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How to get an emotional support animal (ESA): What experts say you should know

Here’s what you should know about current rules and how to obtain an emotional support animal prescription.

How to get an emotional support animal (ESA): What experts say you should know

Anyone who has a close bond with their pet knows that they’re more than just animals we house and feed. “When a reciprocal relationship exists between a human and an animal, you can derive benefits physically, emotionally and mentally,” says Aubrey Fine, a licensed psychologist, Professor Emeritus at California Poly State University and an expert on animal-assisted therapy.

He points to studies that show petting an animal can lower our heart rate and blood pressure, reduce stress hormones and release feel-good ones. Because of these potential benefits, those struggling with emotional or mental issues like anxiety, depression or PTSD may want their pet designated as an Emotional Support Animal (ESA), Fine says.

All that’s required for ESA paperwork is a letter from a mental health professional. But the ease of getting designation combined with previously vague guidelines led to abuse of the system, and more recently, a crackdown on ESA benefits. If you’re wondering how to get an emotional support animal, here’s what you should know about current rules and how to obtain an emotional support animal prescription. 

Types of assistance animals

Assistance animals fall into several categories, Fine says, each with varying requirements and legal rights. Here’s how ESAs compare to the two other main types of assistance animals. 

Emotional Support Animal (ESA)

ESAs are pets — a dog, a cat, or even a bird — that provides comfort and therapeutic support to a person with mental disability, Fine says. But they’re not trained to perform a specific task, so the ADA doesn’t recognize them as service animals, and they’re not entitled by federal law to accompany the owner in public places.

A mental health or medical professional must write a letter attesting that this animal is necessary for your comfort due to a psychological disability. There’s no official certification or database, despite what some illegitimate websites insist, Fine notes. 

While ESAs aren’t protected under the ADA, they are protected under the Fair Housing Act, requiring housing providers to accommodate most assistance animals even if pets aren’t allowed. (Though the Department of Housing and Urban Development released clearer guidelines in 2020, and if the animal causes damage or threatens safety, protections vanish.) 

In general, ESAs aren’t allowed in public places where animals aren’t allowed, though some state and local government laws may permit this.

Service animal

This is an official designation defined in the American Disabilities Act as a dog that’s individually trained to perform tasks or take a specific action to assist someone with a disability. 

Because service dogs aren’t deemed pets and serve a vital purpose in helping someone with a disability, they have special legal rights to be in public places where pets aren’t allowed, explains Russell Hartstein, a certified dog behavior consultant and professional dog trainer, and founder of Fun Paw Care in Los Angeles.

Therapy animal

Therapy animals are not restricted to dogs, are trained and work on a volunteer team with a human and their goal is to help other people, says Hartstein. For example, visiting seniors at a nursing home or bringing joy to children at a hospital. 

Therapy dogs are pets, Hartstein says. This means they aren’t permitted special accommodations other than being allowed into some public places if they’re officially certified, insured and volunteering as a therapy dog team. 

What you need to know about emotional support animal rights

While rules regulating assistance animals were created with good intentions to protect consumers, Fine says, they were too vague, which led to significant abuse of the ESA designation. 

In late 2020, ESAs other than dogs lost their right to fly, and even ESA dogs don’t have to be permitted on board anymore. 

As problems and controversy mounted, mental health professionals became increasingly wary of the ethics and risks in designating ESAs, so some either stopped (or never started) offering ESA letters.  This means getting ESA paperwork is harder than it used to be, but it’s still possible to obtain it.

“Even if you don’t need a service dog, you could still find a tremendous amount of help from an emotional support animal.”


Before getting an emotional support animal, ask these questions

Before pursuing ESA paperwork, Hartstein and Fine recommend exploring the following questions:

Do I actually need an ESA?

If you have anxiety, depression, PTSD or another mental or emotional issue and you receive significant comfort and quality-of-life improvement from an animal, an ESA could be the right choice, Fine says. Just keep in mind your ESA can’t accompany you everywhere — only a service dog can do that.

The best way to determine if you need a service dog or ESA: Ask yourself if you can perform a major life activity with the dog or not. If you don’t need the dog present, you don’t need a service dog, but you could still find a tremendous amount of help from an emotional support animal, says Hartstein. 

Fine says ESAs can be ideal for seniors who would benefit mentally or emotionally from an animal but live in residences that don’t allow pets. “For older people, isolation and the sense of loneliness is extremely traumatic, especially with the pandemic,” Fine says. “Animals can provide that welcomed sense of relationship, company, companionship, purpose and the ability to give love.” However, he does recommend ensuring the older adult is mobile enough for dog walking and that the animal won’t introduce safety concerns like falling hazards.

Also keep in mind that if your dwelling doesn’t restrict pets, there may not be a benefit in ESA designation unless your area has laws that grant them public access. 

Is my animal the right fit for an ESA? 

Hartstein says people often start the ESA process by seeking a mental health professional to write the letter, but that’s putting the cart before the horse. He urges first ensuring the animal is trained and has the appropriate behavior since federal protections can be waived if your dog has behavioral problems. 

He recommends focusing on behavior first and using testing guidelines from the Canine Good Citizen program, or criteria from the International Association of Assistance Dog Partners — either of which you can do on your own or with by hiring a professional trainer. 

How to get an emotional support animal letter

To officially have an ESA, you get a letter from a mental health provider explaining that you require an ESA to support you. 

As ESAs became more controversial, mental health professionals were less inclined to write these letters. After all, their job is to analyze people — not animals — and vouching for an animal comes with major liability. In 2019, the American Counseling Association released a position statement discouraging counselors from writing ESA letters for clients unless they have specialized training and experience in working with human-animal bond in counseling. 

The statement notes that there is no official certificate, tag, ID card or vest needed for an ESA, and websites stating this are fraudulent. Even websites that claim to provide letters from a mental health professional are questionable, Fine and Hartstein say.

“The reciprocal relationship that an animal can contribute to the wellness of the human is remarkable.”


Here’s how to proceed, depending on where you are in the process already.

If you already have a therapist: Ask if they write ESA letters or can recommend someone who does. Rules and processes vary by state, and some may refer you to a professional who specializes in human and animal behavior so they can evaluate you alongside your dog.

If you don’t have a therapist: Fine recommends seeing your family physician to start the conversation. He suggests sharing that you’re struggling and why and explaining how your close relationship with your dog is helping you cope. At that point, they’ll likely refer you to a psychiatrist or a psychologist, Fine says, who will know the requirements in your state. 

You can also try on your own to find a mental health professional who also specializes in animal behavior. Fine says these are less common, but they’re hugely beneficial since they look at “both sides of the leash” and can determine if the animal’s behavior is safe, reliable and consistent.

In addition, Hartstein recommends meeting with a professional dog trainer. They can evaluate your pet to ensure their behavior is appropriate for an ESA and provide training if needed. 

The letter from a mental health professional serves as your ESA paperwork. If you plan to fly (if you find an airline that allows it) or live in housing with special accommodations for your ESA, you may need to complete additional paperwork since the new housing criteria from HUD is very specific. Talk to your landlord or building owner/manager for details on what they require to approve your request for accommodation. But our experts insist there is no legitimate online registration necessary, and you don’t have to buy an ID or vest unless you want to.

Don’t end up in the doghouse

Due to so many people abusing the system, the sad new reality is that ESAs offer fewer benefits, but Fine says legitimate ESAs can still provide significant value. “I believe for some people, having that animal in their life has allowed them to flourish and continue to find quality in daily living, and the reciprocal relationship that an animal can contribute to the wellness of the human is remarkable,” he adds.

Just make sure to work with a trusted mental health professional to ensure your paperwork is above board, and ideally, a dog trainer to make sure your pet’s behavior allows you to utilize your ESA designation successfully.