An Emotional Support Animal (ESA) is defined as "An animal of any species that does not qualify as a service animal under the Americans with Disabilities Act (ADA), which a medical provider has certified can mitigate a person’s psychiatric disability through companionship rather than by any specifically trained task(s).”

The ADA defines a service animal as a “dog that has been individually trained to do work or perform tasks for an individual with a disability. The task(s) performed by the dog must be directly related to the person’s disability.” Notably, the ADA states that animals that provide only “emotional support, wellbeing, comfort, or companionship” cannot qualify as service animals.

As of this writing, the state of Georgia follows federal guidelines concerning Emotional Support Animals (ESAs). ESAs are not defined under Georgia state law, but they are recognized and protected under the federal Fair Housing Act (FHA) and the Air Carrier Access Act (ACAA).

Unlike the ADA, both acts allow (or used to allow) ESAs under certain circumstances. The Fair Housing Act (FHA) allows “assistance animals,” including ESAs, to be accommodated and included in accordance with its prohibition against discrimination in housing. The FHA defines an “assistance animal” as “an animal that works, provides assistance, or performs tasks for the benefit of a person with a disability, or that provides emotional support that alleviates one or more identified effects of a person’s disability.” Importantly, the FHA emphasizes that “an assistance animal is not a pet.”

It's essential to note that to qualify for an ESA, a person must have a diagnosed mental or emotional disability that significantly limits one or more major life activities. “Disability” refers to a physical or mental impairment that substantially limits one or more major life activities and/or a psychological condition that substantially interferes with the individual’s ability to perform major life activities.

The ESA must also be prescribed by a trained and licensed mental health professional, such as a psychologist, psychiatrist, or therapist, who provides an evaluation and formal letter stating the need for the animal to assist with the disability.

Under the FHA, individuals with disabilities can request reasonable accommodations, which may include keeping an ESA in their housing, even if the property has a "no pets" policy. The ESA provides emotional support that alleviates one or more identified symptoms or effects of a person's disability.

Emotional Support Animal Letters and Evaluations

Mental health professionals face both legal and ethical challenges when asked to write a letter certifying an animal is an ESA. The first challenge is to know the client or patient well enough to determine if he or she has a disability or not. The ESA evaluation must also be conducted by a licensed provider who is knowledgeable about ESA guidelines, laws, and requirements. The second challenge is for the provider to understand relevant laws related to ESAs.

A third challenge is for a provider to feel comfortable with the patient and the ESA. Without proper training and knowledge about ESA evaluation, a provider cannot endorse an animal for a patient, especially if the animal is not trained or certified, or has known behavior issues.

Note that licensed mental health professionals do not have an ethical obligation to say “yes” to ESA requests from their patients.

To ensure compliance with current regulations and to obtain a valid ESA letter, individuals should work with a licensed mental health professional who is knowledgeable about ESA guidelines and requirements. This includes a licensed professional:

who has knowledge about laws that regulate ESAs.
who is trained and knowledgeable to conduct a thorough ESA evaluation assessment in order to establish a disability and a disability-related need. Note that this evaluation may take multiple sessions.
who can determine if a given animal is capable of performing the functions of an ESA. For example, some sources recommend getting written documentation from an animal trainer, behaviorist, or veterinarian who has assessed the animal and its temperament in potentially stressful environments. This assessment is often beyond the skill set of most mental health professionals.
who can assess the interaction between the patient and animal and determine whether the animal has demonstrably beneficial effect on the patient.

Due to these guidelines, Atlanta Wellness Collective providers are unable to conduct ESA evaluations or letters at this time.

Additional Considerations

One of many considerations for an ESA evaluation is when a mental health professional prepares a formal disability statement, the letter and any associated evaluations can become part of the patient’s medical record, and the finding of a mental disability might lead to potentially adverse consequences for the patient. Not reporting a disability finding on certain applications can also have serious consequences.

For the latest information related to ESAs, we recommend checking the most recent state and federal regulations or consulting with a legal professional.

References

ADA National Network. Service animal or emotional support animal: What is the difference? https://adata.org/service-animal-resource-hub/differences.

US Department of Justice, Civil Rights Division, Disability Rights Section. Frequently asked questions about service animals and the ADA. https://www.ada.gov/regs2010/service_animal_qa.html.

Yasgur, BS. Legal and Ethical Approaches to a Patient’s Request for an Emotional Support Animal. https://www.psychiatryadvisor.com/home/topics/general-psychiatry/legal-and-ethical-approaches-to-a-patients-request-for-an-emotional-support-animal/

Younggren JN, Boness CL, Bryant LM, Koocher GP. Emotional support animal assessments: Toward a standard and comprehensive model for mental health professionals. Prof Psychol Res Pr. 2020;51(2):156-162.

Disclaimer: This blog is not intended to substitute professional therapeutic advice. Talk with your healthcare provider about your health concerns and before starting or stopping therapies. No content on this site, regardless of date, should ever be used as a substitute for direct professional advice from your doctor or other qualified clinician.

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