Newly Released Study Reveals Health Benefits of Emotional Support Animals

By: Kathryn Anderson Updated: April 21, 2023


Emotional support animals (ESAs) are a type of assistance animal prescribed by a licensed mental health professional or general practitioner and provide support to individuals living with a mental or emotional disability. 

In this study, a joint collaboration between The Assistance Dog Center (TARSQ) and CertaPet, we aimed to investigate the links between the acquisition of an ESA dog and improvements in an individual’s mental, emotional, and/or physical health 



A cross-sectional online survey was conducted between October 12, 2018 and December 7, 2018 in which 298 men and women between the ages of 14 and 81 participated. The survey participants hailed from nine different countries, including the United States. 

A total of 307 ESA dogs were accounted for in the survey. 

Each survey participant answered 46 questions, encompassing demographics, their perceived limitations in day-to-day activities (such as lack of motivation, lack of drive, an unwillingness to participate in work/life, anxiety, panic, depression), any perceptions of changes brought about by the ESA dog from the point of view of the ESA dog owner as well as that of a relative, and viewpoints on the differences, advantages, and disadvantages of having an assistance dog. 



All participants reported that their quality of life had noticeably improved with an ESA dog. 

Of the 298 participants, 285 (95.6%) expressed a desire to have another ESA dog after the death of the current dog. Of the remaining 13, most expressed preference for a service dog over an ESA, as a service dog would be able to accompany them everywhere, whereas ESAs still face limitations in the public venues where they are and are not allowed. 

The majority of the participants stated that their ESA dog fulfilled exactly the tasks they had desired. The tasks desired of the ESA dogs related to everyday life: to provide motivation, to give structure, to lighten the mood, to increase enjoyment of life, and general companionship, followed by offering reassurance in general as well as in specific situations, along with the opening the possibility of social interaction.

A large number of survey participants expressed that the companionship of their ESA dog provided an increased feeling of security (99.29%), independence, and energy (97.86%) while also reducing stress and improving sleeping patterns (96.80%). 

Additionally, among these participants:

  • 98.93% reported an increased zest for life
  • 98.58% reported an increased sense of motivation in everyday life 
  • 94.4% mentioned less generalized anxiety disorders
  • 88.89% experienced a reduction in panic attacks
  • 88.89% felt able to resume education, work, or training
  •  83.33% felt an improvement in compulsive thoughts
  • 77.78% felt an improvement in compulsive acts

In addition to this, 45 participants (15.1%) reported that their ESA dog provided one or two actual relief services beyond what was desired, mentioning distraction on several occasions as an aid that was not previously desired. In one case, these additional services entailed an ESA dog noticing lupus outbreaks in time and another detecting and warning of threatening seizures early.

benefits of ESA

Previous Research

To date, no studies have taken place to investigate the support provided by ESA dogs. 

However, there are a number of studies reporting the positive outcomes from general dog ownership. 

In 2007, a meta-analysis by Janelle Nimar and Brad Lundahl from the University of Utah summarised several studies, which concluded that dogs could be used to support the treatment of traumatized patients and that contact with dogs could improve mood and reduce depressive symptoms, while the simple presence of a dog could significantly reduce anxiety. 

Contact with dogs also displayed neurobiological advantages. Different studies have reported a subdued effect on the human stress system (hypothalamic-pituitary-adrenocortical axis, autonomic nervous system). 

Blood pressure and heart rate decline during interaction with a dog, and the levels of the primary stress hormone cortisol are also reduced. Research states that even by stroking an unfamiliar dog, the body’s levels of oxytocin can be raised. The hormone oxytocin has several positive effects on mental health patients such as a subdued stress reaction and the alleviation of anxiety and depression. 



Based on our findings, there exists a strong correlation between the acquisition of an ESA dog and improvements in an individual’s mental, emotional, and/or physical health. ESA ownership appears to help mitigate the detrimental symptoms of many mental and emotional illnesses such as panic attacks and lack of motivation. 

ESA dogs are commonly prescribed by licensed mental health professionals or general practitioners to provide support to individuals living with a mental or emotional disability. Their support is predominantly of an emotional nature, helping ESA owners through their companionship, which can help to convey a sense of security, loyalty, and love, while also bringing structure to an individual’s day. 

As previous studies have found, general dog ownership can help reduce stress levels in an individual as well as improve mood. As there are limitations to the types of public venues a general pet may access, individuals living with emotional or mental disabilities may consider acquiring an ESA dog, which is entitled to certain housing and travel rights. 

The Healing Impact of Emotional Support Animals 

The Anxiety and Depression Association of America recommends dog ownership as a way to help improve everyday life for those living with a mental or emotional disability. 

The association refers to a public study from 2016, which stated that animals help give mental health sufferers security and routine, which in turn provides them with social and emotional acceptance.

The association additionally emphasizes other advantages to pet ownership, such as pets helping their owners meet new people, thereby allowing men and women to build new friendships and develop new social networks.

Further studies report that dogs, in particular, contribute to well-being. 


The Decline of Mental Health in the United States During COVID-19 

Nearly half of Americans have reported negative impacts on their mental health as a result of the COVID-19 pandemic. 

Researchers from the CDC further found that reports of anxiety, depression, and suicidal ideation were significantly higher following the outbreak of COVID-19 when compared with 2019. Substance abuse has also been on the rise. 

The pandemic has forced many Americans to face job losses, salary cuts, and/or the loss of loved ones, all factors that have contributed to the declining mental health of many U.S. residents, as well as those around the world. 

mental health in the US


Are ESAs a Possible Solution? 

Based on a study conducted by The Assistance Dog Center (TARSQ) in collaboration with CertaPet, participants expressed that the companionship of their ESA dog provided an increased feeling of security (99.29%), independence, and energy (97.86%) while also reducing stress and improving sleeping patterns (96.80%). 

Survey participants also reported an increased zest for life, an increased sense of motivation in everyday life, less generalized anxiety disorders, and a reduction in panic attacks. 

Individuals struggling with mental health difficulties may experience similar results upon acquiring an ESA dog of their own. 

In a Perceptions of Service Animals survey with 992 people, 90.8% of people who applied for an ESA letter struggled with anxiety while 72.4% struggled with depression. 

Other ailments that may necessitate the acquisition of an ESA include:

  • post-traumatic stress disorder (PTSD)
  • fear/phobias
  • panic disorder/panic attacks
  • mood disorders
  • personality disorders
  • seasonal affective disorder
  • social anxiety disorder
  • loneliness
  • suicidal thoughts
  • chronic pain

As ESAs are not considered pets in the United States, they are granted certain rights under the Fair Housing Act and the Air Carrier Access Act. The Fair Housing Act recognizes companion animals as assistive aids and allows tenants with mental or emotional problems to request “reasonable accommodation for their ESAs.” Landlords have no legal right to deny an ESA accommodation–even in units with a no-pets policy. The Air Carrier Access Act allows an ESA to travel with its owner for free, recognizing the support an ESA can provide its owner. 

Individuals desiring an ESA can acquire a prescription (known simply as an ‘ESA Letter’) through their licensed mental health professional or general practitioner. 

Telehealth services such as make the process of acquiring an ESA simple and hassle-free, allowing interested parties to obtain an ESA Letter from the comfort of their own home through a remote consultation with a licensed mental health professional.  


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