Emotional Support Animals

An emotional support animal (ESA) is a companion animal that provides therapeutic benefit to a person with a psychiatric disability through devotion, affection and companionship. ESAs are usually dogs and cats but may consist of any animal, including rabbits, guinea pigs, parrots, and turtles. Unlike other service animals, emotional support animals do not require training to carry out specific tasks, and require only the same amount of training as an ordinary house pet.

Benefits of Emotional Support Animals

Patients get significant benefit from their emotional support animals in terms reduction of symptoms and improvement of overall functioning. Studies show that connection of a person with their dearly loved animal can help alleviate symptoms of anxiety and depression, especially when part of a treatment plan in psychotherapy. Just the mere presence of animals has been proven to reduce the physiological symptoms of anxiety, stress, and blood pressure.

Many other psychiatric conditions are mitigated with the help of an ESA. For example, an individual with Agoraphobia couldn’t normally leave their home but with their ESA is able to leave their apartment and can go out and get food or medication. Another example is an individual with extreme Flight Anxiety who is now able to fly calmly when their ESA is in their lap.

The nature of many animals makes them instinctive healers for humans. Animals are always in the moment and emotionally present. Animals can act as a buffer for their human companions when the world gets stressful, and help their humans cope with difficult feelings. Many animals can sense when their human companion is sad, angry, scared, or happy. Animals can provide reassurance and unconditional love with their simple loving presence. Animals can be nonjudgmental good listeners. A person’s animal is often there for the milestones of their life, from beginning to end, through changes in a family, births and deaths, moves across the country, and shares the collective memory of the individual or family.

Another way that emotional support animals are beneficial is in the patient’s role as a caregiver for the animal. In this role, the patient is focused on the animal’s needs, feeling a sense of responsibility for the animal which takes them away from worrying about their own problems. The animal is dependent on the person to take care of them and gives the person a reason to get up in the morning and feel good about taking good care of their animal. This dependence makes the person accountable to another living being, which adds purpose and meaning to one’s life.

In sum, emotional support animals provide emotional security, unconditional love, and act as a secure base for their owners. People who have psychiatric disabilities can benefit tremendously from having an emotional support animal present in their lives. For some people, their emotional support animal is the one thing keeping them stable in spite of suffering from severe mental illness.

More and more people are alleviating their psychiatric symptoms by exercising their right to have emotional support animals serve as their companions–whether it’s at home, out in public, or on a plane. If you feel you could benefit from an emotional support animal as part of the treatment for a psychiatric disability, contact me at mike@sftherapy.com or 415-642-4662 for more information.

How to designate your dog or cat an ESA

If you already have psychiatric condition that substantially limits at least one of your major life activities, you may qualify to have your dog or cat designated as an emotional support animal.

To designate your dog, cat or other type of domestic animal, as your emotional support animal, you need to get a letter from your psychotherapist or physician (or other licensed professional like nurse practitioner or social worker) recommending the emotional support animal to help with your psychiatric disability. The letter must state that the person has a disability; however it is not necessary to identify the specific disability. The letter must also state that in the professional opinion of the provider, it is essential for the person to have the ESA.

The animal has to be able to live peacefully with people without being a danger or nuisance. To become an emotional support animal, the animal does not require any special training.

Psychiatric Disability

In order to obtain a prescription for an ESA, the individual pursuing an ESA needs to have a verifiable psychiatric disability. To receive full legal protection under federal law, the individual must fulfill the federal definition of disability and have a letter from a psychotherapist or physician. The letter must affirm that the individual has a psychiatric disability and that the ESA provides a benefit for the individual. For example, the patient might have Social Anxiety Disorder and the ESA could help a patient function socially.

The federal definition of disability is “Any person who has a physical or mental impairment that substantially limits one or more major life activities, has a record of such impairment, or is regarded as having such impairment.” Prescriptions for ESAs can be written by a mental health professional or physician who is familiar with the patient’s psychiatric disability and is knowledgeable of how the ESA can provide relief.

Whether the psychiatric disability is from trauma or biologically-based, if it affects one’s ability to function in day to day activities, the company of an ESA can considerably diminish or eliminate their symptoms.

Areas of Protection

Federal protection for people with psychiatric disabilities requiring ESAs is limited to housing and commercial air travel. There are two federal statutes that provide federal protection against housing discrimination and one federal statute that provides protection on commercial airlines. For housing, there is Section 504 of the Rehabilitation Act of 1973 and the Federal Fair Housing Amendments Act of 1988 (FHAA), and for commercial air travel there is the Air Carrier Access Act of 1986 (ACAA). “Emotional support animal” is legal terminology and defines rights to owners by the FHAA and the ACAA.

California law provides similar housing protection as the federal statutes in the Fair Employment and Housing Act (FEHA). FEHA is enforced by the Department of Fair Employment and Housing (DFEH).

The Americans with Disabilities Act (ADA) entitles individuals with disabilities to take their service animals with them into public places. ESAs are not considered service animals under the ADA, however, and therefore not afforded that right unless it’s a place where pets are allowed or local laws offer that protection. Contrary to popular belief, there are no legal protections for disabled people to bring their ESA’s inside commercial establishments.

Airline Protection for ESAs

The federal law that allows psychiatric patients to bring their ESAs on commercial aircraft is the Air Carrier Access Act of 1986 (ACAA). The ACAA allows for the ESA to accompany their human in the cabin of the plane regardless of the animal’s size.
Airline travel is overwhelming for many people, especially for those who suffer from a psychiatric disorder. Emotional support animals are able to lower a person’s stress level and reduce their symptoms dramatically.

The ACAA has made airline travel possible for many people with mental illness–for many, the animals have an amazing calming effect that works better than any drug or therapy. Even people with extreme anxiety around flying are able to fly comfortably when their emotional support animal is accompanying them.

In order to have your dog or cat designated as your emotional support animal, you need to get a letter from your psychotherapist or physician recommending the emotional support animal to help with your psychiatric disability, and the animal has to be able to get along with people without being a danger or nuisance.

Airlines are accustomed to people bringing their emotional support animals and have policies in place. Airlines don’t charge an extra fee for emotional support animals, but this may be different for international flights. Airlines do, however, require the proper documentation and 48 hours’ notice prior to the flight. The airlines require that the psychotherapist or physician recommendation letter is current (less than 12 months old) or they have forms that the psychotherapist or physician can fill out. It’s important to carry a copy of the letter on your person, even if you already faxed it 48 hours prior. Service animal vests or service tags are not required, but they are helpful in identifying the animal as being an ESA. For those with small animals, most people bring their animal in a pet travel crate that can fit under the seat in front of them, although not required.

The ESA’s human is solely responsible for the behavior and control of the animal. The airline has no obligation for caring for the animal. The ESA must act appropriately and be well-behaved for the duration of the flight. The human will need to provide means, like a pad, for the animal to go to the bathroom. This will obviously be more necessary on longer trips. The airline has a right to deny your animal if it is misbehaving or out of control.

All year round, many people with mental health conditions travel with their emotional support animals on airplanes headed to destinations across the country.

Housing Protection for ESAs

The federal laws that grant the right for people with psychiatric disabilities to have ESAs in rental housing are Section 504 of the Rehabilitation Act of 1973 and the Federal Fair Housing Amendments Act of 1988 (FHAA). These federal statutes combined with the corresponding case law establish the general rule that landlords cannot discriminate against people with disabilities in housing. Also if a reasonable accommodation will allow a person with a disability to equally enjoy and make use of the rental property, the landlord must supply the accommodation. Disabled individuals may ask for a reasonable accommodation, like foregoing a no-pets policy for any assistance animal, and this includes ESAs under both Section 504 of the Rehabilitation Act of 1973 and the FHAA.

California law provides similar housing protection as the federal statutes in the Fair Employment and Housing Act (FEHA). FEHA is enforced by the Department of Fair Employment and Housing (DFEH).

In order to have your dog or cat designated as your emotional support animal for the purposes of housing, you need to get a letter from your psychotherapist or physician recommending the emotional support animal to help with your psychiatric disability, and the animal has to be able to get along with people without being a danger or nuisance.

Landlords are required to allow disabled tenants to have an emotional support animal even when there’s a “no pet” policy if they have the proper documentation. Landlords must waive security deposits for pets, but the tenant can be charged for any damage caused by the emotional support animal.

Public University Housing Protection for ESAs

In April 2014, the Department of Housing and Urban Development (HUD) notified its regional offices that public universities must comply with the Fair Housing Act (including its 1988 amendments) and allow psychiatric disabled students to have ESAs in their college residence halls and dormitories.

For those off-campus students, Section 504 of the Rehabilitation Act of 1973 and the Federal Fair Housing Amendments Act of 1988 (FHAA) already offer protections that allow psychiatrically disabled tenants to have an emotional support animal even when there’s a “no pet” policy provided they have the proper documentation.

Going away to college for the first time is hard for most students, but is made even harder for those prone to depression or other mental illness. Emotional support animals provide emotional security, unconditional love, and act as a secure base for their owners, thus providing symptom relief for both anxiety and depression.

In order to have your dog or cat designated as your emotional support animal for the purposes of housing, you need to get a letter from your psychotherapist or physician recommending the emotional support animal to help with your psychiatric disability, and the animal has to be able to get along with people without being a danger or nuisance.

Commercial Establishments & ESAs

The protections for ESA’s are limited to commercial airline travel and housing. If a disabled individual wants to bring his ESA into a commercial establishment, he has no legal right to under Federal law, and it is up to the discretion of the establishment whether to allow the ESA in with the individual.

It’s important to train your animal so that it doesn’t bother other people, as there are still establishments that will allow let them to accompany you–but it is up to the establishment.

Right of Government Buildings for San Francisco ESAs

The ADA made a rule change in March 2011 that applied only to service animals, limiting the type of animal covered by the ADA as a dog or miniature horse trained to perform tasks related directly to a person’s disability. San Francisco decided to maintain a broader interpretation of the laws, consistent with Section 504 of the Rehabilitation Act and the Fair Housing Amendments’ Act, allowing service animals can be of any species and thus be afforded appropriate rights.

While the ADA does not grant the rights for ESAs to enter government buildings for ESAs, this right is afforded to San Francisco residents. ESAs are given the same rights as service animals when it comes to: City and County buildings, agencies and departments such as City Hall, Department of Public Health or the County Clerk; Contracted agencies and programs such as public health clinics, case management or mental health services; and Public or private housing, including SROs, homeless shelters and residential treatment programs funded by or contracted with The City.

To obtain a California Assistance Dog tag from San Francisco Animal Care and Control, city residents have to provide a letter from their psychotherapist or physician recommending an emotional support animal.

San Francisco Animal Care & Control

California registers service animals through each county’s animal control department, or related agency. Service animals get an “assistance animal” tag. All counties use a narrow definition of service animal (ADA) except for San Francisco, where an assistance animal can include an ESA. In San Francisco, the assistance tag is available for both service animals and ESAs.

To obtain a California Assistance Dog tag from San Francisco Animal Care and Control (ACC), city residents have to provide a letter from their psychotherapist or physician recommending an emotional support animal. ACC is located at 1200 15th Street in San Francisco. The phone number for ACC is 415-554-6364.

Assistance animal tags or vests are not required by law, but they are an easy and noticeable way for officials and landlords to identify a service animal.

Caring for your ESA

We all want our ESAs and service animals to be cared for in the humanely and healthiest manner possible. Humans are responsible for their ESA, which means cleaning up after the animal and avoiding creating a public nuisance that affects other people, like a barking dog.

If a person is having difficulty affording food and veterinary care for the animal, there are programs in most communities and nationwide that can help. Below are some links of such organizations that can help with both food and veterinary care for animals. The links with an asterisk (*) have comprehensive lists of national programs.

San Francisco Animal Help (food, etc.)

http://shanti.org/pages/paws_about_us.html
http://www.sfccc.org/veterinary-street-outreach-services-vetsos

San Francisco veterinary help

http://sfafa.org/
https://www.sfspca.org/vet-services/financial-programs

State of California Animal Help (food, etc.)

http://www.cdss.ca.gov/cdssweb/pg82.htm

National Animal Help (food, etc.)

*http://www.petco.com/content/petco/PetcoStore/en_US/pet-services/petco-foundation/partners.html
*http://pgaa.com/index.php/financial-aid-for-pets/
*http://bestfriends.org/resources/financial-assistance-pet-guardians

National veterinary help

*http://www.thepetfund.com/resources/additional-links-for-help *http://www.humanesociety.org/animals/resources/tips/trouble_affording_pet.html
*http://www.rosesfund.org/
*http://www.redrover.org/node/1199

Other Types of Service and Therapy Animals

Difference between Service Animals and Emotional Support Animals

The Americans with Disabilities Act of 1990 (ADA) allows service animals to accompany people with disabilities in public places. The ADA defines service animals as dogs trained to perform specific tasks for an individual with a disability. These include guide dogs for the visually impaired, hearing dogs for the hearing impaired, and seizure alert dogs that warn a person of an impending seizure.

Service animals are often confused with emotional support animals. While service animals are trained to perform specific tasks that benefit a disabled person and are covered by the ADA, emotional support animals are trained only as much as an ordinary pet, and are not covered by the ADA. People with disabilities are allowed to bring their service dogs into commercial establishments, government buildings, and public places, but that does not apply to emotional support animals.

Difference between Psychiatric Service Dogs and Emotional Support Animals

Psychiatric service dogs are often confused with emotional support animals. Psychiatric service dogs, like other service animals, require special training to perform specific tasks. In the case of psychiatric service dogs, the focus is on helping a person mitigate the effects of a mental illness and special training is necessary to accomplish that goal. Examples of a dog’s training and thus abilities include warning of an impending manic episode or panic attack, or guiding the person home during a dissociative episode.

Difference between Therapy Animals and Emotional Support Animals

Therapy dogs are often confused with emotional support animals. A therapy animal is not a service animal, and individuals with therapy animals are not afforded any rights like being permitted to enter public places, businesses, “no-pets” housing, or commercial airliners. A therapy animal is a person’s pet, usually a dog or cat, which has been trained, tested and insured to work in an institutional setting like a hospital, nursing home or school. The role of the therapy animal is to go to an institution and interact with patients and residents in a friendly way that helps them relieve stress.


If feel you could benefit from having an emotional support animal to help treat your psychiatric disability, or have any questions about having an emotional support animal, feel free to contact me for more information.

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Michael Halyard, LPCC, LMFT

Licensed Professional Clinical Counselor & Marriage and Family Therapist

Psychotherapy & Referrals

533-A Castro Street
San Francisco, CA 94114

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(415) 642-4662
mike@sftherapy.com