The Department of Transportation has also clarified guidelines about air travel with support animals.

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Not everyone can have their pet deemed an emotional support animal (ESA), but new standards aim to better clarify the process to secure the designation.

In the past, a lack of guidance has surrounded which pets qualify as ESAs.

This has put mental health professionals in a difficult position. Many may not understand what signing a letter declaring a pet as an ESA will mean for their patient, the animal, or the general public.

Now mental health experts are trying to provide stricter guidelines and have given new assessment recommendations for when a psychologist or psychiatrist should approve a pet as an ESA.

With some reported stories of people attempting to bring pigs or birds as emotional support animals on flights, airlines and other transportation groups have been struggling to determine what can be considered an ESA.

Just this week, The U.S. Department of Transportation (DOT) said it doesn’t intend to take action against airlines that ask support animal owners for documentation on vaccination, training, or behavior — so long as it would help the airline determine if the animal poses any threat to others.

ESAs are not specially trained service animals, such as guide dogs. A service animal has to be trained to demonstrate that they provide a function to their owner.

And unlike therapy dogs, ESAs don’t also go through a certification process. Therapy dogs are often taken by their owners to help at nursing homes, schools, and the like.

To designate an animal as an ESA, a therapist must sign a letter for the pet owner. The letter from a therapist, which is good for one year, states that a patient has an emotional disability defined under the Americans with Disabilities Act.

People who may qualify include those struggling with anxiety or depression, or victims of crime and war veterans, to name a few.

“Writing such letters constitutes a disability determination that becomes a part of the individual’s clinical records,” according to a report authored by Dr. Jeffrey Younggren, a forensic psychologist and clinical professor at The University of New Mexico.

Younggren’s team recently published a paper with the American Psychological Association that recommends a new assessment model for practitioners to follow when receiving a request to designate a pet as an ESA.

“An ESA is an example of a well-intended idea that has metastasized and developed into a world of nonsense,” Younggren said in a statement.

He hopes the guidelines will define who needs the animals, and will educate others who must comply with allowing the animals on site.

Currently, someone can request letters online without having met a therapist or having their animal evaluated. There’s no way to ensure the person needs the animal, the animal alleviates the person’s symptoms, or that the animal won’t harm others.

“There is no such thing as a registered ESA. That is needed,” said Dr. Rebecca Johnson, a nurse at University of Missouri Health who studies human-animal interactions. “Many people fake an ESA out of their pet by putting a vest on it.”

Animals can provide clear emotional support for people who have diagnosed mental health issues. But the rise of people claiming they need emotional support from an animal that has no training and isn’t providing aid is concerning mental health experts.

“The ESA movement harms people who need service dogs by creating confusion about service dogs that are recognized under federal law,” Johnson added.

Under Younggren’s proposed standards, mental health professionals must:

  • Conduct a thorough evaluation of the person requesting an ESA certification.
  • Assess the animal to confirm that it performs all valid functions.
  • Review the interaction between the animal and the person to ensure the animal has a demonstrated benefit to the person.
  • Understand and apply laws that regulate ESAs.

Cassandra Boness, University of Missouri PhD candidate and second author, would like to see more research on the impacts of ESAs on patients, she said in a statement.

Johnson said documented benefits of ESAs on people are anecdotal.

“We know that our pets cause us to relax, but not how this plays out for mental health patients,” she told Healthline.

Though his standard, if adopted, would make it more difficult for people to receive a letter, Younggren said it would be safer for society as a whole.

Younggren’s team hopes the standards ensure that others aren’t harmed by ESAs, as there have been reports of animals hurting others.

By law, an ESA can live in a housing setting otherwise not open to pets. They can also travel with owners in airplane cabins. But unlike service dogs, an ESA can’t go everywhere a person goes.

Going to an airport, for example, can be stressful on an untrained animal, Stevens said.

“Why should we act surprised when the animal acts out?” Chaz Stevens, founder and director at ESAD International, told Healthline.

ESAD International is a group of licensed mental health professionals that aim to provide emotional support animal services both online and in person.

“Currently, federal guidelines do not require any training for an ESA. Recent changes from the airline industry require the passenger to acknowledge the ESA will be under their control at all times,” Stevens said.

ESAD International’s therapists specialize in understanding human behavior but not animal behavior.

Companies dispensing ESA letters are also an issue.

“Duplicity and false advertising runs rampant,” said Stevens, who supports better standards. “There’s no quality control or regulation of this business at all.”

Some websites promising ESA letters are registered out of the country and some sites might even prompt users to share protected health information online.

“The person who qualifies under federal law to have an ESA is someone who has a verifiable disability that’s affecting his or her ability to concentrate, sleep, focus, or interact socially,” Stevens explained.

As the business of ESA letters is now, someone with a disability could be misled to share their protected health information online.

But Stevens noted the limits that mental health professionals have with signing off on ESAs.

“Assessing a dog’s temperament and behavior is outside the scope and training of my clinical team,” said Stevens, noting he bans some breeds.

He encourages his clinicians to make strict judgement calls to ensure animals are well cared for by their owners.

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