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Laws and Ethics Related to Emotional Support Animals
Joshua D Carroll1, Brian S Mohlenhoff2, Charlie M Kersten2
1Dr. Carroll is Assistant Clinical Professor of Psychiatry, Department of Psychiatry, University of California San Francisco, San Francisco, CA. Dr. Mohlenhoff is Director of Pharmacotherapy, San Francisco Veterans Affairs Medical Center San Francisco, San Francisco, CA. Dr. Kersten is Resident Physician, West Suburban Medical Center, Oak Park, IL. Dr. McNiel is Professor of Clinical Psychology, Department of Psychiatry, University of California San Francisco, San Francisco, CA. Dr. Binder is Professor of Psychiatry and Director, Psychiatry and the Law Program, University of California San Francisco, San Francisco, CA. joshuacarroll.md@icloud.com.
Abstract:
The use of animals for therapeutic benefit is well-established. For example, for individuals with a disability such as blindness, trained service dogs can enhance the ability to live independently and participate fully in society. An emotional support animal (ESA) is an untrained animal that is used to support a person disabled by an emotional or mental disorder. For an animal to qualify as an ESA, a mental health or medical professional needs to write a letter saying that the animal is needed for the mental health of the person with the disability. This article describes the legal framework for service animals and ESAs, as well as the differences between them. We summarize information about the Americans with Disabilities Act, the Fair Housing Act, the Air Carrier Access Act, and other laws governing an individual's right to be accompanied by a support animal. We also summarize the clinical research on ESAs and argue that, although there are few studies on the clinical effectiveness of ESAs, a broader body of research indicates that animals may have positive clinical effects on medical and mental illness. Finally, we suggest there is a need for further research and provider education on ESAs.
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