March 03, 2017
The Supreme Court favored a girl and her dog
Service dogs have been used by the vision-impaired since the late 1920s, but more recently people have begun to rely on monkeys, miniature horses, and even rats to cope with conditions ranging from seizure disorders to PTSD to autism.
While most agree that service animals are an effective and affordable alternative to medications for certain conditions, the increase in certified "helpers" does not come without controversy.
Several incidents -- such as a Supreme Court case involving a girl with cerebral palsy and her service dog -- have people questioning what conditions should qualify for using service animals and when.
It's been argued that animal assistance reduces incentive for people with disabilities to be self-reliant -- to what extent is that valid?
Jenna Saul, MD, FAACAP: "This argument feels reminiscent of the rather naïve judgment that medications for mental health issues are a "crutch" rather than recognizing that they can significantly alleviate symptoms and allow improved function. When emotional service animals are offered in conjunction with other therapies, the role of the animals is to decrease experiential avoidance and can help a patient set goals to achieve optimal functioning."
Jessica Smidt, Healing Enhancement Therapy Coordinator at Mayo Clinic: "I don't think this is valid in most cases. True assistance animals are trained to do services or tasks for people with diagnosed disabilities. The tasks they perform are tasks their handler may not ever be able to do on their own, no matter how hard they try."
Cheryl A. Krause-Parello, PhD, RN, FAAN, University of Colorado: "The argument is inherently flawed. It assumes that individuals with disabilities' main priority should be to become self-reliant and that this should be 'incentivized.' In reality, the main priority for many individuals with disabilities is to live a fulfilled day-to-day life in as healthy a way as possible, whether that involves reliance on medication, therapy, or other interventions to achieve this."
Jeanne Eichler, MOT, OTR/L, Saint Louis University: "Assistance animals are trained to carry out roles that the person may not otherwise be able to perform without assistance or cannot perform efficiently or safely. Part of being independent is to have strategies to maintain personal safety, both with and without the assistance animal. In some cases, without the help of the assistance animal, safely performing a task may not be possible."
Donna A. Baker, CTRS, Emory Rehabilitation Hospital: "Service animals allow a disabled individual to perform activities of daily living more independently. Having an animal that is trained to open a door, retrieve dropped items, or help someone off the floor following a fall can mean the difference in being able to live independently or having to rely on someone else."
Is "emotional support" a valid role for a service animal? Should there be limits for what qualifies as a service animal, and, if so, how should they be enforced?
Smidt: "Emotional support animals are not legally considered service animals. They provide comfort and companionship for individuals but they are not designed to be out in public like service animals. Emotional support animals are beneficial to people who need a friend, daily motivation, or are dealing with depression or anxiety, but they are not meant to go everywhere in public like assistance animals."
Krause-Parello: "A service animal is specifically trained to perform tasks that aid in mitigating the disability of an individual. An emotional support animal is not required to have any such training. However, they can perform tasks that promote the emotional support of individuals with disabilities. Emotional support is a fully valid role for a trained service animal."
Saul: "There are significant differences between emotional support animals and service animals. Emotional support animals are not trained, but simply provide emotional support to a person with a disability. They cannot go out in public where dogs are normally prohibited."
Eichler: "Some people function best with a companion who they feel safe with. Many disabilities are 'hidden' and can be incredibly challenging because they may not be completely 'tangible.' Because of this, people using animals for emotional support may be regarded differently from people who have obvious disabilities. As a clinician who has recommended assistance animals for anxiety, depression, and difficulty socializing with others, I have seen these animals make life accessible where quality of life was once poor."
Baker: "Mental or psychological disabilities can be every bit as 'crippling' as a physical impairment. Having a service animal can provide an emotionally disabled person the confidence to function in an environment that they could not otherwise tolerate. We need guidelines for what qualifies an animal as a true service animal in order to prevent just anyone from getting their animal certified -- [such as] providing medical proof of need and proof of proper training and certification."
On the flip side, what problems with discrimination against service animals and the people using them have you seen, and how can those problems be overcome?
Baker: "These cases are related to either fear of the animal or someone not trusting that the animal is a 'real' service animal. Many people are afraid of animals and that is not something that is going to change, but knowing that an animal has very specific training and is there to help can often alleviate some of these fears."
Eichler: "People do not understand the etiquette for being around assistance animals. If people were openly educated about the roles of these important animals in the lives of our family members, friends, associates, and neighbors, stigmas and judgments would lessen. Better general awareness of how life-changing an assistance animal can be for another person is an important step in this direction."
Smidt: "We need to educate the public and business owners on what they can ask and how to identify true service animals. We need to educate doctors and counselors on when and why to prescribe an emotional support animal and also have them understand the difference between an emotional support animal and assistance animal so they can inform their patients."
Krause-Parello: "There is a disconnect between many public establishments and individuals with service animals -- more often than not derived from a lack of understanding on the part of the establishment of the rights of the individual with the disability. Federal and state-level efforts, as well as social media campaigns by individuals, businesses, and NGOs, should be supported in order to perpetuate advocacy and the spread of education and awareness about the rights of service animals."
Saul: "I have seen some schools resist having service animals present in their buildings which is a violation of ADA law. I have also seen service dogs whose families have not maintained their training, and as a result, the dogs cause damage and disruption in the settings that they are permitted to be in. The down side to this is that it increases discrimination against service dogs, and for clinics who have traditionally welcomed service dogs and who have followed ADA laws, this creates some significant challenges."