Points to Consider When Asked to Write Emotional Support Animal Advocacy Letter

This article first appeared in Psychiatric News. Cheryl D. Wills , M.D. Published Online: 27 Jun 2023

As in any clinical situation, psychiatrists should proceed with care when patients ask them to write an emotional support animal advocacy letter.

Psychiatric training prepares us to serve in many capacities. We evaluate patients, teach, practice psychotherapy and psychopharmacology, engage in research, have administrative responsibilities, and collaborate with other medical professionals. One shortcoming in psychiatric training and education is documentation for patients who are pursuing disability entitlements. This includes letters advocating for patients to have emotional support animals (ESAs).

The request for ESA advocacy letters increased precipitously in the last decade, along with the range of reactions from people who have been told by psychiatrists that they do not meet criteria for an ESA. Psychiatrists should not feel obligated to write such letters. On one occasion, an angry patient refused to leave my office after I chose not to write the letter. Eventually, law enforcement officers escorted the person from the building and cited the person for trespassing. Psychiatrists need to feel comfortable when assessing patients for ESA eligibility.