As many as 20 percent of veterans who served in operations Iraqi Freedom and Enduring Freedom are affected by post-traumatic stress disorder, according to the Department of Veterans Affairs.

While there are multiple options one could choose for treatment, nonprofit organizations like K9s for Warriors and Southeastern Guide Dogs have championed a treatment method that veterans can’t receive directly from the VA: service dogs.

These trained animals can perform a range of tasks such as providing tactile stimulation to help the veteran cope with anxiety or panic attacks, or standing directly in front of their handler in a crowd to give the veteran space from other people. The goal is to empower veterans who are living with PTSD.

“The dogs are never going to be a cure for it, they’re simply going to be a tool to help them in their recovery with it,” Suzy Wilburn, director of admissions and alumni support at Southeastern Guide Dogs, told Military Times.

The VA is currently evaluating whether service dogs can benefit veterans diagnosed with PTSD. Although Congress first mandated a study on the topic in 2010, it has been put on the back burner twice.

Most recently, it was launched again in 2015 and is still being conducted. According to the New York Times, the VA said in May it will unveil the study’s results in 2020.

But K9s for Warriors, who matches post-9/11 veterans with service dogs, has pointed to research Purdue University released in 2018 that found veterans with service dogs experienced lower overall symptoms of PTSD, lower levels of depression and a greater ability to engage in social activities.

Purdue partnered with K9s for Warriors for the study and examined 141 veterans with PTSD: 75 who had graduated from K9s for Warriors program, and 66 who were on the waitlist.

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Under current policy, veterans cannot be matched with a service dog through the VA. But the agency can recommend veterans work with nonprofits that are members of Assistance Dogs International or the International Guide Dog Federation, coalitions that provide accreditation to organizations who train and place service dogs, to start the process of adopting a service dog.

Military Times spoke with experts at K9s for Warriors and Southeastern Guide Dogs, accredited organizations with the agencies above, and here’s what you need to know.

What’s the process like?

In order to apply for a service dog, veterans typically must submit documentation that they have been diagnosed with PTSD from their military service, conduct a series of interviews over the phone and/or at home with the service dog providers, undergo criminal background checks, and participate in a training course.

Information, including the contact information of the veteran’s current mental health provider, primary care physician, and references, are also commonly requested.

“Here at Southeastern Guide Dogs we have a pretty extensive application process that they go through,” Wilburn said.

“What we want to find out is if they’re appropriate to have a dog,” Wilburn added.

This is to ensure that Southeastern Guide Dogs knows important information about the applicant up front to prevent wasting a veteran’s time, and the organization’s time if it’s not a right match.

Approximately 50 percent of the applications Southeastern Guide Dogs receives are rejected due to various reasons, including a criminal background or if the veteran is not also receiving treatment from a mental health professional, Wilburn said.

“We tend not to place our dogs if there’s a tendency toward any kind of violence,” Wilburn said.

The organization also conducts an at-home interview to guarantee that the veteran lives in an environment safe for a dog.

During those checks, Wilburn said they figure out what a veteran is looking for in a service dog. That is, do they want a dog that will help them leave the house for the grocery store during the middle of the day, or one that will help them cope with flashbacks or nightmares.

At that point, Southeastern Guide Dogs determines which dog they’ve been training is best suited for the veteran, and then they work with that animal for 12 weeks to customize commands tailored to that specific veteran.

Lastly, veterans are brought to Southeastern Guide Dogs campus in Palmetto, Fla., for an 11-day training course to instruct them on how to work with their service dog.

Altogether, it can take up to two years for Southeastern Guide Dogs to train the service dogs the organization breeds, Wilburn said. Matching a veteran with a dog through Southeastern Guide Dogs takes between six months to a year.

K9s for Warriors also has a thorough application process, and asks for a variety of information in its 37-page application to service veterans diagnosed with PTSD, a traumatic brain injury, and/or military sexual trauma.

“We look at your mobility, we look at your activity level, we look at your home life, we look at the animals that you have in your home, we look at the goals that you have within three to five years,” Mike Drafts, Warrior Relations Manager at K9s for Warriors and a Marine Corps veteran, told Military Times.

Similar to Southeastern Guide Dogs’ application process, veterans must submit documentation from a physician confirming they have service-connected PTSD. K9s for Warriors also conducts criminal background checks and contacts references.

Likewise, veterans also must submit confirmation that they are physically and mentally able to participate in a 21-day training program where they will go out in public with a service dog.

According to Drafts, 85 percent of the dogs K9s for Warriors trains are rescue dogs. The organization has a dedicated procurement team that evaluates dogs in shelters to determine if the dogs have an aptitude and are medically cleared to work as a service animal.

In the event a dog cannot pass K9s for Warriors training program, they are then adopted through the organization to prevent them from ending up in a kill animal shelter.

According to Drafts, K9s for Warriors has accepted approximately 360 applications in 2019. Drafts said a “good percentage” of applicants are accepted, however noted that failing to meet requirements disqualifies some candidates.

Those who are approved won’t receive a dog immediately though. Even after being accepted into the K9s for Warriors program, veterans must be patient because the organization’s wait list is between 12 to 18 months.

The final portion of the matching process requires the veterans to undergo 120 hours of training on site at its headquarters in Ponte Vedra, Fla., where the veteran is matched up with a fully trained service dog. The training is designed to show the veterans how they can instruct the service dog and work together as a team.

Once veterans graduate from programs like Southeastern Guide Dogs and K9s for Warriors, they must cover costs associated with having a service animal.

However, veterans who have substantial mobility limitations stemming from a mental health disorder can qualify to receive veterinary benefits for their service dogs, provided the dogs were adopted through an organization Assistance Dogs International or International Guide Dog Federation has accredited.

Drafts said approximately 38 graduates from the K9s for Warriors program have received approvals for this benefit this year.

Service dog vs. emotional support animal

Service dogs and emotional support animals are not the same, and do not perform the same functions. Although emotional support animals have attracted media attention in recent years, experts note there are several major distinctions between the two.

“The big difference between a service dog and an emotional support animal is actually not the dog itself, but the handler,” Rory Diamond, K9s for Warriors CEO, told Military Times. “For a service dog, the handler has a disability and that dog is trained to help with that disability.”

That differs from an emotional support animal that could help anyone “feel better,” regardless of whether the handler has a disability or not, Diamond said.

Wilson expressed similar sentiments when asked about emotional support animals.

“Although it does the emotional part of it, it’s not trained in any specific tasks to do that,” Wilson said. “It’s going to sit on your lap and let you pet it and love it, and you’re going to feel better about yourself...but it’s not going to help you mitigate anything disability-wise.”

Wilburn also pointed out service dogs have public access rights covered by the Americans with Disabilities Act, which only recognizes dogs and miniature horses as animals specifically trained to perform tasks for those with disabilities.

In contrast, emotional support animals do not have public access rights at all.

The PAWS Act

Groups like K9s for Warriors do not charge veterans going through their program to train and place a service dog. But both chambers of Congress have introduced legislation that would provide veterans a voucher to use to receive a service dog, known as the Puppies Assisting Wounded Service Members Act, or PAWS Act.

“The PAWS Act would change VA policy completely,” Diamond said, adding this could allow groups to match more veterans with service dogs.

The legislation would instruct the VA to establish a grant program to give veterans with PTSD $25,000 vouchers they can use to adopt a service dog, if that organization belongs to the Association of Service Dog Providers for Military Veterans. K9s for Warriors estimates it costs $27,000 to train and place each dog.

Rep. John Rutherford, R-Fla., introduced the measure in the House in June, and Sen. Debbie Fischer, R-Neb., reintroduced it in the upper chamber in November.

Previous efforts to pass the legislation have been unsuccessful. For example, it was first introduced in 2016, again in 2017, and most recently in 2019. Even so, the legislation has consistently been referred to the House and Senate Veterans Affairs committees, and hasn’t faced a vote.

Diamond said that K9s for Warriors will continue working to advance the legislation, and will instead invest more energy into the Senate in 2020 to try to ensure the legislation advances this time around.

“What you’ll see is a big push in the Senate in January...we’re going to put all of our efforts into the Senate side, since the House seems to want to kill it every year,” Diamond said.

Advice for veterans?

For veterans starting the process of adopting a service dog, Wilburn and Diamond advised veterans to do their research ahead of time.

In particular, Wilburn warned that illegitimate organizations could attempt to target veterans because they may be in a “vulnerable” state.

“Although they may not feel that way, there are organizations and scammers out there that know that they’re vulnerable and will take advantage of that,” Wilburn said.

To safeguard against this, Wilburn said that veterans should head to Assistance Dogs International, which establishes standards of training to ensure the dogs “meet the highest standards in the industry,” according to the organization’s website.

“That’s the best place for a service member to start, is to look at these accredited organizations around the country,” Wilburn said.

Diamond also recommended that veterans visit the Association of Service Dog Providers for Military Veterans’ website to familiarize themselves with various providers that connect veterans with service dogs, what the standards are, and what’s expected during the process.

Similarly, he recommended that veterans avoid working with organizations that require veterans to pay for the service dogs.

“There are lots of groups that are working for free,” Diamond said.

For Drafts, he recommended that veterans have ample support from their family to adopt a service dog because it can significantly alter the dynamic between a veteran and his or her family.

“What I mean by support is that this is a lifestyle change like no other, meaning that it is a service dog and it’s almost like you’re adding a third person to a relationship,” Drafts said.

Drafts pointed out that the service dog is very different from a family pet, and said the animal is designed to develop a bond with one person: the veteran.

But no matter what, Drafts said K9s for Warriors wants to be a resource for veterans — even if their organization can’t directly assist them. If you need help, let someone know, Drafts said.

“It’s not just that we’re providing service dogs for veterans,” Drafts said. “We’re here to help any and every veteran.”

According to the VA, veteran suicides increased in 2017, averaging approximately 17 per day. Reducing that number is K9s for Warriors’ ultimate mission, and Drafts said that’s why they want to help all veterans — period.

“We’re just here to change lives,” Drafts said. “And that’s what we’re trying to do.”

The Veterans and Military Crisis Line offers service members and their families 24/7 confidential support. They can be reached by calling 800-273-8255, via text at 838255, or via online chat.