Psychiatric support animal

How They Can Help People with Anxiety

Written by WebMD Editorial Contributors

Medically Reviewed by Dan Brennan, MD on October 25, 2021

In this Article

  • Types of Service Animals
  • Who Can Get Psychiatric Service Dogs?
  • Tasks and Training

Psychiatric service dogs (PSDs) are dogs that are specially trained to work with people who have certain kinds of mental illnesses or learning disabilities. These dogs can help their owners perform tasks that they otherwise might not be able to do or help them to live a more independent lifestyle.

Types of Service Animals

PSDs are trained animals that aren’t to be confused with other types of service animals.

‌Emotional support animals. Emotional support animals (ESAs) are pets or animals that can provide you with emotional support during difficult times. Unlike PSDs, ESAs don’t need any special training. They can be any kind of domestic animal, not just a dog. However, dogs and cats are the most common choices when it comes to emotional support animals.

ESAs aren’t trained to do specific tasks in the way that service dogs are. They can simply offer you comfort and help you relax during stressful situations.

Service animals. The Americans with Disabilities Act (ADA) says that service animals are dogs that are trained to work with people who have disabilities. Each dog is individually trained to help people with tasks that they might not otherwise be able to do. Service dogs can help guide people with vision, mobility, or physical difficulties.

Psychiatric service dogs. PSDs are trained to work with people who have certain mental health issues rather than physical disabilities. These dogs have the same rights as service dogs do, meaning they can go with you in places where pets usually aren’t allowed. PSDs also can travel with you on planes without any additional cost.

Psychiatric service dogs can be any breed of dog or any size, as long as the dog is able to accompany the owner to public places. Psychiatric service dog training can be done by you, as the owner, but usually, these dogs are individually trained by organizations. 

Who Can Get Psychiatric Service Dogs?

Psychiatric service dog training focuses on helping people with certain mental illnesses, such as:

  • Depression
  • Anxiety
  • Post-traumatic stress disorder (PTSD)
  • Panic attacks
  • Bipolar disorders
  • Schizophrenia
  • Obsessive-compulsive disorder (OCD)
  • Agoraphobia
  • Social phobias

The ADA states that anyone with a diagnosed disability can get a service dog. The disability may be physical or mental, and it must impact your life to the point where major activities are limited. Mental illnesses – like anxiety, depression, or PTSD – can be a disability if they put limitations on your life. Some examples might be if you can’t work or leave your home due to the illness.

To qualify for a PSD, your mental illness has to prevent you from living your life independently. If you have a mental illness, but it doesn’t limit your daily life, you wouldn’t be able to get a psychiatric service dog. You also must be able to show that you can give the dog commands, care for it, and give it a stable and loving home.

PSDs for Anxiety. Anxiety is the most common mental illness around the world, and a psychiatric service dog can help you manage it.

A psychiatric service dog for anxiety can:

  • Pick up on signs and symptoms of anxiety attacks before they start
  • Distract you during an anxiety attack so that you can calm down 
  • Apply physical pressure with its body to help calm you down
  • Warn others to give you space
  • Get your medication during an anxiety attack
  • Give you a sense of safety with their presence
  • Alert others for help if they sense that you’re in danger

Tasks and Training

Psychiatric service dogs are highly trained to perform tasks that help their owners.

‌Physical tasks. Your PSD can perform physical tasks like waking you up in the morning, or even at night if they sense that you’re having bad dreams or nightmares. They may also be able to get you water or medication if you’re unable to get them for yourself. Your psychiatric service dog may even remind you to take your medication at a specific time.

Emotional support. These dogs are also trained to support you emotionally. In social situations, your dog can help you create personal space so that social situations aren’t so overwhelming. PSDs help calm you down during emotional situations so that you can carry on. Your dog can also alert others to help you if they sense that you’re under extreme distress.

While psychiatric service dogs can be any breed, it’s important that these dogs are well-behaved and good-tempered. They shouldn’t be too aggressive or easily stressed, since they will help guide you when you are around others. These dogs should like to be touched, as they will often be around you.

Along with this, a PSD must be able to adapt to new environments and situations. These dogs are trained to keep calm in loud areas, crowded places, and environments with lots of stimuli. The calmer they are, the more they can help you.

How to Make Your ESA Into a Psychiatric Service Dog

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In the world of assistance animals, emotional support animals (ESA) are frequently mixed up with psychiatric service dogs (PSD). Both ESAs and PSDs are used by their owners to help with similar types of mental and emotional illnesses and learning disabilities. However, that’s generally where the similarities end. There are key differences between them, including the legal rights they have. For example, Emotional Support Animals can no longer fly with their handler, only Psychiatric Service Dogs can.

How to Turn your ESA into a Psychiatric Service Dog

  1. Understand your situation

    Make sure you have a qualifying mental health disability under the ADA and ACAA by consulting with a licensed healthcare professional.  

  2. Work with a therapist

    For peace of mind, you can request a PSD letter from your healthcare professional. 

  3. Train your dog

    Train your dog by yourself or with the help of a professional trainer to perform a job or task that assists with your mental health disability.

  4. Test your Service Dog’s manners

    Make sure your dog has the ability to be calm, alert and well-behaved in a variety of busy public settings, like airports and stores.  

  5. Order uniform for your Service Dog

    You can optionally use items like vests, tags, collars and ID cards to signal that your dog is an on-duty service dog. 

To learn more about Psychiatric Service Dog, keep reading. We’ll explain what those differences are and answer a commonly asked question ESA owners have.

  1. What are the legal rights of emotional support animals versus psychiatric service dogs?
  2. What’s the difference between my ESA and a psychiatric service dog?
  3. How do you qualify for a psychiatric service dog versus an ESA?
  4. Can an ESA become a psychiatric service dog?
  5. How do I get a letter for my Psychiatric Service Dog?
  6. How can I train my ESA to become a PSD?
  7. How does someone verify whether you have a PSD or an ESA?
  8. Final thoughts


What are the legal rights of emotional support animals versus psychiatric service dogs?

Emotional support animals and psychiatric service animals are regulated by different laws and have different privileges. A PSD has broad public access rights under the Americans with Disabilities Act (ADA), while ESAs do not. A PSD, for the most part, can go anywhere members of the public can go. That means a PSD can accompany their handler at a store, library, arena, hotel, or beach that prohibits dogs, but an ESA owner doesn’t have that same right. 

Both PSDs and ESA owners have rights under the Fair Housing Act (FHA), which allows them to live with their animals in most housing types, even in buildings that prohibit pets. 

PSDs also have special rights when it comes to flying on planes. You may have heard that the U.S. Department of Transportation (DOT) recently overhauled their rules regarding assistance animals on planes. As of January 11th, 2021, airlines are no longer required to accommodate emotional support animals, although they may continue to do so voluntarily. However, psychiatric service dogs will continue to be able to board flights free of charge, subject to new documentation requirements. 


What’s the difference between my emotional support animal and a psychiatric service dog?

Both emotional support animals and psychiatric service dogs help people with invisible disabilities such as severe depression, anxiety, PTSD, phobias, and other psychiatric conditions. They can also help with autism and learning disabilities. The difference between an ESA and PSD lies in how they provide support to their owners. 

A PSD must be trained to perform tasks related to the owner’s disability. By contrast, ESAs do not require any specialized training. ESAs provide comfort for their owners just by being present during times of difficulty. ESAs can also be a wide range of animals. They are most commonly dogs and cats, but rabbits, fish, hamsters, iguanas, and many other species serve as emotional support animals.  

Unlike ESAs, psychiatric service animals can only be trained dogs. A PSD must be fully trained to perform tasks specifically relating to the owner’s disability. PSDs are used for an incredible variety of work, including the following: 

  • Reminding their handler to take medication
  • Interrupting episodes such as crying, dissociation, flashbacks, and nightmares 
  • Interrupting harmful actions, such as scratching, picking, and self-harm
  • Providing pressure and tactile stimulation to calm
  • Grounding and orienting the handler during panic attacks
  • Lying on the handler during psychotic episodes
  • Applying gentle pressure with teeth or nuzzling to disrupt psychiatric episodes
  • Interrupting repetitive behaviors
  • Helping the handler maintain a stable routine
  • Preventing the handler from oversleeping

To further understand the difference between an ESA and a PSD, the ADA gives the following example: If a dog has been trained to sense an imminent anxiety attack and takes specific action to help avoid or mitigate the attack, then it would be a psychiatric service dog. However, if the dog is used to comfort a person’s anxiety just through its presence, it would not be considered an ADA service dog and is more likely an emotional support animal.


How do you qualify for a psychiatric service dog versus an emotional support animal?

Much like emotional support animals, psychiatric service dogs are used by people with psychiatric disabilities. A “disability” for purposes of assistance animal laws means a “mental impairment that, on a permanent or temporary basis, substantially limits one or more major life activities.” A mental impairment includes things like emotional or mental illnesses and learning disabilities. 

In essence, to qualify for a psychiatric service dog, the owner must have a mental illness or learning disability that limits their function in a major life activity such as working, sleeping, or learning. The standard to qualify for an emotional support animal is similar. PSD and ESA owners use their assistance animals to help them deal with conditions like depression, anxiety, PTSD, autism, learning disabilities, and phobias.  

If you believe you may have a qualifying condition, a licensed healthcare professional is the best way to get confirmation. A licensed therapist can evaluate whether the symptoms and challenges you’re facing rise to the level of a psychiatric disability that an assistance animal can help with. A therapist can determine how severe your mental or emotional illness is and whether it impacts essential life activities. A professional can also recommend ways to address your issues, which may include the use of an assistance animal. If you’ve been struggling with your mental and emotional health, you should always seek the help of a professional. 


Can an emotional support animal become a psychiatric service dog?

If you have an ESA that is a dog, it is possible to train your ESA to become a psychiatric service dog if certain conditions are met:

  1. If your psychiatric disability doesn’t require your dog to perform any tasks to provide the support you need, then it is an emotional support animal, and you do not need a PSD.
  2. If you need your assistance dog to perform a task that helps with your disability, such as the ones we previously discussed, then your ESA may qualify as a PSD. Note that a PSD has to be fully trained to perform its task—a service dog in training is not yet considered an official service dog with all of the attendant legal rights.  

Psychiatric service dogs must also be trained to behave in public. Unlike emotional support animals, PSDs can be taken wherever the public is allowed to go. A psychiatric service dog has to perform its tasks anywhere the handler goes, including crowded, busy environments with lots of distractions. 

A PSD that is not behaving in public, for example by running around, barking or growling, acting aggressively, or jumping on others, can be asked to leave an establishment. Under the DOT’s air travel rules, a psychiatric service dog that demonstrates these traits has not been properly trained and can be asked to leave the airport or plane. If your assistance animal is not capable of being composed and focused on its tasks in spaces with other people and animals, it is not suited to be a psychiatric service dog. 


How do I get a letter for my psychiatric service dog?

In order to qualify for a psychiatric service dog, you must have a qualified psychiatric disability and train your dog to provide a task or service for that disability. If you require further documentation or if you are unsure that your disability qualifies for a PSD, you can ask your doctor or therapist for a psychiatric service dog letter or PSD letter. If your current doctor or therapist is unable to accommodate your request you can request your PSD letter online.

  • Determine your needs for a PSD
  • Ask your doctor or therapist
  • Use an online service to connect you with a doctor or therapist

A PSD letter is a letter written by a doctor, therapist, or other health care professional and states your eligibility for an assistance animal. Having a psychiatric service dog gives you rights in housing, flights and public areas. A PSD letter contains your doctor’s or therapist’s contact information and will address whether you have a qualifying condition for a psychiatric service animal. To get started on qualifying for a psychiatric service dog letter, complete the PSD questionnaire here.


How can I train my ESA to become a PSD?

If you have a psychiatric disability that a trained dog can perform tasks to assist with, it may be possible to train an existing emotional support animal to become a psychiatric service dog. A psychiatric service dog does not need to be professionally trained or certified by an organization. While there are organizations and professional trainers available that can help with training, both the ADA and the DOT allow owners to do the training themselves. 

There is no official certification process for the completion of training for psychiatric service dogs, but there are organizations that promote unofficial guidelines and standards.


How does someone verify whether you have a PSD or an ESA?

How a third party is able to verify whether you have a PSD or ESA depends on the circumstances. If you own a PSD and enter a public space such as a store, the staff members are allowed to ask you two questions:

  1. Is the psychiatric service dog required because of a disability?
  2. What work or task has the PSD been trained to perform?

The staff members cannot demand any written documentation, insist on the PSD to demonstrate its task, or ask intrusive questions about the owner’s disability. 

Psychiatric service dogs are not required to wear vests, ID tags, specific harnesses, and owners do not need to carry around ID cards or certifications. Many PSD owners use these items voluntarily to help them manage interactions in public. PSD owners, in particular, can be self-conscious about their invisible disability and use a Psychiatric Service Dog letter or service dog gear to ward off potentially embarrassing inquiries. The DOT has also stated that airlines can weigh the presence of things like harnesses, vests, and tags to determine whether a dog is a PSD. 

If you’re flying with a psychiatric service dog, starting on January 11th, 2021, airlines can require that you submit a form created by the DOT prior to your flight. The form requires PSD owners to certify various statements, including the following: 

  1. The PSD has been individually trained to do work or perform tasks for the owner. 
  2. The PSD has been trained to behave in public. 
  3. The PSD will be under the handler’s control at all times. 
  4. If the PSD misbehaves, the airlines can elect not to treat the PSD as a service animal. 
  5. The handler is liable for damages caused by their PSD. 

The handler must also certify that the PSD is vaccinated. The form is self-certifying, meaning that the handler must sign the document and make all of the certifications themselves. Lying on the form can result in fines and other penalties under Federal law.  You can find a sample of the DOT Service Animal Transportation Form below.

Sample US DOT Transportation Form for Air Travel

For emotional support animals, a letter of recommendation from a licensed healthcare professional is required. Landlords can request a tenant present a signed letter from a licensed therapist before agreeing to accommodate an ESA. Prior to the DOT’s latest rules, ESAs were also allowed on flights if the passenger submitted an ESA letter. After the new DOT rules take effect on January 11th, 2021, it’s unclear whether airlines will continue to accept ESA letters or begin to treat ESAs as normal pets, subject to pet fees and restrictions. 


Final thoughts

Can my ESA also be a psychiatric service dog? The short answer is maybe—a PSD is not suitable for all ESA owners, and not all ESAs can become PSDs. The answer depends on a few factors because for an animal to qualify as a PSD, both the owner and the PSD have to meet certain legal criteria.  If you’re thinking about training your emotional support animal to become a psychiatric service dog, there are many things to consider. ESAs and PSDs are often used by people with the same kinds of conditions, but most individuals with a mental illness do not have a condition that requires the involvement of a task trained service animal. 

However, if you’re an ESA owner and have a mental or emotional disability where a trained service dog could provide assistance, an ESA can be trained as a PSD. You may even have an ESA that is already performing certain tasks to help you manage your mental illness or learning disability. To qualify for a PSD letter, complete the PSD Questionnaire here.

Remember, a PSD must be fully task-trained, and the task must directly relate to the owner’s psychiatric disability. In addition, if the PSD is being taken into public areas and on planes, it must be trained to cope with high-stress environments filled with other people, children, and animals. Not all emotional support animals will have the temperament or innate personality traits to do so.

Training a dog to become a PSD is not an easy endeavor, but it can be done on your own or with the assistance of an organization or a professional trainer. If you think you may qualify for a PSD but are unsure, the best place to start is to discuss your mental health needs with a licensed mental health professional. 

Click here to get your PSD Letter

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Distinctive features and differences between the concepts of "assistant dog" (assistant dog), "emotional support animal" and "therapy dog"

What is the difference between a service dog (assistant dog), an emotional support dog and a therapy dog ?

These dogs differ in their function, degree of training received and access rights to public places (in accordance with federal laws, the laws of the United States and other countries where these dogs are used).

Assistance and Assistance Dogs - ASSISTANCE DOGS and SERVICE DOGS

ASSISTANCE DOGS (assistant dog) is a dog that has been specially trained to perform tasks of assisting people with disabilities, improving their independence and quality of life.

According to the terminology used in the USA (according to the Americans With Disabilities Act): SERVICE DOGS (service dog, assistance dog) - any dog ​​that has been individually trained to do work and perform tasks in the interests of a person with a disability, including physical, sensory , mental, intellectual or other health limitations. They are considered "medical equipment" such as crutches or a wheelchair for a person with a physical disability, or a glucometer for a person with diabetes. The work or tasks performed by the assistance dog should be directly related to the health limitations or illness of the owner and aimed at partially compensating for these limitations, increasing the degree of independence and autonomy of the person.

Examples of functions or tasks that these dogs perform include, but are not limited to: assisting individuals who are blind or have low vision with navigation and other tasks; alerting people who are deaf or hard of hearing to the presence of people or sounds; helping a person during an attack; warning people about the presence of allergens; assistance in towing a wheelchair; carrying objects, opening doors and other physical actions; providing physical support and assistance with balance and stability while walking for persons with gait and balance disorders; helping people with mental and neurological disabilities by preventing or interrupting impulsive or destructive behavior.

The psychological effects of the presence of a dog, providing emotional and psychological support, well-being, comfort, and communication are not functions and tasks for the purposes of the definition of SERVICE DOGS (help dog). Natural dog behavior such as guarding, barking, needing to walk, licking and comforting the owner are also not functions of service dogs within the scope of this definition. Having a disability alone is not enough; many people with physical disabilities have pets. A Service Dog differs from a pet in the specific, clearly identifiable tasks or work it is trained to do in order to compensate for the owner's disability and increase his autonomy.

The terms ASSISTANCE DOGS and SERVICE DOGS are commonly used by the public, by law (in countries where such dogs are used) and by various organizations. According to the classification of the international organization AssistanceDogsInternational, there are three main categories of assistance dogs:

  • GUIDE DOGS: guide dogs for people who are blind or visually impaired;
  • HEARING DOGS: assistance dogs for people who are deaf or hard of hearing;
  • SERVICE DOGS: Assistance dogs for people with physical disabilities other than sight or hearing, such as physical disabilities, mental disorders, autism, epilepsy and many other conditions.

Emotional Support Animals (ESAs)

An emotional support animal can be any animal that provides companionship and comfort for people with psychological disorders. As a rule, these are dogs, but sometimes they are cats or other animals. Emotional support animals do not receive specific training for physical assistance to humans and do not belong to the SERVICE DOG category, their task is emotional and psychological support.

This term is used in the USA and gives a number of advantages to the owners of such animals, for example, in some airlines, ESAs can fly on airplanes with their owners, the ESA owner is also given the right to live with the animal (in the USA, it is far from possible to live with pets). Schools, universities, and other organizations set their own policies on whether they allow visits with emotional support animals.

ESA benefits must be recommended by a qualified physician, psychiatrist, or other mental health professional based on mental health needs in order to receive benefits.

Therapy Dogs

Canistherapy is a method of rehabilitation of people using specially trained dogs for diseases such as cerebral palsy, psychomotor developmental disorders, recovery after a stroke, in case of depression in children and adults, in the treatment of hospitalism ( hospital syndrome) and acute stress disorders, psychological trauma. Canistherapy dogs are successfully used for socialization and adaptation to everyday life of children and adults with various mental disorders: autism, Down syndrome. Such dogs can provide assistance in schools, hospitals, nursing homes, boarding schools, hospices, disaster areas.

Specially trained canistherapy dogs are a tool in the hands of the specialist who works with the patient and they are not service dogs. Therapy Dogs (canis therapy dogs) is a separate line of training for dogs that are not "medical equipment", which increases the degree of independence and quality of life of a person with a disability.

What's the difference? Let me explain with an example: the surgeon's scalpel is not a tool with which the patient improves his quality of life, it is a tool in the hands of the surgeon that allows the surgeon to improve the quality of life of the patient.

Therapy dogs do not have public access to public places where they are not allowed to be with dogs, except for those facilities in which they work or receive permission to visit.

All three types of dogs that were listed above differ significantly in their functions, tasks and purpose. These concepts are not equivalent!

---// Publication in the Service dog group VKontakte //---

Emotional support dog

Emotional Support Dogs ( Emotional Support Dog ), as the name implies, provide emotional support to their owners. To do this, they do not need special training, they do not need to have a diploma or possess special skills. Your dog may be one too if it helps you relieve symptoms of anxiety, depression, or panic attacks.

An Emotional Support Animal (ESA) can be almost any animal, but dogs or cats are more common.

How are they different from service dogs? Those, in turn, must be able to do a lot. Especially those functions that are not available to their owners with disabilities. A lot of time and money is spent on training, for example, guide dogs. They are trained to perform certain tasks that some people, due to their characteristics, cannot perform. They are becoming so indispensable that in many countries such dogs are considered "medical equipment". And therefore they are allowed to accompany their master or mistress in places where ordinary animals are not allowed to enter.

Emotional support dogs do not have to follow any special commands, they only provide their "help paw" in a difficult situation. They help the owners, giving them comfort from their very presence. Emotional Support Dog provides emotional support to its owner and helps to stabilize the mood (mental health) of the person.

In Russia, the term “emotional support dog” is not legally defined, so support in most situations will have to be provided on a general basis.

In the US, the right to travel with an emotional support dog is enshrined in air travel law. And the Anti-Discrimination in Housing Act of 1988 helps owners of such animals find housing that is prohibited from keeping animals. That is, ESA animals have the right to accompany their owner when flying by plane and do not need to pay for them in a rented apartment (because he is working).

However, the landlord has the right to request documentation of the disability. But they are not allowed to request specific medical data relating to a disability. Here is a sample of the documentation required to prove a disability where having an emotional support animal is vital.

A request to the landlord for their emotional support for the animal must be in writing and must explain that placing your dog with you alleviates the symptoms of your disability, which you do not need to disclose details.

In order to obtain the proud title of an emotional support dog, the owner must obtain a certificate from a psychologist, psychotherapist or psychiatrist detailing the reasons why he needs such an assistant. Roughly speaking, Emotional Support Dog can only be prescribed by a doctor (licensed therapist or psychiatrist) to people who have a diagnosis from a certain list. Such a recommendation, of course, is issued in writing.

The emotional support dog is part of an overall treatment plan designed to improve the patient's condition and quality of life. The mere desire to fly with a dog in the cabin of an airplane or live in an apartment that does not allow pets is not enough to appoint your dog Emotional Support Dog. Such an animal is only accessible to people with a disability certified by an authorized physician.

Most often, this recommendation is given to war veterans and victims of psychological and/or physical abuse. Psychological support dogs are provided, for example, to people with the following conditions - PTSD (post-traumatic stress disorder), anxiety, panic attacks, depression, or suicidal tendencies. And these are just some of the diagnoses from the "list". The dog provides emotional support in a way that alleviates one or more of the identified symptoms of the person's disability. It's so much more than just hanging out with someone who's lonely.

Emotional animal owners are not restricted by age, marital status or immigration status in the country.

Mandatory, effective January 1, 2019, the ESA animal must be over 4 months old. This is done for the safety of the caudate, because at this age all vaccinations have not yet been made and, accordingly, it is too early to travel.

Some US airlines have recently tightened regulations on the transport of assistance animals. This applies mainly to abuses by passengers. The fact is that not only a dog, but also a hamster, a bird, and even a pony can be considered an emotional support animal.

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