Dr. Estevez, Psy.D. is a Clinincal Psychologist with experience prescribing Emotional Support Animals (ESAs) and working with patience who require them.
1) What are the requirements for having an ESA?
The requirements for having an ESA include an individual being diagnosed with a mental health disorder (also known as a mental health disability) that prevents them from using or enjoying their home. The ESA serves the specific purpose of helping the disabled individual use their home and enjoy their home life. This is a broad requirement because using/enjoying one’s home can include situations such as the ESA sleeping with (and thus comforting) an individual who has insomnia or the ESA calming an anxious person who has panic attacks throughout the day.
There are many other examples and possibilities that constitute “using and enjoying” the home. The main requirement though is that the person requesting an ESA must be diagnosed with a mental health disorder by a mental health professional.
2) What types of conditions would benefit from having an ESA?
The mental health conditions that can require an ESA also vary widely, from depression or anxiety disorders, to Posttraumatic Stress Disorder (PTSD), insomnia or sleep disorders, psychotic disorders, mood disorders like Bipolar Disorder, etc. The main point is for the individual and the mental health professional prescribing the ESA to provide a reason or reasons why the ESA will help the individual use and enjoy their home.
3) What are the questions you would ask people to determine if you would write a letter verifying that they should seek an ESA?
When a mental health professional conducts an ESA evaluation with a client, the mental health professional would ask questions that any mental health professional would ask in any initial “intake” evaluation. This type of evaluation serves the purpose of gathering background history, current and past mental health symptoms, any prescribed medications, family history of mental illness, any previous history of mental health treatment or diagnoses, medical problems, work and educational history, maybe a brief childhood and adult history of significant life events, and any current life stressors.
The purpose of asking these “interview-type” questions is to gather comprehensive information on the individual and come up with a diagnosis (if any). The reason this is important for an ESA evaluation is because in order to be prescribed an ESA, the individual must meet criteria for a mental health disorder.
Keep in mind that aside from the individual providing answers to questions, the mental health professional also makes behavioral observations. These observations are based on the manner in which the client acts, speaks, behaves, communicates, interacts, etc. So, in other words, being diagnosed with a mental health disorder is not just about the individual “saying all the right things.” Mental health professionals are trained to make observations and identify whether what the person is saying, matches the observable behaviors and thus the diagnosis.
4) Do the requirements for getting an ESA for travel differ from getting an ESA for housing reasons?
About travel: That’s a great question. To get the exact details on the requirements to take an ESA on a plane for instance, it’s best to check with the airlines website. I believe that the airline must allow the ESA as long as the ESA owner (i.e., disabled individual) has a letter from a mental health professional. It’s also possible that the airline might have a specific form that the mental health professional may have to fill out.
5) What resources does a mental health professional consult when considering whether someone is a good candidate for an ESA?
I don’t know of any specific resource that a mental health professional would consult in order to determine whether a person should be prescribed an ESA. The best sources in general would be the scientific research that is available, which provides data stating that animals help to mitigate mental health symptoms and contribute to improved quality of life and even prognosis for individuals with mental health disorders.
The field of psychology and mental health bases diagnostic guidelines and treatment on scientific research. That’s how we know what works and what doesn’t in order to help clients. Mental health professionals writing ESA letters can cite this relevant research or state that they would be willing to provide this research. This isn’t necessary, but it let’s the skeptical reader know that there is reliable research that supports the fact that ESAs are not pets, but important “assistive aids” to individuals with mental health disorders. Any mental health professional (or anyone who’s good at Googling and identifying good research from bogus research) can look up the research that has been done on ESAs.
6) Does a person require a separate letter for an ESA for housing reasons vs. an ESA for travel reasons?
I believe the housing and travel ESA letters are similar in content. To differentiate the two, the content of the letter should state the purpose (i.e., the ESA is for the purpose of the individual using and enjoying their home versus a travel letter would state that the individual needs to travel with the ESA for other reasons, such as anxiety while flying). So, I would say that yes, a person should have a separate letter for travel and for housing.