Hi, I'm Dr. Tracey Marks, a psychiatrist,
and I make mental health education videos.
In this video, I'm going to talk
about emotional support animals.
I'm going to answer the questions,
what are they and what do they do?
What rights do you have with them?
And what's the difference
between an emotional support animal,
a psychiatric service animal, and a therapy animal?
An emotional support animal is an animal
whose presence is required for your mental wellbeing.
Required is the operative word here.
They bring comfort and they minimize the negative symptoms
of your psychiatric disability.
Your need for this animal is documented
by a mental health professional.
Anyone can derive benefit from interacting with an animal
but there are certain protections
and accommodations allowed by law
if you have an emotional support animal.
Before 2020, if you went to your therapist or doctor
to write a letter saying that you need an animal
for emotional support,
you could fly on an airplane with your pet
without paying an extra fee.
If the pet was small enough,
it could get a seat in main cabin with you.
With a similar letter, you can be allowed to bring your pet
into places that normally restrict
the presence of animals like a restaurant
or you could get a housing pet waiver that you could use
to rent property that restricts animals
and not have to pay an additional deposit
in the case of damage from the pet.
What if you had a pet and wanted to take it on a flight
and didn't have a therapist?
Well, a whole cottage industry has popped up
to address this need.
There are online sites
where you can fill out a questionnaire,
pay a fee and get your letter.
This made it super easy
to bring any animal that you want on a plane.
Airlines got frustrated with some of the requests
like this one for Dexter, the emotional support peacock,
who was rejected from getting on that plane.
Then, there were complaints from passengers
not wanting to listen to Stanley, the pot-bellied pig,
oink and squeal all the way through the flight
when his poor eardrums popped.
So in December of 2020,
the Department of Transportation
ruled that airlines are no longer required
to treat emotional support animals as service animals
and were not required to provide accommodations for them.
Most of the US airlines like Delta, American,
United, JetBlue and Southwest
stopped allowing emotional support animals on the plane
but they still make accommodations for a service animal,
and what's the difference?
The Department of Transportation
defines a service animal as a dog,
regardless of breed or type,
that is individually trained
to do work or perform tasks
for the benefit of a qualified individual with a disability
including a physical, sensory,
psychiatric, intellectual or other mental disability.
Notice the service animal is limited to dogs.
The ruling also goes into detail
about how the service animal
must be able to travel the entire trip
without relieving themselves
or be able to do it in a sanitary manner.
I'm not sure what that looks like.
Let's break down this definition a little.
A service animal is trained.
It's not just your well-mannered, super smart dog.
They have received specific training to handle a disability.
An example of this is a dog who's been trained to sense
when you're having a panic attack
and calm you down by licking your arm.
Someone with autism
who is very reactive to intense sight, sounds, or textures,
may have a service animal that screens objects
or situations for them to prevent
sensory overload when their owner goes into public places.
This is a very specific purpose and more
than I want to have Fluffy with me because I love him
and he makes me feel good.
The requirements for training vary.
Usually, it's a rigorous program from a trainer
but some certification programs
allow you to train the animal yourself.
Another part of the definition
is a qualified individual with a disability
and this is where things can get very gray
when it comes to psychiatric disability.
What's considered a disability?
You can have depression that comes and goes
and you may be stable on meds
without symptoms for the past five years.
Are you disabled?
The answer to that question usually depends on who's asking
and what there is to gain if you are considered disabled.
Disability usually refers to some level
of functional impairment,
meaning there are some things in your social,
occupational or personal life that you can't do
when you're having symptoms.
So in theory, you can have a mental disorder
but have mild enough symptoms
that it's not considered a serious mental illness.
The National Institute of Mental Health
defines a serious mental illness
as a mental, behavioral, or emotional disorder
resulting in serious functional impairment
which substantially interferes with or limits
one or more major life activities.
The operative term here is substantial.
That word is used a lot in the literature
around using animals to get accommodations.
So the airlines drew a line in the sand
and said you need a service animal
to get flying accommodations
but the Fair Housing Act still allows
for waivers for emotional support animals.
The documentation needed has to come
from a licensed mental health provider.
This can be a therapist or a doctor.
Some clinicians won't write such a letter
and that's where these sites like Dogtor come in
to fill in the gaps,
and I'm not promoting the site or recommending it, in fact.
I'm just showing you an example of what I'm talking about,
but why wouldn't your therapist write a letter for you?
How hard is it?
Well, here's the rub for therapists around these letters.
When your therapist writes the letter
or completes a form and signs their name,
they're supposed to be answering the questions,
are you disabled by a disorder
that's listed in the "DSM-5"?
Does the disability require the presence of an animal
to be able to perform necessary functions
that you wouldn't be able to perform
if the animal was not present?
If so, what are those functions?
What does your disability keep you from doing?
And what does the animal do to allow you to do that thing?
If the therapist really can't answer
these questions affirmatively,
then they do sign off on a form for you,
they are attesting to something
that they don't really believe is true.
Here's an example.
Let's say you own a dog that you've had about six months.
You move to a new rental property
and the landlord allows pets but you have to pay
an extra $1000 security deposit for the pet
and the deposit is not refunded
because it's presumed there will be damage to the property.
Your friend tells you,
"Hey, didn't you see a therapist a while back
to help you with your relationship?"
And you say, "Yeah, I was going through a hard time
but things are better now and I haven't needed to go back."
Your friend says, "Well, you can get your therapist
to write a letter saying your dog helps you with anxiety
and you won't have to pay the $1000."
You then contact the therapist
and request an emotional support housing letter.
The therapist who hasn't seen you in a year thinks,
"How does this puppy that I know nothing about
serve as an emotional support?"
The therapist may not feel comfortable
stating in writing that you're disabled
from the stress and relationship problems
that you had before.
You didn't really talk about anxiety
all that much at the time,
and also say that the dog provides essential functions
that allow you to perform despite your disability.
If the therapist just signs the form to make you happy
and the property owner disputes it,
the therapist can be pulled into litigation
to defend their position,
a position that they really didn't support
but just took that position to help you.
So that can present an awkward situation
and interfere with the therapeutic process
when your therapist needs to be loose with the truth
to help you get something outside of the therapy.
So that's the behind-the-scenes issues
that you probably aren't aware of
when you ask your therapist to sign a form
so that you don't have to pay a security deposit.
Your therapist may tell you
that you need to see an independent evaluator
to make the determination and that may seem like overkill.
You've got to go see a whole new person?
All you have to do is sign a form
but it's more than just a form.
Despite all these regulatory issues,
whether or not you have your pet certified or not,
or get some financial benefit or not,
animals do confer positive, physical,
and mental health benefits and it's not just dogs.
There is lots of support for animals
being beneficial and improving several health measures.
Some studies show physiological changes
from human interactions with animals,
and it's thought that the benefit
comes from oxytocin release.
Oxytocin is often called the love hormone
and it makes us feel
emotionally close to the object before us.
It's released during labor, breastfeeding, sex,
and other types of intimate touch.
So in the case of an animal and human interaction,
the act of touching your pet and meeting their eyes
increases oxytocin release
which makes you feel close to them.
This theory of oxytocin-mediated reactions
could explain how some people
feel like their pets are like their children.
The bond feels that strong
and goes well beyond just liking a cute animal.
The theory is that you actually fall in love with them.
Studies have also shown
that animal-human interaction improve social attention,
interpersonal interactions, reduces cortisol levels,
and reduces heart rate and blood pressure.
Those benefits are how animals can be used
as therapy animals.
Therapy animals, usually dogs,
are trained to provide affection, comfort and calming.
The training is not as specific
as it is for service animals
and therapy animals are not covered
under the Americans with Disabilities Act,
so they can't go into animal-restricted places
or be used to get accommodations.
They are commonly used
for what's called therapeutic visitations.
Some schools will bring dogs in for student wellness events
or even use them as an intervention
for students in distress.
Instead of seeing the school nurse,
you go see the therapy dog.
Therapy dogs can be helpful
for people with social anxiety
as the presence of the dog can be an icebreaker
and make other people approach you more
and feel more approachable
when they see you with a friendly dog.
You can use your own pet this way
in addition to having the pet
for calming, grounding and companionship.
Check out these other videos that YouTube thinks
that you'd be interested in watching from me.
Thanks for watching this one.
See you next time.