Service Animals and Emotional Support Animals: Should You Write That Letter? - Current Psychiatry - November 2021

Sep 15, 2026

The article examines disability service animals versus emotional support animals, focusing on differences in purpose, training, and legal recognition. It explains how service animals are specially trained to perform disability-related tasks, while ESAs provide comfort based on presence alone and lack task-specific training. Practical guidance addresses forensic and ethical concerns when advocating for patients, including risks of honor-system verification and limitations on what professionals may request. It also summarizes ADA protections for service animals and recent changes restricting ESAs in aircraft cabins since December 2020.

LanguageEnglish

CategoryLetters

FormatPDF

Pages5

Reading Time2 min

AccessFree to download

Service animals and emotional support animals

Differences in purpose and training

Legal protections and limitations

Evidence and verification considerations

Service animals and emotional support animals: Should you write that letter? Kaustubh G. Joshi, MD Associate Professor of Clinical Psychiatry Associate Director, Forensic Psychiatry Fellowship Department of Neuropsychiatry and Behavioral Science University of South Carolina School of Medicine Columbia, South Carolina 16 Current Psychiatry November 2021 ALIAKSANDRA IVANOVA / EYEEM Understand the ramifications before advocating for patients to have such animals F or centuries, animals, especially dogs, have assisted humans in a variety of ways in their daily lives. Animals that assist people with disabilities fall into 2 broad cat- egories: disability service animals, and emotional support animals (ESAs) . Often there is confusion in how these categories differ because of the animal’s role and the laws related to them. This article describes the differences between disability service animals and ESAs, and outlines the forensic and ethical concerns you should consider before agreeing to write a letter for a patient outlining their need for a disability service animal or ESA. A letter may protect a patient and their service animal or ESAin situations where laws and regulations typically prohibit animals, such as on a flight or when renting an apartment or house. Note that a description of how to conduct the formal patient evaluation before writing a verification letter is beyond the scope of this article. The differences between disability service animals and ESAs Purpose and training. Disability service animals, or service animals, are dogs of any breed (and in some cases miniature horses) that are specially trained to perform tasks for an individual with a disability (physical, sensory, psychiatric, intellectual, or other mental disability).1-3 These tasks must be directly related to the individual’s disability.1,2 On the other Disclosure The author reports no financial relationships with any companies whose products are mentioned in this article, or with manufacturers of competing products. doi: 10.12788/cp.0183 hand, ESAs, which can be any species of animal, provide support and minimize the impact of an individual’s emotional or psychological disability based on their presence alone. Unlike disability service animals, ESAs are not trained to perform a specific task or duty.2,3 There is no legal requirement for service animals to know specific commands, and professional training is not required—individuals can train the animals themselves.1 Service animals, mainly dogs, can be trained to perform numerous tasks, including4: • attending to an individual’s mobility and activities of daily living • guiding an individual who is deaf or hearing impaired •helping to remind an individual to take their medications • assisting an individual during and/or after a seizure • alerting individuals with diabetes in advance of low or high blood sugar episodes • supporting an individual with autism • assisting an individual with a psychiatric or mental disability • applying sensory commands such as lying on the person or resting their head on the individual’s lap to help the individual regain behavioral control. Service dog verification works via an honor system, which can be problematic, especially in the case of psychiatric service dogs, whose handlers may not have a visible disability (Box 11,5) . Legal protections. Under the Americans with Disabilities Act (ADA), individuals with disabilities can bring their service animals into buildings or facilities where members of the public, program participants, clients, customers, patrons, or invitees are allowed.2 This does not include private clubs, religious organizations, or places of worship that are not open to the public.6,7 ESAs do not qualify as service animals under theADAand are not given the same legal accommodations as service animals.1,3 Although ESAs were initially covered by the Air Carrier Access Act, they are no longer allowe

FAQs

What is the core difference between disability service animals and emotional support animals (ESAs)?

Disability service animals are specially trained to perform tasks directly related to a person’s disability, while ESAs provide emotional or psychological support based on presence and are not trained for specific duties.

Are emotional support animals covered by the ADA the same way as service animals?

No. ESAs do not qualify as service animals under the ADA and do not receive the same legal accommodations.

How does verification work for service dogs in public settings?

Verification operates through an honor system and there is no national certification or mandatory registry. Employees generally may not require documentation or ask for disability details, but they can ask two questions about the animal’s necessity and its trained task.

Sep 15, 2026

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