few years, I have found that a large number of mental health care providers, including many licensed counselors, are playing loose with the ethics of the duty of care in the way they are providing this documentation.

Allow me to outline three questionable activities I have observed or learned about that give me cause for concern.

  • Some mental health care providers supply documentation of a person’s need for an emotional support animal after only a single visit and then exercise little or no follow-up. Thus, the client’s need is not thoroughly assessed or properly monitored.

Technically, a person may be considered to be “under the care” of a mental health care provider after only one visit, but in my opinion, a single visit for the sole purpose of providing emotional support animal documentation is a gross misrepresentation of the duty of care. Also, I recommend that mental health care providers place a termination date of six months on the supplied documentation because a person’s condition can change and, thus, so can the need for an emotional support animal.

  • When supplying documentation, some mental health care providers do not assess or consider the client’s ability to determine whether a pet (emotional support animal) might be a disturbance, a danger or destructive.

Providers of emotional support animal documentation need to consider their obligation to public safety — that is, their role in helping to protect those with whom a client with an emotional support animal may come into contact. Remember, an emotional support animal is any pet that an owner wants to declare as such. It is unlikely that the designated emotional support animal will have training or have been evaluated for proper temperament.

  • Some mental health care providers supply documentation endorsing the need for an emotional support animal to people with whom they have had little to no direct contact.

Consider this scenario: A new for-profit enterprise is growing by leaps and bounds. This enterprise involves website services that document individuals’ needs for emotional support animals. These internet services are recruiting large numbers of mental health care providers, especially licensed counselors, to join a network to review questionnaires completed by applicants requesting documentation of their need for an emotional support animal. On the basis of the questionnaire, and sometimes a brief communication with the applicant via telephone, email or webcam, the mental health care provider assesses the applicant, provides a diagnosis and determines that the applicant could benefit from having an emotional support animal. On the basis of the mental health care provider’s brief assessment and applied diagnosis, the website service then provides a form letter to the applicant after taking a fee.

Several counselors have contacted me asking whether they should accept the invitation they received to become a provider for this type of web-based service that supplies emotional support animal documentation. I always recommend that they decline such offers. I do not consider these types of services ethical or responsible. Furthermore, I believe any mental health care provider who works for this type of service to provide emotional support animal documentation in this accelerated and impersonal manner is:

1) Performing at a highly questionable level of ethical functioning regarding duty of care

2) Contributing to the potential endangerment of those who may come into contact with emotional support animals that do not have the proper temperament and training to be out in public

3) Contributing to an epidemic of emotional support animals

An escalating problem

The large and growing number of emotional support animals is highly problematic. The public often confuses emotional support animals with working service animals. Unfortunately, because of this, people have learned that they can get away with taking their emotional support animals just about anywhere, even though they have no legal right to do so.

This confusion often occurs because:

  • Federal law does not require that a service animal wear a uniform or have documentation.
  • People often do not want to offend a person who may be accompanied by a service animal, so they do not inquire if the animal is truly a service animal.
  • The law places a limit on what a person accompanied by a service animal can be asked. Only two questions regarding a service animal are allowed: Is the animal required because of a disability? What work or task has the animal been trained to perform? Specific questions about the person’s disability are not allowed.

Because of the general public’s confusion concerning service animals versus emotional support animals, people with emotional support animals can easily misrepresent themselves as being accompanied by a service animal and go places where they are not allowed. Falsely claiming that a pet, including an emotional support animal, is a service dog is illegal in some states. According to a 2018 article in Texas Monthly, such a false claim made in Texas is classified as a misdemeanor and is subject to a fine of up to $300 and community service at a place that serves people with disabilities.

There is no way to determine how many emotional support animals there are, but it is clear they are rapidly growing in number. A 2014 article in The New Yorker detailed one commercial website that registers pets as emotional support animals. It reported 2,400 such registrations in 2011; the number at just that one site grew to 11,000 in 2013. So, yes, we have a growing epidemic of emotional support animals.

Lack of official oversight regarding the behavior of emotional support animals, along with the poor judgment of some owners, is resulting in public nuisances and endangering public safety. It has been demonstrated that people want to take their pets places that pets should not go. Furthermore, the public’s confusion about rights of access for service animals versus emotional support animals is adding to the problem. In addition, many health care and mental health care providers are contributing to the epidemic numbers of emotional support animals by their irresponsible, and perhaps unethical, approach to providing documentation.

Significant efforts need to be made to address the problems caused by the epidemic numbers of emotional support animals. USA Today reported that several states are cracking down on individuals who falsely claim to have service dogs just so they can take their pets or emotional support animals anywhere they please. Mental health care providers can certainly assist by being more responsible in their provision of documentation for emotional support animals. This can be accomplished by:

1) Providing proper and thorough assessment of a client’s need for an emotional support animal

2) Placing a time limit on the validity of the documentation they supply

3) Requiring follow-up visits from clients to renew documentation for emotional support animals

Mental health care providers can also decline to associate themselves with commercial web services that provide emotional support animal registries and documentation, because these services are designed to attract as many customers as they can, as fast as they can, for as much profit as they can.

In concluding this article, I want to clarify that I am very much in favor of emotional support animals living with their owners in housing. However, until federal or state governments pass legislation requiring greater oversight for emotional support animals, especially related to animal behavior requirements, and until many suppliers of emotional support animal documentation act more responsibly, we are all going to be at risk for being bitten, especially on an airplane. For now, our welfare is in the hands of the owners of emotional support animals.

 

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For more information, refer to the following resources:

 

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Cynthia K. Chandler is a licensed professional counselor and a licensed marriage and family therapist in Texas. She is a professor in the Department of Counseling and Higher Education at the University of North Texas and director of the university’s Consortium for Animal Assisted Therapy. Contact her at cynthia.chandler@unt.edu.

 

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Confirming the benefits of emotional support animals

By Cynthia K. Chandler April 20, 2015

Have you received a telephone call of the following nature? “Can you certify my pet to be an emotional support animal?”

If you are a professional counselor, then the likelihood of you receiving such a request is on the rise. This is because word is spreading that the U.S. Department of Housing and Urban Development dog_1(HUD) recognizes the benefits of emotional support animals and provides regulations allowing them to live with an owner in designated nonpet housing (with a few exceptions) without requiring a pet deposit fee.

Exercising this right does not require that an animal be certified. What it does require is documentation that an individual has a legitimate need for an emotional support animal. The responsibility of providing this documentation lies with professional counselors and other mental health or health providers. In 2008, HUD stipulated that “persons who are seeking a reasonable accommodation for an emotional support animal may be required to provide documentation from a physician, psychiatrist, social worker or other mental health professional that the animal provides support that alleviates at least one of the identified symptoms or effects of the existing disability.”

Documentation and other considerations

A counselor who chooses to provide such documentation must do so in letter format on the counselor’s letterhead. The documentation should state that:

1) The named individual is under the counselor’s care

2) The individual has an emotional or psychiatric disability

3) The counselor recommends the individual have an emotional support animal to assist with the disability

The letter is provided directly to the individual who wants to have an emotional support animal live in the home. The individual can then choose with whom to share the letter.

In the documentation, the counselor does not label, define or describe the particular disability of the client. Rather, the counselor must state in general terms that the client has an emotional or psychiatric disability and that an emotional support animal can alleviate one or more of the symptoms or effects of the disability. Individuals need only provide proper documentation to a landlord to have a pet live with them as an emotional support animal in housing typically designated as excluding pets. The judicial system has interpreted this right to fair housing to additionally extend to individuals who wish to have emotional support animals live with them in college or university housing facilities, such as residence halls, dormitories or university-owned apartments.

The responsibility of providing documentation that would allow individuals to have an emotional support animal live with them should not be taken lightly. Based on the accompanying symptoms of a client’s emotional or psychiatric disability, a professional must determine whether living and engaging with an emotional support animal in the home might provide the client with some relief from the disability. To make this determination, it may be useful to have some understanding of how an animal may alleviate symptoms or effects of an emotional disability. Fortunately, there is research that provides guidance in this area.

In my 2012 book, Animal Assisted Therapy in Counseling, I reviewed several research studies on the psychophysiological and psychosocial benefits of positive social interaction with a pet, such as holding or stroking an animal. These benefits include calming and relaxing, lowering anxiety, alleviating loneliness, enhancing social engagement and interaction, normalizing heart rate and blood pressure, reducing pain, reducing stress, reducing depression and increasing pleasure. Based on the results of these studies, it is plausible that living with an emotional support animal may alleviate symptoms associated with a number of emotional and psychiatric disabilities. HUD states, “Emotional support animals by their very nature, and without training, may relieve depression and anxiety, and/or help reduce stress-induced pain in persons with certain medical conditions affected by stress.”

Another factor to consider in recommending that a client have an emotional support animal is whether the client has the ability and desire to properly care for an animal. Although human-animal interaction is known to assist people with developmental, emotional, social and behavioral disorders, it is important to assess whether any impairment is so severe that an animal would be neglected or harmed.

Dogs are the most common species to serve in the role of emotional support animals, but Section 504 of the Rehabilitation Act and HUD’s Fair Housing Act (FHAct) do not designate species restrictions for this role: “While dogs are the most common type of assistance animal, other animals can also be assistance animals.”

Emotional support animals vs. service animals

HUD legislation uses the broad term “assistance animals,” which is inclusive of both service animals and emotional support animals, when addressing the right to fair housing for individuals with these animals. In contrast, the fair housing rights and rights of access to other facilities included in the Americans with Disabilities Act addresses service animals only. To be clear, an emotional support animal is not the same as a service animal or a psychiatric service animal. Thus, emotional support animals do not have the same federal rights of access to facilities as do service animals. HUD provides the only current federal legislation that covers rights regarding emotional support animals, and this legislation is specific to allowing individuals to have animals live with them as emotional support in designated nonpet housing without financial penalty.

In 2013, HUD clarified that an emotional support animal is not merely a pet: “An assistance animal is not a pet. It is an animal that works, provides assistance or performs tasks for the benefit of a person with a disability, or provides emotional support that alleviates one or more identified symptoms or effects of a person’s disability.” However, HUD also stipulated that emotional support animals “do not need training to ameliorate the effects of a person’s mental and emotional disabilities.” Furthermore, “For purposes of reasonable accommodation requests, neither the FHAct nor Section 504 requires an assistance animal to be individually trained or certified.”

There are no qualification requirements for determining whether a specific pet is appropriate to serve as an emotional support animal. So, by default, an emotional support animal is basically a person’s pet that lives with that person and provides emotional support. HUD does stipulate that housing providers are not required to provide accommodations if an animal is destructive, poses a direct threat to the health and safety of others or interferes with the ability of a facility to perform its intended purpose. So, in practice, most people with proper documentation can have a pet live with them and serve in the role of emotional support animal as long as the animal is not destructive, disruptive or dangerous.

Recommendations

Because federal law does not require emotional support animals to be trained or certified, the potential exists for some of these animals to be unpredictable and cause harm. Until there is greater oversight regarding emotional support animals, I recommend that counselors avoid a chain of liability and not name a specific pet to serve as an emotional support animal. When providing documentation, refer only to the benefit of the individual having an emotional support animal, but do not name a specific animal. The decision concerning the specific pet to be designated as an emotional support animal should be made by the individual owner of the pet. It is not the responsibility of the counselor or other mental health provider to sanction the appropriateness of a particular pet to serve as an emotional support animal. That is not to say that counselors should avoid assisting individuals in the decision-making process regarding emotional support animals.

For instance, counselors can recommend that clients have their pets evaluated by a qualified evaluator before designating the pets to serve as emotional support animals. A standardized evaluation can often determine if an animal possesses the appropriate stamina and temperament to serve in this role.

Evaluation is important for health and safety reasons. Some animals may find the role of emotional support animal to be too stressful, and the emotional and physical health of the pet will be damaged. We must not overlook the welfare of the animals when considering whether they might provide emotional support for individuals with emotional and psychiatric disabilities. In addition, some pets can respond to stress with overprotective tendencies and aggression, putting members of the public at risk.

Many individuals desire to have their emotional support animals accompany them to pet-restricted facilities outside the home. Many businesses and institutions today are wrestling with how to make this happen while still maintaining the safety of those who may come in contact with these animals. It is my opinion, as a very experienced handler and animal team evaluator, that if individuals were to have their pets’ temperament evaluated by a qualified evaluator, both initially and periodically (say every two years), and provide current documentation that the animal had passed a standardized temperament evaluation, then they might be granted permission by a business or institution on a case-by-case basis to have their emotional support animal accompany them to places where pets are typically not allowed.

Animal temperament evaluations

Animal temperament evaluations assess the animal’s social attitude and behavior toward both people and a neutral test dog. In addition, the evaluation assesses the animal’s ability to walk politely on a leash, interact with a small crowd of people and respond to a variety of basic obedience commands by its handler. Failing a temperament evaluation would not interfere with the right of an individual to have the pet live in the home in the role of emotional support animal. Federal law protects this right. Qualified animal temperament evaluators can be found through national organizations such as the American Kennel Club (AKC) Canine Good Citizen (CGC) program and the national Pet Partners program.

The AKC website (akc.org/dog-owners/training/canine-good-citizen/) provides information about the CGC evaluation, which is best suited for the simple purpose of determining if a pet is well-behaved enough to be around the general public. However, it is designed solely to evaluate the temperament of dogs, not other species. The CGC evaluation is relatively inexpensive, takes about 30 minutes to complete and requires the handler to take the dog through a series of basic obedience commands. Local CGC evaluators can be found at many large pet stores that offer dog training for handlers or at community obedience training clubs. The Pet Partners organization offers evaluations for a number of different domestic animal species, but the investment in cost and effort is higher. This is because the intended purpose is to register Pet Partners teams that can provide services to the public as handler and therapy animal (note that a therapy animal is not the same as an emotional support animal). The Pet Partners registration requires a rigorous handler-team evaluation — for temperament, skills and aptitude — and requires the handler to complete a training that is available online or through an eight-hour, in-person workshop. The training includes learning about risk management and infection control procedures that are valuable to follow when a pet is engaging with the public. The Pet Partners website (petpartners.org) provides information on training and finding a local evaluator.

The animal temperament evaluation procedure may resolve a prominent ethical dilemma. If an emotional support animal can alleviate or assist with a person’s emotional or psychiatric disability at home, why shouldn’t the animal be allowed to serve this purpose outside of the home as well, such as in the classroom or a work environment? At the same time, because no oversight exists regarding behavioral requirements for emotional support animals, how do businesses and institutions protect the public from danger posed by a potentially unruly animal? Because there is no federal regulation that requires facilities other than housing to allow the presence of emotional support animals, then businesses and institutions can establish their own policies around this issue.

Requiring a standardized animal temperament evaluation may be a reasonable solution to thisDog_2 ethical quandary. The business or institution could provide a letter of access, for a designated period of time, to an individual accompanied by an emotional support animal if that person provides the institution with:

1) Official documentation from a professional counselor, or other mental health or health provider, designating the need for an emotional support animal (this could be the same documentation used for federal housing rights)

2) Proof that the animal passed a recently administered standardized temperament evaluation from a reputable source such as AKC or Pet Partners (the evaluation should have been completed within the past two years because appropriate animal temperament can deteriorate over time)

Advocacy

Perhaps the greatest source of confusion today is around the concept of emotional support animals. The general public may not be aware that emotional support animals are not the same as psychiatric service animals and therefore do not have all of the same federal rights to access facilities. Many people are unaware that current federal law does not require emotional support animals to be trained or evaluated. Thus, some emotional support animals with inappropriate temperament may pose a risk to the general public. Generally, the public does not realize that most emotional support animals are essentially a person’s pet serving in the role of emotional support.

I am an advocate for the idea of emotional support animals, but I firmly believe there should be greater oversight. This would include evaluation of the appropriateness of a pet to serve as an emotional support, taking into consideration both the prospective health and welfare of the animal and the health and welfare of the public, particularly if the animal is to accompany the individual to facilities outside the home. Current federal law clearly states that an emotional support animal does not have to be trained or certified to be allowed to live with a person, implying that the animal does not have to be evaluated either. But federal law does not make stipulations about access to facilities other than the home for emotional support animals. Thus, businesses and institutions are free to make policies that allow individuals to be accompanied by their emotional support animals, while also providing for the safety of the public.

Counselors can more effectively advocate for their clients if they understand federal regulations pertaining to emotional support animals. Additionally, this information is beneficial for protecting the general public from those who might misrepresent the role of their animal or the right for the animal to accompany them into pet-restricted areas. Unfortunately, profit opportunists exist who encourage such misrepresentation by selling (to anyone who is willing to pay) an official-looking — yet completely unofficial — vest for a pet to wear and a worthless “certification” document that may ultimately confuse the public about the legitimate role of the animal and the rights of the individual the animal is accompanying.

Federal advocacy for those with emotional or psychiatric disabilities, through recognition of the right to have an emotional support animal in the home, is a positive development in our society. Moreover, businesses and institutions that recognize the potential benefits of allowing an emotional support animal to accompany a person with a disability outside of the home reflects enhanced sensitivity to human welfare.

Animals are an excellent source of nurturance and companionship. Creating additional yet responsible opportunities for human-animal interaction enhances people’s lives. Movement toward greater integration of well-behaved animals into our daily lives at home, school and work is a reflection of enlightened social evolution.

 

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Related reading: See Cynthia Chandler’s second Counseling Today article on this topic, “Is there an epidemic of emotional support animals?”

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Cynthia Chandler is a professor of counseling and director of the Consortium for Animal Assisted Therapy at the University of North Texas. She is author of the book Animal Assisted Therapy in Counseling (2012). Contact her at cynthia.chandler@unt.edu.

 

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.