Emotional support animals (ESAs) 101

What do an American alligator named WallyGator, a peacock named Dexter, an Indian Runner duck named Daniel Turducken Stinkerbutt (Daniel for short), a Yorkshire Terrier named Tyson, and a cat named Mr. Fuzzy have in common? They're all real-life emotional support animals. And though the peacock became infamous after he was grounded by United Airlines at Newark Airport in New Jersey, emotional support animals, a.k.a. ESAs, can be lifesaving.

There’s been a lot of controversy about ESAs after “peacock gate” went global. Dexter’s attempted in-cabin flight resulted in the US Department of Transportation issuing a new regulation in December 2020 that relieved air carriers from recognizing emotional support animals as service animals. Consequently, most are no longer allowed to travel in the cabin unless they can fit into a carrier stowed under the seat, just like any other pet. Unfortunately, this isn’t good news for individuals who rely on their ESAs, especially for those with anxiety or fear around flying.

Dr. Janet Hoy-Gerlach has studied the issue in depth. A professor in the School of Social Justice at the University of Toledo, she has more than 20 years of experience advocating for the bonds between people and animals as client strengths within social work practice. Dr. Hoy-Gerlach’s research has confirmed that emotional support animals can be a powerful tool in reducing depression, anxiety, and loneliness in people struggling with mental health issues.

And on a legal level, a prescription for an emotional support animal allows people to live with their ESA regardless of no-pet housing policies. Unfortunately, this has resulted in a glut of online sites that charge hundreds of dollars to register an emotional support animal. Advertisements that broadcast “live for free with your dog” are fraudulent, says Hoy-Gerlach. “That’s misrepresenting the law.”

These sites and others have made it more important than ever to understand the legal rights regarding an emotional support animal’s public access. Generally, a letter from a physical or mental healthcare professional will be all you need to grant your animal ESA status. “Unfortunately, there’s a lot of misinformation, misunderstanding, and concerns about what an ESA is and isn't,” notes Hoy-Gerlach, “so not every provider is comfortable with writing a letter, even for folks that do have legitimate need.” 

What Is an Emotional Support Animal?

An emotional support animal is different from a service animal, Dr. Hoy-Gerlach tells ManyPets. One of the most important distinctions is the animal’s training.

 “A service animal is an animal that has been taught or trained to do specific things that alleviate something to do with a specific person’s disability. It can be a mental or physical disability,” she says. Guide dogs, for example, are highly trained to help people who have a visual impairment by leading them around obstacles, guiding people across a street, preventing them from stepping off a subway platform, and other tasks that facilitate more independent lives.

In contrast, an emotional support animal is an assistance animal that provides aid to a person with a physical or mental disability, but that assistance is not due to trained tasks. “The assistance is provided through the everyday benefits, the physical, psychological, social, and emotional,” Hoy-Gerlach explains. “In each of those areas, the benefits arise from the human-animal interaction.”

An emotional support animal can provide comfort, companionship and stress relief, and also encourage a person to leave their home — in order to walk their dog, for example. This not only gets a person out into fresh air and sunshine, but can lead to meeting new people and socializing with neighbors and other dog owners. A person with depression will be motivated to get up in the morning to feed their animal, whether they have a dog or a rabbit. And while the person is up, they may be motivated to eat their own breakfast, bathe, and put on clean clothes — all of which can otherwise fall by the wayside for people who suffer from depression.

A major difference between emotional support animals and service animals is training and certification. Service animals undergo extensive training that may take up to a year or more. Seizure dogs, for instance, can sense a person’s imminent seizure well before their human becomes aware of it, and are trained to issue an alert, such as barking, circling, or pawing. And psychiatric service dogs, such as those that work with veterans suffering from PTSD, are trained to wake a person having a nightmare, use gentle pressure or tactile therapy with a person having an anxiety attack, interrupt obsessive or compulsive behavior, and other critical tasks.

Misinformation about emotional support animals often centers on the need for written proof, which has led to numerous websites that provide certification — for a price. However, ESAs do not require certification. Instead, ESA documentation consists of a letter written by the person’s medical doctor or mental healthcare provider.

The Americans with Disabilities Act (ADA) states that a service animal is defined as a dog that performs specific tasks. (Federally, a miniature horse is also recognized.) While certification is NOT required for either service or emotional support animals, the legal rights of a service animal differ significantly from those of an ESA. Service animals are allowed in public spaces where they are usually banned, such as in grocery stores, restaurants, and buildings that are pet-free. However, a service animal must be well-behaved, remain on the floor in a harness, and they cannot override public health rules; a service dog is allowed in a restaurant but not in the kitchen.

Emotional support animals do not enjoy most of these rights. But while you don't have a right to bring an ESA to the opera, you can live with your ESA in your dream apartment, regardless of any no-pet policy (or local and state laws), so long as you have that letter from your health provider. You'll just need to make a written reasonable accommodation request. That's because the federal Fair Housing Act and the US Department of Housing and Urban Development's guidelines state that landlords and housing providers must provide “reasonable accommodation” for service or emotional support animals in the home: “A common reasonable accommodation is an exception to a no pet policy.”

Can Any Type of Animal Be an ESA?

Remember WallyGator, the cuddly alligator? Essentially, any domesticated animal can become an emotional support animal. People have had miniature horses, ferrets, rabbits, birds, pigs, hedgehogs, guinea pigs, and others, as well as the traditional emotional support dogs and cats. An animal who inspires a sense of calm, motivates a person to leave their house, or provides emotional support in any other way will make a good emotional support animal. 

Again, all of these animals do require a valid ESA letter from an appropriate source confirming the need for the animal as well as what benefits the animal provides. For a person with an ESA to reap the greatest benefit, this letter should be from a health provider who has in-depth knowledge about the condition and the circumstances.

Regrettably, says Hoy-Gerlach, online businesses provide brief assessments. “And that’s really unfortunate and predatory because a lot of these services charge a fair amount of money, and it should be something that people could get through regular healthcare channels and not have to pay hundreds of dollars.” These businesses often sell harnesses, vests, ID badges, and registrations. “There’s no registry nationally, so all of that is really fraudulent.”

Do Emotional Support Animals Really Help?

Real-life stories abound. Mr. Fuzzy, a cat, alleviates Mark Crowne’s symptoms of obsessive-compulsive disorder. Tyson, the Yorkshire Terrier, reduces Jack Trevor’s social anxiety disorder. Max the dog helps Shelly McArthur, diagnosed with Foniasophobia (or the fear of being killed), feel safe. Charlie, an emotional support Blue and Gold Macaw parrot, has helped generalized anxiety disorder sufferer Will Freeman become more carefree. WallyGator helps Joseph Henney  overcome depression, and a trio of goats named Mama, Deputy, and Princess helps Bill Steele navigate his grief over his son’s death. (You can learn more about Henney and Steele in this video.) 

People with anxiety disorders experience frightening physical symptoms, Hoy-Gerlach says. Anxiety causes a fight, flight or freeze response. “We start breathing faster. Our heart is pounding. Our blood pressure goes up.” People who have had panic attacks often feel as if they are having a heart attack.

An emotional support animal can alleviate this physical response because interaction such as petting, cuddling, and even simple eye contact initiates a surge of oxytocin, a hormone that has been linked to positive emotional states. According to early research studies, oxytocin is increased in the body as a response to social bonding, such as a mother and her child, which was revealed in the initial studies. Later studies revealed that an increase in oxytocin also occurs as a result of the relationship between humans and animals.

“In my particular study, says Hoy-Gerlach, “we did see oxytocin going up with cats as well [as dogs]. So, in addition to the comforting feeling we may have snuggling our animal, we experience a physical cascade of effects when oxytocin is released.” These include our blood pressure lowering, a slower, more comfortable heart rate, and deeper, slower breathing. “We have this sense of warm, fuzzy well-being. This feels good for any of us, but for somebody with anxiety, that kind of a reaction literally offsets the physical symptoms.”

Would I Benefit From an Emotional Support Animal?

An emotional support animal may be helpful if you are struggling with anxiety, depression, or any other emotional issue, and you relate to animals. “For folks who have a particular disability, the benefits of the human-animal connection can help offset aspects of having a mental or physical disability, and actually help the person with their functioning,” says Hoy-Gerlach. If a particular animal can improve specific issues or behaviors, then “that makes the animal therapeutically necessary for a particular person.”

The most effective way to decide is to seek out a health provider. “That could be a therapist, a primary care doctor, or any healthcare or mental health professional who’s knowledgeable about the person’s condition and the ways that condition affects the person,” says Hoy-Gerlach, “and how the benefits of having an animal are able to offset the impairing aspects of that condition.”

For a person who feels socially isolated, an emotional support dog can make an enormous difference. The need to walk a dog forces a person to get out of their house, and dogs naturally invite social interaction. Animals also instill specific routines around feeding, grooming, and other necessary caretaking tasks.

Before deciding on an ESA, make sure that you are able to care for the animal. If you get a dog, that dog needs to be walked two to four times a day. Cats need grooming and litter box cleaning. All animals require consistent care. Before deciding to get an ESA, be sure you'll be able to take care of the animal properly and have the financial means to provide regular veterinary care.

What Will an ESA Prescription Actually Do for Me?

There are many people who may experience significant improvement in their mental health due to an emotional support animal. For that reason, it’s important to understand that falsely claiming an animal is an ESA in order to receive special benefits can ultimately make it harder — or even impossible — for people who really need ESAs to benefit from a prescription. Improper (or fake) ESAs are responsible for the change in airline rules, for example.

A valid ESA prescription from a health provider who is familiar with your condition is the first step. That provider can help you choose the most effective emotional support animal for your specific mental health needs. They may also help you plan for the animal’s arrival, direct you to information regarding the animal’s care and equipment needs, and even offer suggestions about finding a convenient veterinarian.

A prescription for an ESA will allow you to live with your animal — and this even goes for students using college or university housing facilities. “The Fair Housing Act is federal law in the United States that recognizes emotional support animals as a disability accommodation in housing,” says Hoy-Gerlach. “That animal has a legally recognized status, and is no longer considered a pet. So the person can’t be prohibited from having the animal in a no-pet housing, for example, nor can they be charged a pet fee, a pet deposit, or anything like that.” She does note that you will still be responsible for any damage your ESA causes.

Housing in the United States, whether pets are allowed or not, is basically the only place you are always allowed to bring an ESA. However, there are some airlines in the US that will accommodate emotional support animals; always check with the airline carrier first. You will generally not be able to board with an animal that doesn’t meet the airline’s height and weight requirements. Airlines that have opted to reject ESAs in the cabin include United Airlines, American Airlines, JetBlue, Frontier, Alaska Airlines, and Southwest Airlines — although pets under 20 pounds that can fit in a carrier are usually allowed.

Airlines that still allow ESAs to fly in the cabin include LATAM Airlines, Volaris, and Westjet. Their routes are typically between the US and Canada or between the US and Mexico. There are several international airlines that still allow ESAs, including Air France, Asiana Air, China Airlines, KLM, Lufthansa, and Singapore Air. These airlines may have restrictions on destinations and the animal’s weight, so always check before booking.

Access to other public locations, such as restaurants, are determined by the individual establishment. Always call ahead before showing up with your ESA.

Ultimately, an emotional support animal is beneficial far beyond the possibility of housing and other access. They live with you every day, improving your life in countless ways. ESAs have even been known to be instrumental in saving lives.

“I was doing suicide risk assessments,” recalls Hoy-Gerlach, “and one question I always ask people who are suicidal was what stopped you up until now? And many answers were certainly the ones I’d been trained to expect.” Typical reasons were not wanting to impact their family, or that suicide went against their religious beliefs. “But often enough that it struck me were people saying, I can’t leave my pet. On a regular basis people told me that their animal was literally the reason they were still alive.”  

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