Major airlines Delta and United have adopted new policies that require medical and mental health providers to sign a standardized form when requesting an emotional support animal (ESA) for their patients.
Under the newly adopted policies, passengers may have a more difficult time using automated letters for ESAs acquired through websites from unscrupulous companies. The new forms require a provider to:
- Certify that the passenger has a mental or emotional disability listed in the DSM-5.
- State that he/she is providing ongoing treatment to the passenger for the disability.
- Provide license and contact information and signature.
What does this mean for psychologists?
Psychologists should do a thorough analysis to help determine whether signing such a document is ethical, clinically indicated and in the best interest of the patient. The new airline policies make it clear that the passenger must disclose a disability diagnosis, which only underscores the importance of this exercise. Some important considerations include:
- Can you be objective?
- Does the patient have a legitimate diagnosis?
- Does the patient realize that this diagnosis, which he or she has the right to keep confidential, will be shared with a third party?
- Does an ESA benefit the patient, or might he/she benefit from other coping strategies to alleviate the anxiety associated with travel?
- Will your decision to sign — or not to sign — hurt the therapeutic relationship?
New restrictions may minimize abuse
There is a difference between “service animals” and “emotional support animals.” A service animal is specifically defined in the Americans with Disabilities Act (ADA) as a dog that is specifically trained to help a disabled patient cope with a particular disability. An ESA, by contrast, can be any animal that provides comfort and support to its owner through companionship. While ESAs are not defined by the ADA, they are recognized under the Fair Housing Act and the Air Carrier Access Act, and are considered a “reasonable accommodation” for a disability.
Airlines had imposed few restrictions for ESAs and did not require passengers to demonstrate that the animals were housebroken or otherwise trained. These lax policies, and the fact that ESAs are allowed to fly for free, led to abuses by some mental health providers and passengers. A cottage industry soon sprang up of providers who generate letters of support after a brief online questionnaire and payment of a fee. Passengers were all too willing to take advantage of the low cost for this service without regard or understanding that they were agreeing to be diagnosed with a disability and share this information with outside parties.
These abuses were soon apparent and prompted some airlines to revisit their practices. According to a statement by United Airlines, “…we have seen a 75 percent increase in customers bringing emotional support animals onboard and as a result have experienced a significant increase in onboard incidents involving these animals.” ESAs have a place, but it is important for psychologists to discern when patients may truly benefit from their companionship and when they simply want to fly a pet for free.
If you have questions or concerns about providing letters of support for ESAs, contact Legal and Regulatory Affairs.
A more detailed article on ESAs and ethical considerations for psychologists is available in the Winter 2018 issue of Good Practice magazine .
Additional resources:
- Americans with Disability Act (ADA) guidance on service animals (PDF, 237KB)
- Service Animals and Assistance Animals for People with Disabilities in Housing and HUD-Funded Programs (PDF, 6.24MB)
- Aviation Consumer Protection: Service Animals (Including Emotional Support Animals)
- Younggren, J. N., Boisvert, J. A., & Boness, C. L. (2016). Examining emotional support animals and role conflicts in professional psychology. Professional Psychology: Research and Practice, 47(4), 255-260.
Disclaimer : *Legal issues are complex and highly fact-specific and state-specific. They require legal expertise that cannot be provided in this article. Moreover, APA/PO attorneys do not, and cannot, provide legal advice to our membership or state associations. The information in this article does not constitute and should not be relied upon as legal advice and should not be used as a substitute for obtaining personal legal advice and consultation prior to making decisions.
Article updated Feb. 25, 2019