Service animals help owners navigate daily tasks and often have years of training to help them serve disability-related functions. However, little consensus exists when it comes to the certification of "emotional support animals" (ESAs). These animals usually have little or no specific training, which poses a challenge for mental health professionals who are asked to certify them. Now, researchers at the University of Missouri have conducted a survey to examine what techniques and instruments mental health professionals are using to aid in their determinations of whether certification of an ESA is appropriate. Researcher recommendations could help mental health practitioners make better judgments when certifying ESAs and steer policy-making decisions for housing and travel sectors.

"ESAs are legally different from service animals, such as guide dogs," said Cassie Boness, a graduate student in clinical psychology in the MU College of Arts and Science. "An ESA usually provides companionship, relieves loneliness and sometimes helps with anxiety or depression. Although emotional support animals can be pets, they're not considered pets under the law and sometimes special accommodations must be afforded to individuals who have ESAs. Because of this requirement, owners seek out ways to get their pets certified without thinking about the ramifications of their actions."

Federal and state laws regulating ESAs often are convoluted and ever-changing. For example, landlords who normally prohibit pets must allow ESAs and waive any fees or pet deposits. Airlines are required to allow ESAs to accompany their owners in the main cabins of aircraft. As a result, it can be implied that some patients who claim they need ESAs are doing so to "buck the system," causing a dilemma for mental health professionals who often are tasked with certifying these animals, Boness says.

Boness, working with Jeffrey Younggren, a forensic psychologist and clinical professor at MU, surveyed 87 mental health professionals, 31 percent of whom have made ESA recommendations. Survey participants were required to read ESA policies, including the Department of Transportation's requirements for airline travel. Participants then answered questions about the certifying process.

The survey demonstrated that both clinical and forensic practitioners are making ESA recommendations; both groups believe certifying ESAs is appropriate for treating patients. Results and recommendations from the study indicate that clinicians should not certify ESAs and doing so can trigger ethical and legal challenges, including a pending case in Colorado, Younggren says.

Based on their findings, Boness and Younggren recommend that:

Requests for ESAs should be met with the same thoroughness that is found in any disability evaluation

Professional guidelines outlining the types of assessments, who conducts them and how they are conducted are needed

Local, statewide and national policymakers should consult with mental health professionals as they vet and evaluate future legislation

"A clinical practitioner's primary goal is treatment; often, personal relationships with their clients can lead to biased assessments and a willingness to certify ESAs," Younggren said. "Forensic psychologists, such as those who give expert testimony on mental capacity in court, often use comprehensive methods to assess patients. These mental health professionals generally don't have relationships with those they are assessing, are much more objective and are likely to certify ESAs correctly."