After the ADA: service dogs on inpatient psychiatric units

This article explores the case histories of two disabled patients admitted with service dogs to an inpatient psychiatric unit in compliance with the Americans with Disabilities Act (ADA). These cases illustrate the clinical realities of provisions in this new law that affect inpatient practice. Federal, New York state, and case law that frame the issue are reviewed. The experience of living and working with service dogs in an inpatient milieu required many accommodations and exposed potentially dangerous consequences that were not immediately recognized. The authors examine the clinical and medicolegal issues raised by these cases. Recommendations for proactive planning and a screening questionnaire for decision making are offered to guide administrators and clinicians attempting to balance civil liberties with clinical common sense in making reasonable accommodations for the disabled.