Emotional support animals

[FlowRate]

I guess I don't see much difference in filling out a legal document that supersedes certain rules for animal occupancy, than filling out paperwork similarly for SSDI.

That actually is the difference. The ADA definition of disability is "looser" than the definition for SSDI. Case in point that workplace accommodations require an ADA-defined disability but obviously those people are trying to work, not to be declared permanently disabled.

This is enshrined in federal law so I wouldn't get too bogged down with what your state laws have to say.

The fair housing act uses basically the same language regarding disability-related need although does not as affirmatively proscribe what the licensed professions must do when a patient requests an ESA letter. My most recent template version basically stated "the patient believes their pet helps during acute episodes of illness" which was my hedged way of stating disability-related need without myself affirmatively saying I agree with it. But that seems to skirt the state statutes.

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[Mass Effect]

Was reading up more on this lately and state law defines that a licensee approached by a patient desiring an assistance animal as a housing accommodation is obligated to:

(a) MAKE A WRITTEN FINDING REGARDING WHETHER THE PATIENT HAS A DISABILITY AND, IF A DISABILITY IS FOUND, A SEPARATE WRITTEN FINDING REGARDING WHETHER THE NEED FOR THE ANIMAL IS RELATED TO THAT DISABILITY; OR

(b) MAKE A WRITTEN FINDING THAT THERE IS INSUFFICIENT INFORMATION AVAILABLE TO MAKE A FINDING REGARDING DISABILITY OR THE DISABILITY-RELATED NEED FOR THE ANIMAL.

So I now feel less comfortable with my hedged way of writing my ESA letters. What is the bar for "disability related need" in this case? Is it more than "has DSM diagnosis and would feel sad about finding a different apartment/giving away pet"?

I'm opposed to these letters for many reasons, including the above. In my experience, there are very few people who legitimately "need" an ESA. More common in my experience, it's people who want to live in pet-free housing, but have a pet, or want to bring their dog on the plane.

 

[gamesafoot]

ESAs are a relatively new phenomenon. Just because a psychiatrist hasn't been sued regarding an ESA letter doesn't mean he or she couldn't be sued and found liable for something. It would probably depend on the contents of the letter (i.e. how much is said in it), what happened, and how the legal system (and/or expert witnesses) interpret the situation. I would imagine a more circumscribed letter (My patient feels they benefit from this animal, sincerely, MD) and/or one that reflects statutes on ESA is more protective against liability than one that goes out on more limbs (This animal is crucial to their wellbeing, it is 100% safe, I think it should be allowed on all the planes, etc).

In my personal practice - I wouldn't be so concerned about liability from the former types of letters, but I would not write ESA letters because I think they foster maladaptive coping skills. I also think there are legitimate private interests (i.e. landlords) and medical interests of tenants (such as bad allergies, asthma) that make pet free living desirable/necessary for some. But really, that's not my business, my bottom line is that I'm a psychiatrist and I don't think ESAs are good for patients. (Yes, I think pets are very therapeutic. I love my cat. But I think that therapeutic benefit ends when I try to take my cat to the movies. Also - the poor cat!).

 

[Merovinge]

ESAs are a relatively new phenomenon. Just because a psychiatrist hasn't been sued regarding an ESA letter doesn't mean he or she couldn't be sued and found liable for something. It would probably depend on the contents of the letter (i.e. how much is said in it), what happened, and how the legal system (and/or expert witnesses) interpret the situation. I would imagine a more circumscribed letter (My patient feels they benefit from this animal, sincerely, MD) and/or one that reflects statutes on ESA is more protective against liability than one that goes out on more limbs (This animal is crucial to their wellbeing, it is 100% safe, I think it should be allowed on all the planes, etc).

In my personal practice - I wouldn't be so concerned about liability from the former types of letters, but I would not write ESA letters because I think they foster maladaptive coping skills. I also think there are legitimate private interests (i.e. landlords) and medical interests of tenants (such as bad allergies, asthma) that make pet free living desirable/necessary for some. But really, that's not my business, my bottom line is that I'm a psychiatrist and I don't think ESAs are good for patients. (Yes, I think pets are very therapeutic. I love my cat. But I think that therapeutic benefit ends when I try to take my cat to the movies. Also - the poor cat!).

I'm not sure how you can think pets are very therapeutic but simultaneously be against a letter to allow a patient to have a pet in their public housing that does not allow pets. There is a wide chasm between something indicating a pet should be allowed in a plane/restaurant/store etc. (which I also agree is maladaptive) and one indicating that if they are forced to get rid of the animal that they have due to a change in housing it could reasonably be expected for this to worsen their mental health.

For full disclosure, I used to not want anything to do with writing these letters but after thinking about my potential risk of liability versus what each dog/cat means to the kids I take care of (mostly with ASD), I decided to suck it up and do the right thing. It's been going well to date.

 

[Stagg737]

I'm not sure how you can think pets are very therapeutic but simultaneously be against a letter to allow a patient to have a pet in their public housing that does not allow pets. There is a wide chasm between something indicating a pet should be allowed in a plane/restaurant/store etc. (which I also agree is maladaptive) and one indicating that if they are forced to get rid of the animal that they have due to a change in housing it could reasonably be expected for this to worsen their mental health.

For full disclosure, I used to not want anything to do with writing these letters but after thinking about my potential risk of liability versus what each dog/cat means to the kids I take care of (mostly with ASD), I decided to suck it up and do the right thing. It's been going well to date.

Idk, as someone on the side of "pets can be very therapeutic", I certainly understand making an exception for some patients. At the same time, I also think it's wrong to infringe on other residents' well-being to bring a pet along. My wife is deathly allergic to cat dander to the point that being around other people who own cats effects her breathing. I've also lived in a duplex next to someone whose dog would bark all. night. long. It got to the point where my sleep was affected enough that my grades were suffering and I actually had to start prescription medication for sleep during that time. There's a reason that "no pets allowed" housing exists other than some people just don't like pets. What right does someone have to cause others to suffer to alleviate their own problems?

All that being said, I have written a couple letters for ESAs. However, in both instances I contacted the patient's landlord myself and made sure they were okay with an animal being present and both times it seemed like it was nbd and mostly just to prevent damage to their units.

 

[PsyDr]

I'm not sure how you can think pets are very therapeutic but simultaneously be against a letter to allow a patient to have a pet in their public housing that does not allow pets. There is a wide chasm between something indicating a pet should be allowed in a plane/restaurant/store etc. (which I also agree is maladaptive) and one indicating that if they are forced to get rid of the animal that they have due to a change in housing it could reasonably be expected for this to worsen their mental health.

That line of reasoning has limits. Which other rules should be waived for mental health purposes?

Speeding tickets?

 

[WisNeuro]

That line of reasoning has limits. Which other rules should be waived for mental health purposes?

Speeding tickets?

I have "sensory processing disorder" so I will require my apartment complex to have 24/7 quiet hours. They will also need to replace the carpet padding with an extra 2" of foam to deaden footfall sounds. All babies will need to be housed in rooms with sound dampening padding on the walls.

 

[Mass Effect]

I'm not sure how you can think pets are very therapeutic but simultaneously be against a letter to allow a patient to have a pet in their public housing that does not allow pets. There is a wide chasm between something indicating a pet should be allowed in a plane/restaurant/store etc. (which I also agree is maladaptive) and one indicating that if they are forced to get rid of the animal that they have due to a change in housing it could reasonably be expected for this to worsen their mental health.

For full disclosure, I used to not want anything to do with writing these letters but after thinking about my potential risk of liability versus what each dog/cat means to the kids I take care of (mostly with ASD), I decided to suck it up and do the right thing. It's been going well to date.

Very easily. You can look at your patient and say, "yes, I think a pet will help you" or "I think losing your pet might hurt you" and in the same breath "better find a place to live that allows pets." If there was a shortage of communities allowing pets, I could see it. But there isn't. In fact, I'd say it's the opposite. It's harder to find a decent place that doesn't allow pets than it is to find one that does in my city and that's a damn shame for people who make the choice not to live with pets.

I'm not writing letters on behalf of my patients for whom I think a pet will harm them saying "their neighbor has to get rid of their pet." Why psychiatrists deem it ok to let patients have a pet in pet-free housing when others there have every right to enjoy a pet-free environment is beyond me, especially when there's very little actual evidence for it.

 

[Merovinge]

Very easily. You can look at your patient and say, "yes, I think a pet will help you" or "I think losing your pet might hurt you" and in the same breath "better find a place to live that allows pets." If there was a shortage of communities allowing pets, I could see it. But there isn't. In fact, I'd say it's the opposite. It's harder to find a decent place that doesn't allow pets than it is to find one that does in my city and that's a damn shame for people who make the choice not to live with pets.

I'm not writing letters on behalf of my patients for whom I think a pet will harm them saying "their neighbor has to get rid of their pet." Why psychiatrists deem it ok to let patients have a pet in pet-free housing when others there have every right to enjoy a pet-free environment is beyond me, especially when there's very little actual evidence for it.

I see many people sharing this opinion, so I will just say this does not speak to my experiences with public housing in the part of the country that I practice in. I actually personally just looked/signed a lease to move to a new area and yes, when looking at 4k+/month places about 85-90% allow pets. If this were the case for my patients, I agree 100%, simply look elsewhere. This is not the case for my patients. I've even driven past some of these locations in my current city and seen the signs myself.

I have little interest delving into a SES debate where someone trashes the slumlords running this housing and hearing other people opine about how if my patient's parents can afford a pet they should be able to afford their own housing. I do feel much better about this topic now based on reading Spilk's comments and certainly agree it's a grey area open to interpretation and differing opinions.

 

[FlowRate]

Very easily. You can look at your patient and say, "yes, I think a pet will help you" or "I think losing your pet might hurt you" and in the same breath "better find a place to live that allows pets." If there was a shortage of communities allowing pets, I could see it. But there isn't. In fact, I'd say it's the opposite. It's harder to find a decent place that doesn't allow pets than it is to find one that does in my city and that's a damn shame for people who make the choice not to live with pets.

I'm not writing letters on behalf of my patients for whom I think a pet will harm them saying "their neighbor has to get rid of their pet." Why psychiatrists deem it ok to let patients have a pet in pet-free housing when others there have every right to enjoy a pet-free environment is beyond me, especially when there's very little actual evidence for it.

I don't have a great understanding of my new local market but where I did residency almost all affordable housing (and I don't mean Affordable Housing TM with a 3 year waitlist, I mean not 4k+ per mo) had pet bans.

 

[VA Hopeful Dr]

I don't have a great understanding of my new local market but where I did residency almost all affordable housing (and I don't mean Affordable Housing TM with a 3 year waitlist, I mean not 4k+ per mo) had pet bans.

In my current location, lots of under 1K apartments that are pet friendly (one place even has a dog park). Same with my old apartment complex from med school and my wife's (state capitol).

 

[WisNeuro]

In my current location, lots of under 1K apartments that are pet friendly (one place even has a dog park). Same with my old apartment complex from med school and my wife's (state capitol).

I was curious, so also did a search of low income units available within 5 miles of the nearest downtown that allow dogs. Currently 152 units available.

 

[Mass Effect]

I see many people sharing this opinion, so I will just say this does not speak to my experiences with public housing in the part of the country that I practice in. I actually personally just looked/signed a lease to move to a new area and yes, when looking at 4k+/month places about 85-90% allow pets. If this were the case for my patients, I agree 100%, simply look elsewhere. This is not the case for my patients. I've even driven past some of these locations in my current city and seen the signs myself.

I have little interest delving into a SES debate where someone trashes the slumlords running this housing and hearing other people opine about how if my patient's parents can afford a pet they should be able to afford their own housing. I do feel much better about this topic now based on reading Spilk's comments and certainly agree it's a grey area open to interpretation and differing opinions.

I mean, I'm not going to argue about SES or slumlords and all that, but suffice it to say that people who choose to live in a pet-free building or complex usually do so for very good reason and I think it's irresponsible of mental health professionals to force them to live with pets around when there's very little evidence to support it. The argument for it seems to be (based on others I've talked to about this) that it's low risk, high reward, but that's not the case for other people living in the complex and that's something not too many psychiatrists writing these letters think about. I do hope eventually this is decided in the courts. It's not just the person with the "disability" who has rights (quotes because many patients who've asked me for such letters actually aren't disabled).

 

[erg923]

I mean, I'm not going to argue about SES or slumlords and all that, but suffice it to say that people who choose to live in a pet-free building or complex usually do so for very good reason and I think it's irresponsible of mental health professionals to force them to live with pets around when there's very little evidence to support it. The argument for it seems to be (based on others I've talked to about this) that it's low risk, high reward, but that's not the case for other people living in the complex and that's something not too many psychiatrists writing these letters think about. I do hope eventually this is decided in the courts. It's not just the person with the "disability" who has rights (quotes because many patients who've asked me for such letters actually aren't disabled).

I think this whole ESA thing is abuse of power for a physician. Period. This is not ADA stuff. Thus, telling others that you wish to violate their rights (either as private property owners, or as citizens choosing to live in pet free surroundings) because you have a patient that is chronically sad or anxious is egregious overreach.

I mean, we wouldn't agree to write a letter to a building owner saying they should forbid tenants from lighting off fireworks in the area year round cause
a vet (or a post-partum depressed mom, or autistic child) living there might get spooked. Right? We would "treat" that, right? However we might do it .... coping skills, exposure therapy, or "buck up sissy pants," But we we would "treat" it. That's what we are suppose to do, as mental health professionals, We treat things. And we treat the individual, not society.

We should all be sensitive to others needs within our neighborhood to a degree, certainly. But let's not go so far as to make your problem... MY problem. Right?

 

[Crayola227]

What animals are we talking about here? Cats or dogs?

Indoor only cats can be great ESA and better neighbors than any human. The allergy thing is vastly overblown.

Most apartments have enough turn over if there was a real issue with allergies you could have people (like the pet owner) move apartments. No one says in accommodating the animal or the disability the property owner can't work with the pet owner for the sake of neighbors. Maybe they would be prevented by ADA from asking the pet owner to move. Neighbors with issues could be offered another apartment. That might sound extreme, but it would be pretty rare for it to come to this.

From what I can tell most landlords, especially cheaper units/lower income, just want to avoid property damage, it has little to do with them trying to provide cat free housing to people with allergies. If your allergies are so severe you're affected by your neighbor's indoor only cat, you probably need to be HEPA filtering your air hardcore anyway.

If the patient wants an indoor only cat, and they seem responsible enough to keep it from pissing on the floor, I would probably just try to determine why the landlord has the pet ban (to create a pet-free community for allergic tenants, vs they just don't want to deal with it).

 

[hamstergang]

If the patient wants an indoor only cat, and they seem responsible enough to keep it from pissing on the floor, I would probably just try to determine why the landlord has the pet ban (to create a pet-free community for allergic tenants, vs they just don't want to deal with it).

But why would you as a doctor attempt to figure out the landlord's reasoning? Why is this a medical thing at all? Lots of things would help to reduce stress and therefore improve symptoms in our patients, but we don't turn those into medical excuses. We don't write letters to reduce rent, get free gym membership, or get extra fruits and vegetables from the supermarket. Why is it okay for us to force an animal on a landlord who doesn't want them for whatever reason they feel?

 

[calvnandhobbs68]

But why would you as a doctor attempt to figure out the landlord's reasoning? Why is this a medical thing at all? Lots of things would help to reduce stress and therefore improve symptoms in our patients, but we don't turn those into medical excuses. We don't write letters to reduce rent, get free gym membership, or get extra fruits and vegetables from the supermarket. Why is it okay for us to force an animal on a landlord who doesn't want them for whatever reason they feel?

I mean yes we do though. Patients can get prescriptions for nutritional supplements, for physical therapy, etc if we think they have a condition that would benefit from that.

We aren’t writing a prescription that will allow them to get a dog for free which is what your analogies would extrapolate to. I think the philosophical difference this comes down to is whether you actually think certain classes of animals are therapeutic or are a lifestyle choice.

That being said, I generally don’t sign emotional support animal stuff. I personally think the number of people who try to abuse this because of the Fair Housing Act is much larger than the number of people who’s animal is truly therapeutic for them. It’s a very case by case basis if I do consider it.

 

[hamstergang]

I mean yes we do though. Patients can get prescriptions for nutritional supplements, for physical therapy, etc if we think they have a condition that would benefit from that.

They get physical therapy at a place that wants to offer it, and the patient pays for it. They get supplements from places that want to sell them, and the patient's pay for them. If the patient wants to live in an apartment with a pet, they should do so in a place that wants to offer that and the patient pays for it.

 

[calvnandhobbs68]

They get physical therapy at a place that wants to offer it, and the patient pays for it. They get supplements from places that want to sell them, and the patient's pay for them. If the patient wants to live in an apartment with a pet, they should do so in a place that wants to offer that and the patient pays for it.

The patient doesn’t pay for either of these things if they’re on Medicaid. But whatever that’s beside the point. The patient also paid for the pet presumably and pays for the care of the pet. They’re not asking the landlord to pay for the pets food and Chewy boxes.

Landlords are allowed to charge a pet deposit to hold against any damages by the pet, even for emotional support animals. So again, a landlord can have protection against damages incurred by the pet. They just aren’t allowed to charge a monthly pet fee.

 

[VA Hopeful Dr]

The patient doesn’t pay for either of these things if they’re on Medicaid. But whatever that’s beside the point. The patient also paid for the pet presumably and pays for the care of the pet. They’re not asking the landlord to pay for the pets food and Chewy boxes.

Landlords are allowed to charge a pet deposit to hold against any damages by the pet, even for emotional support animals. So again, a landlord can have protection against damages incurred by the pet. They just aren’t allowed to charge a monthly pet fee.

Not quite:

Assistance Animals

www.hud.gov

A reasonable accommodation request for an assistance animal may include, for example:

• A request to live with an assistance animal at a property where a housing provider has a no-pets policy or
• A request to waive a pet deposit, fee, or other rule as to an assistance animal.

 

[Mass Effect]

What animals are we talking about here? Cats or dogs?

Indoor only cats can be great ESA and better neighbors than any human. The allergy thing is vastly overblown.

Most apartments have enough turn over if there was a real issue with allergies you could have people (like the pet owner) move apartments. No one says in accommodating the animal or the disability the property owner can't work with the pet owner for the sake of neighbors. Maybe they would be prevented by ADA from asking the pet owner to move. Neighbors with issues could be offered another apartment. That might sound extreme, but it would be pretty rare for it to come to this.

From what I can tell most landlords, especially cheaper units/lower income, just want to avoid property damage, it has little to do with them trying to provide cat free housing to people with allergies. If your allergies are so severe you're affected by your neighbor's indoor only cat, you probably need to be HEPA filtering your air hardcore anyway.

If the patient wants an indoor only cat, and they seem responsible enough to keep it from pissing on the floor, I would probably just try to determine why the landlord has the pet ban (to create a pet-free community for allergic tenants, vs they just don't want to deal with it).

I typically agree with you on a lot of issues, but here, I have to strongly disagree. Whatever the landlords reason, we as medical professionals, should not be turning this into a medical thing. It's dishonest and unethical in my view. If your patient wants a cat, then your patient needs to find a place that allows cats. A landlord should be allowed to make the rules for his/her own building. We don't write letters that our patients don't want to wear shoes and shirts and should be allowed in a grocery store. Because we acknowledge that store owners can do what they want and if you don't like it, shop somewhere else.

There are people with extreme allergies to pet dander and I think it's dismissive to say it's overblown. Putting that aside, there are also patients who don't want to be around pets for whatever reason and they should have that right. I have a patient right now who was attacked by two dogs a few years ago. Had reconstructive surgery on her face and is deathly afraid. I'm seeing her for PTSD. If she intentionally moves into a pet-free building that is forced to allow ESAs, how is that not infringing on HER right?

We get so caught up in the rights and accommodations for our patients that we sometimes overlook the rights of others and that is not ok.

 

[Mass Effect]

I mean yes we do though. Patients can get prescriptions for nutritional supplements, for physical therapy, etc if we think they have a condition that would benefit from that.

Except these things don't infringe on the rights of others so your analogy doesn't fit. We don't force anyone to do physical therapy with our patient. We don't force anyone to sell our patient nutritional supplements. They go to places that offer these services.

 

[Mass Effect]

The patient doesn’t pay for either of these things if they’re on Medicaid. But whatever that’s beside the point. The patient also paid for the pet presumably and pays for the care of the pet. They’re not asking the landlord to pay for the pets food and Chewy boxes.

Landlords are allowed to charge a pet deposit to hold against any damages by the pet, even for emotional support animals. So again, a landlord can have protection against damages incurred by the pet. They just aren’t allowed to charge a monthly pet fee.

But again, why should landlords be forced to do that and why should people who intentionally choose to live in a place without pets be forced to live with them? That's what I want to know. Why is it we accept that we can't force Piggly Wiggly to allow ESAs, but we strongarm landlords into dealing with it?

 

[Mass Effect]

Those of you writing ESAs: if your patient claimed loud music helps them sleep, would you write a letter allowing him/her to blast the radio all night in an apartment building? My guess is that you wouldn't because you'd acknowledge it would infringe on the rights of other residents. My point is that pet lovers (and I am one) are sometimes blind to the fact that not everyone likes pets or wants pets and they should have the right to make that decision without some mental health professional writing a letter to allow Susie a cat because she's anxious.

 

[calvnandhobbs68]

Those of you writing ESAs: if your patient claimed loud music helps them sleep, would you write a letter allowing him/her to blast the radio all night in an apartment building? My guess is that you wouldn't because you'd acknowledge it would infringe on the rights of other residents. My point is that pet lovers (and I am one) are sometimes blind to the fact that not everyone likes pets or wants pets and they should have the right to make that decision without some mental health professional writing a letter to allow Susie a cat because she's anxious.

I agree overall and that’s why I won’t generally do this. I think there are far too many patients who try to abuse this. However about the rights thing,

Except these things don't infringe on the rights of others so your analogy doesn't fit. We don't force anyone to do physical therapy with our patient. We don't force anyone to sell our patient nutritional supplements. They go to places that offer these services.

Well yeah but nobody has a RIGHT to live in an apartment complex with no animals in it. Regarding the noise, if I lived next to a loud baby who cried every night or lived under neighbors who got up at 4:30AM to walk all over the hardwood floors above my apartment (not holding a party, just getting up to walk around), I’d be hard pressed to say I have some kind of right to keep them from doing these things. If the animal is an unreasonable nuisance, the landlord can then start proceedings to have the animal or tenant removed. The landlord also doesn’t have the RIGHT to impose whatever restrictions they want on tenants….there are other housing regulations besides this specific thing we’re talking about.

 

[calvnandhobbs68]

Not quite:

Assistance Animals

www.hud.gov

A reasonable accommodation request for an assistance animal may include, for example:

• A request to live with an assistance animal at a property where a housing provider has a no-pets policy or
• A request to waive a pet deposit, fee, or other rule as to an assistance animal.

So yes, true, a patient can request they waive it and this is generally considered a reasonable accommodation, however any damage to the unit from the pet can be taken out of the overall security deposit and charged to the tenant if it exceeds the security deposit. This also doesn’t seem to preclude the landlord from trying to charge a pet deposit.

 

[WisNeuro]

As an individual I don't like the righst issues of forcing ESAs on others, but as a professional, I'm more worried that other professionals are so readily willing to essentially "prescribe" something that doesn't have an empirical basis in and of itself. Particularly when you can counsel the patient to do other things (e.g., diet, exercise, socializing, etc) that actually have an empirical basis, with fairly large effect sizes well above and beyond having pets.

 

[Merovinge]

Why is this a medical thing at all? We don't write letters to reduce rent, get free gym membership, or get extra fruits and vegetables from the supermarket.

Ironically. the interventions you listed above (housing, gym, healthy food), are likely much better population based health strategies than nearly anything we do in psychiatry even if we judge it exclusively on mental health outcomes. How much individual doctors get involved in these areas is certainly open to debate, but I would hardly say that this makes these things not medical at all. Certainly any reasonable ACT psychiatrist is considering all those factors as well when devising a treatment plan.

That being said, we also didn't make the rules with regards to this. I would definitely prefer this be decided like disability, but alas here we are being the final arbiter in this case.

 

[Mass Effect]

Well yeah but nobody has a RIGHT to live in an apartment complex with no animals in it.

Hold up, if I move into a complex, sign a lease that acknowledges the rules, including no pets, then under contract, I have a right to literally expect no pets, do I not? No, I don't have a right to just move into any building and dictate no pets, but if I intentionally move into a building that doesn't allow pets, then I'd argue I have every right to expect that the rules I signed up for apply and that I won't be exposed to pets.

Regarding the noise, if I lived next to a loud baby who cried every night or lived under neighbors who got up at 4:30AM to walk all over the hardwood floors above my apartment (not holding a party, just getting up to walk around), I’d be hard pressed to say I have some kind of right to keep them from doing these things

Babies and people walking, no, but that isn't what I'm discussing. Most apartment complexes have rules on noise. If a patient wanted a letter to excuse them from that rules on noise, most of us wouldn't write it. Yet some don't think twice about ESAs.

The landlord also doesn’t have the RIGHT to impose whatever restrictions they want on tenants….there are other housing regulations besides this specific thing we’re talking about

The landlord absolutely has the right to impose pet and noise restrictions. We're not talking about other restrictions so I don't know what you're referring to.

 

[Mass Effect]

That being said, we also didn't make the rules with regards to this. I would definitely prefer this be decided like disability, but alas here we are being the final arbiter in this case.

You mean ESAs? There's a reason ESAs aren't treated like service animals. If we, as a profession, refused ESAs, then maybe things would change and they actually would be decided like disability.

 

[WisNeuro]

Also, you don't have to be the final arbiter, all you have to do is say that you don't write these letters. I get requests relatively regularly, and simply say no. From what everyone says, it's extremely easy to fill your clinic in most areas, what exactly do you have to lose?

 

[calvnandhobbs68]

Hold up, if I move into a complex, sign a lease that acknowledges the rules, including no pets, then under contract, I have a right to literally expect no pets, do I not? No, I don't have a right to just move into any building and dictate no pets, but if I intentionally move into a building that doesn't allow pets, then I'd argue I have every right to expect that the rules I signed up for apply and that I won't be exposed to pets.



Babies and people walking, no, but that isn't what I'm discussing. Most apartment complexes have rules on noise. If a patient wanted a letter to excuse them from that rules on noise, most of us wouldn't write it. Yet some don't think twice about ESAs.



The landlord absolutely has the right to impose pet and noise restrictions. We're not talking about other restrictions so I don't know what you're referring to.

Your lease applies to yourself. It is a contract between you and your landlord, not between you, other tenants and your landlord. Your individual contract between yourself and your landlord does not apply to other contracts between the landlord and other tenants in the complex. You also have a monthly rent you agree to pay. Does everyone else have to pay the same monthly rent? You also have a number of people you state on your lease who will be living in the household. Does everyone else in the complex agree to the same number of people in their household? YOU agree that YOU will not have any pets in your lease. You could also have the understanding that the walls would be painted blue in the lobby but unless it's in the lease, your landlord can certainly repaint the walls without telling you, even though you might hate green walls. The landlord might also increase the price you pay for the washers on the first floor to 1.50 a load even though you had the understanding when you moved in that laundry would be 1.00 a load.

Certainly if you signed a lease that stated that this apartment complex was a 100% animal (not pet because ESAs are not considered "pets") free zone where no animals whatsoever would be allowed in the complex and you have proof that someone else is living with an animal in that complex, that may be a basis for you to assert that the landlord has breached your contract and you can exit your contract to find another place to live. Most leases do state that you have the expectation to reasonable quiet enjoyment of the property...if there are consistent noise complaints that your landlord is not able to resolve that you have documented, that may also be another basis to assert a breach of contract and exit your lease. Again though, your recourse is to exit the lease in all of these situations (AKA find another place to live), not to have the absolute right to make other tenants behave the way you want them to.

I think you're also weirdly operating under the assumption that all ESAs are loud animals that will incessantly keep the neighbors awake all night. Again, I'm not really in support of ESAs but this is a quite broad assumption.

There are other restrictions imposed by the federal/state/local governments besides the Fair Housing Act that affect other components of the landlord/tenant relationship. Framing these as "rights" is really an incorrect way to frame them. For instance, in my state, the landlord does not have the "right" to enter the residence whenever he wants...he has to give 24 hours notice. My landlord also does not have the "right" to evict me whenever he wants on a month to month lease unless I'm doing something illegal...he has to give 30 days notice to vacate. He does not have the "right" to withhold money from my security deposit unless he provides a written list of charges applied against the security deposit. Etc etc etc.

 

[Stagg737]

That being said, we also didn't make the rules with regards to this. I would definitely prefer this be decided like disability, but alas here we are being the final arbiter in this case.

Are we though? If I felt strongly enough that a patient NEEDED their ESA to be semi-functional then I'd certainly be talking about a formal disability eval and potentially having the animal trained as a service animal. I'd argue that if someone is so dependent on their pet for emotional support that they become totally non-functional from having to find other housing or losing the animal, then they should be getting a disability eval anyway.

I can think of very few situations where a patient isn't either just trying to get a pet into a pet-free unit or legitimately has SMI/disability, and in those cases it's likely worth it to contact the landlord or gain collateral to consider writing a letter.

 

[Mass Effect]

Your lease applies to yourself. It is a contract between you and your landlord, not between you, other tenants and your landlord. Your individual contract between yourself and your landlord does not apply to other contracts between the landlord and other tenants in the complex. You also have a monthly rent you agree to pay. Does everyone else have to pay the same monthly rent? You also have a number of people you state on your lease who will be living in the household. Does everyone else in the complex agree to the same number of people in their household? YOU agree that YOU will not have any pets in your lease.

Except if the complex bills itself pet-free, then that is a reasonable expectation by the person signing the lease. Often, these places specifically state in the lease "X Apts is a pet-free community" and if someone signs it, they can reasonably expect there are no pets. If a mental health professional writes an ESA letter and the landlord allows the ESA, they're infringing on the rights of those who chose that place because it's pet-free.

You could also have the understanding that the walls would be painted blue in the lobby but unless it's in the lease, your landlord can certainly repaint the walls without telling you, even though you might hate green walls. The landlord might also increase the price you pay for the washers on the first floor to 1.50 a load even though you had the understanding when you moved in that laundry would be 1.00 a load

You're arguing semantics that don't ordinarily appear in the lease.

Certainly if you signed a lease that stated that this apartment complex was a 100% animal (not pet because ESAs are not considered "pets")

Let's get real here. We can argue until the cows come home about whether or not ESAs are good, but let's not pretend these are not pets. They absolutely, 100%, definitely, certainly are pets. We just like to pretend they're not so we can pretend they're servicing our patients in some way, even if they're not service animals.

free zone where no animals whatsoever would be allowed in the complex and you have proof that someone else is living with an animal in that complex, that may be a basis for you to assert that the landlord has breached your contract and you can exit your contract to find another place to live. Most leases do state that you have the expectation to reasonable quiet enjoyment of the property...if there are consistent noise complaints that your landlord is not able to resolve that you have documented, that may also be another basis to assert a breach of contract and exit your lease. Again though, your recourse is to exit the lease in all of these situations (AKA find another place to live), not to have the absolute right to make other tenants behave the way you want them to

I'm not going to get into the legalities of what you can and can't do as a tenant when someone else gets an ESA because that was never the point of the thread. The point is that a tenant who moves into one of these buildings is doing so with the expectation that there will be no pets/animals and as mental health professionals, we should not be infringing on their rights to live in a pet-free environment when the entire notion of an ESA is based on minimal, if any, evidence. It's irresponsible.

I think you're also weirdly operating under the assumption that all ESAs are loud animals that will incessantly keep the neighbors awake all night. Again, I'm not really in support of ESAs but this is a quite broad assumption

I'm not operating under any such assumption. ESA can be any domesticated animal the patient wants designated an ESA and those do include loud animals. But again, this isn't even my objection. You're misrepresenting what I'm saying.

There are other restrictions imposed by the federal/state/local governments besides the Fair Housing Act that affect other components of the landlord/tenant relationship. Framing these as "rights" is really an incorrect way to frame them

As long as state and federal law considers them "tenants rights" and "landlord rights," I think I'll continue to frame them as such. Again, I'm not going to get into the nuances of the law as that isn't the point.

For instance, in my state, the landlord does not have the "right" to enter the residence whenever he wants...he has to give 24 hours notice. My landlord also does not have the "right" to evict me whenever he wants on a month to month lease unless I'm doing something illegal...he has to give 30 days notice to vacate. He does not have the "right" to withhold money from my security deposit unless he provides a written list of charges applied against the security deposit. Etc etc etc.

This does not negate anything I said and has nothing to do with anything. No one said that landlords have carte blanche to do whatever they want. You're arguing against a point no one made.

 

[calvnandhobbs68]

As long as state and federal law considers them "tenants rights" and "landlord rights," I think I'll continue to frame them as such. Again, I'm not going to get into the nuances of the law as that isn't the point.

Except if the complex bills itself pet-free, then that is a reasonable expectation by the person signing the lease. Often, these places specifically state in the lease "X Apts is a pet-free community" and if someone signs it, they can reasonably expect there are no pets. If a mental health professional writes an ESA letter and the landlord allows the ESA, they're infringing on the rights of those who chose that place because it's pet-free.

Where in any state or federal law are there tenants rights for other tenants to not have any pets? You're totally disregarding the fact that the lease is the contract and what's in the lease is what matters, aside from any other applicable federal/state/local laws. Whats in the contract is what matters. Just like any other contract.

Again, there are no "tenants rights" regarding places being or not being pet-free. So they are not infringing on anyones right to live in a place because it's pet free because no such right exists. If their animal is loud or disruptive, then yes they are infringing on other tenants rights to quiet enjoyment of the property, which is generally a right in most states.

For example:

• Landlords can write warnings or even evict a tenant with a service or emotional support animal if the animal is disturbing others, posing a threat to others or causing considerable damage to the property.

You're arguing semantics that don't ordinarily appear in the lease.

Semantics (or specifics of what is/is not in a lease) are exactly what's being argued here. It also does not ordinarily appear in any lease that you are living in an animal-free apartment complex, just that YOU are or are not allowed to have any pets. Nuances of the law IS the point. You can't frame something as someone's "right" to anything unless its actually been legally defined as a right. Just because someone would like to live in a pet-free building and they thought the building was pet-free when they leased the apartment, doesn't mean the landlord can't decide 3 months later that they'll allow pets and start allowing other tenants to have pets.

Let's get real here. We can argue until the cows come home about whether or not ESAs are good, but let's not pretend these are not pets. They absolutely, 100%, definitely, certainly are pets. We just like to pretend they're not so we can pretend they're servicing our patients in some way, even if they're not service animals.

From a legal standpoint, ESA and service animals are not considered "pets". That's what I'm referring to. I agree that from a practical standpoint, they're basically pets.

 

[Mass Effect]

Again, there are no "tenants rights" regarding places being or not being pet-free. So they are not infringing on anyones right to live in a place because it's pet free because no such right exists. If their animal is loud or disruptive, then yes they are infringing on other tenants rights to quiet enjoyment of the property, which is generally a right in most states


For example:

• Landlords can write warnings or even evict a tenant with a service or emotional support animal if the animal is disturbing others, posing a threat to others or causing considerable damage to the property.

Semantics (or specifics of what is/is not in a lease) are exactly what's being argued here. It also does not ordinarily appear in any lease that you are living in an animal-free apartment complex, just that YOU are or are not allowed to have any pets. Nuances of the law IS the point. You can't frame something as someone's "right" to anything unless its actually been legally defined as a right. Just because someone would like to live in a pet-free building and they thought the building was pet-free when they leased the apartment, doesn't mean the landlord can't decide 3 months later that they'll allow pets and start allowing other tenants to have pets.

From a legal standpoint, ESA and service animals are not considered "pets". That's what I'm referring to. I agree that from a practical standpoint, they're basically pets

I'm not going to go back and forth on this nonsense with you. Bottom line: I hope the courts will get to decide and I believe they will eventually. I never want to root against our patients, but in this case, I have to.

 

[calvnandhobbs68]

I'm not going to go back and forth on this nonsense with you. Bottom line: I hope the courts will get to decide and I believe they will eventually. I never want to root against our patients, but in this case, I have to.

Uh yeah cause there is no tenant right for other tenants to not have pets, no matter how a complex was advertised as “allowing” pets or not. The info about when animals become disruptive is right there in black and white. But hey let me know when you find that right spelled out somewhere.

There are a lot more persuasive arguments against ESAs than “other people who thought an apartment complex wouldn’t have pets in it have some “right” to live in a pet free environment”….including that ESAs are an overly broad concept that has no evidence behind it.

 

[Crayola227]

But why would you as a doctor attempt to figure out the landlord's reasoning? Why is this a medical thing at all? Lots of things would help to reduce stress and therefore improve symptoms in our patients, but we don't turn those into medical excuses. We don't write letters to reduce rent, get free gym membership, or get extra fruits and vegetables from the supermarket. Why is it okay for us to force an animal on a landlord who doesn't want them for whatever reason they feel?

Actually, there is a process with EBT to raise the amount of food stamps to accommodate medical need in diet for more expensive food, including for more produce. It's pretty onerous though.

I would only wonder about the landlord's intent in gauging how much I'm trampling the rights of other tenants, which if people are going to say that's a factor in NOT writing these letters, seems only fair to factor in, in the decision TO write the letter.

Doctors do factor in people besides the patient in making decisions for a patient all the time.

There are good alternatives to gym membership for fitness (except for maybe a pool, sometimes there are ways to get a patient subsidized/cheaper access). The shoes and shirt analogy is ridiculous.

There is not a good substitute for some kind of pet ownership.

It really does help keep people on this planet, like having a child might be protective to suicide.

If as a society we are going to make home ownership so impossible to attain for so many, then I think we need to reconsider the place of pets and how to keep greedy landlords from making the housing market a pet-free place or charging the poor pet rent.

But I may take the controversial view of pet ownership being a human right like healthcare (also controversial). That doesn't mean I think people should take every kind of pet everywhere.

 

[Crayola227]

Not quite:

Assistance Animals

www.hud.gov

A reasonable accommodation request for an assistance animal may include, for example:

• A request to live with an assistance animal at a property where a housing provider has a no-pets policy or
• A request to waive a pet deposit, fee, or other rule as to an assistance animal.

In any case, though, read what the landlord can do:

"The housing provider has not demonstrated that:

Granting the request would impose an undue financial and administrative burden on the housing provider

The request would fundamentally alter the essential nature of the housing provider’s operations

The specific assistance animal in question would pose a direct threat to the health or safety of others despite any other reasonable accommodations that could eliminate or reduce the threat

The request would not result in significant physical damage to the property of others despite any other reasonable accommodations that could eliminate or reduce the physical damage"

This addresses most of the arguments people have brought up. If the neighbor has anaphylaxis, the landlord has recourse to deny the request. If their whole operation is based in being pet-free for allergy sufferers, they have recourse.

 

[Crayola227]

But again, why should landlords be forced to do that and why should people who intentionally choose to live in a place without pets be forced to live with them? That's what I want to know. Why is it we accept that we can't force Piggly Wiggly to allow ESAs, but we strongarm landlords into dealing with it?

Because not being able to have your animla in your place of residence is different than having to leave them at home to go to the convenience store.

 

[Crayola227]

As an individual I don't like the righst issues of forcing ESAs on others, but as a professional, I'm more worried that other professionals are so readily willing to essentially "prescribe" something that doesn't have an empirical basis in and of itself. Particularly when you can counsel the patient to do other things (e.g., diet, exercise, socializing, etc) that actually have an empirical basis, with fairly large effect sizes well above and beyond having pets.

I don't see a benefit or empirical basis to allowing an anxious patient to never leave the house without their ESA, that is probably maladaptive.

However living alone with no other mammals I think is horridly unnatural for human beings, and we have evidence that it is bad for them. There is some evidence about the health benefits of pet ownership.

I don't agree there is no evidence a patient is not better served not coming home to an empty apartment, especially with certain mental illnesses.

It would probably be better for the patient to have a roommate or seek humans some way, and maybe one should think about if the pet prevents this. However that isn't always feasible and sometimes a substitute mammal is needed.

We go off label all the time and this is one example where I would because it makes sense.

 

[Crayola227]

Hold up, if I move into a complex, sign a lease that acknowledges the rules, including no pets, then under contract, I have a right to literally expect no pets, do I not? No, I don't have a right to just move into any building and dictate no pets, but if I intentionally move into a building that doesn't allow pets, then I'd argue I have every right to expect that the rules I signed up for apply and that I won't be exposed to pets.



Babies and people walking, no, but that isn't what I'm discussing. Most apartment complexes have rules on noise. If a patient wanted a letter to excuse them from that rules on noise, most of us wouldn't write it. Yet some don't think twice about ESAs.



The landlord absolutely has the right to impose pet and noise restrictions. We're not talking about other restrictions so I don't know what you're referring to.

As for noise, that also applies to animals for disabilities.

Also the patient that needs sound, there are all kinds of options for wireless earbuds that can connect to just about anything (radio, computer, tv) and you can wear one and leave the other out to still hear aroud you. Or other portable speakers so it wouldn't be too loud for the neighbors. The patient who is deaf in one ear AND needs really loud music to function and can't use these solutions is going to be fairly rare.

Because of ADA and ADA animals, no one actually can expect that they move into an apartment and there's ZERO chance of any pet neighbors, any more than you can expect no children. (Not sure how that works in 55 and older parks and such....)

 

[VA Hopeful Dr]

In any case, though, read what the landlord can do:

"The housing provider has not demonstrated that:

Granting the request would impose an undue financial and administrative burden on the housing provider

The request would fundamentally alter the essential nature of the housing provider’s operations

The specific assistance animal in question would pose a direct threat to the health or safety of others despite any other reasonable accommodations that could eliminate or reduce the threat

The request would not result in significant physical damage to the property of others despite any other reasonable accommodations that could eliminate or reduce the physical damage"

This addresses most of the arguments people have brought up. If the neighbor has anaphylaxis, the landlord has recourse to deny the request. If their whole operation is based in being pet-free for allergy sufferers, they have recourse.

Sure, but has that ever happened?

 

[Crayola227]

Because not being able to have your animla in your place of residence is different than having to leave them at home to go to the convenience store.

To expound on this and what I was saying about mammals needing mammals, I don't know that it's reasonable for someone to be unable to go grocery shopping without their pet/ESA, but I think needing a pet at home emotionally might be very reasonable.

I think for a lot of reasons people might not have an intimate partner or children. I think some people can adapt to this way of being, I think a lot of people struggle and I don't think that's abnormal in any way. I think a lot of the connections we now lack in our society is wholly unnatural and I'm not surprised or think it's pathological people struggle without the connections they would otherwise have in a small tribe with no access to birth control.

People also can forget how isolating in our society having a disability is. It can take people many, many years to build a new social network when they develop a disability. It is more challenging than you might think.

A pet at home could be a small stopgap measure for someone alone, disabled, limited funds, ability to go out, or is in an abusive relationship. Yes, the answer is to leave abusive relationships and find ways to cope and adapt and find people that love you despite your disabilities. Assuming you don't just complete suicide first. It's a harder thing to do when a loving furry companion is staring you in the face.

How is someone crippled by loneliness supposed to find the emotional strength alone to get a better diet, go out and exercise, and make friends? For a lot of patients their therapist and small animal are absolutely seen as safe social contacts to help mitigate loneliness, stabilize their mental health, and hopefully work on other aspects to help their MH. But to tell the depressed person living alone, hey, forget the dog and hit the gym, sounds totally ridiculous to me.

The law has recourse for landlords and neighbors to deal with unruly pets.

I'm just not seeing the harm unless the person becomes overly reliant on an ESA for ADLs.

 

[Mass Effect]

Uh yeah cause there is no tenant right for other tenants to not have pets, no matter how a complex was advertised as “allowing” pets or not. The info about when animals become disruptive is right there in black and white. But hey let me know when you find that right spelled out somewhere.

There are a lot more persuasive arguments against ESAs than “other people who thought an apartment complex wouldn’t have pets in it have some “right” to live in a pet free environment”….including that ESAs are an overly broad concept that has no evidence behind it.

You don't think patients who are deathly allergic to cats have a right to live in a place that doesn't allow cats? Really? Who the hell made one argument at the exclusion of others?? Even I specifically listed other arguments against it. But jsut because there are other arguments does not mean that the argument that people allergic to animals should not have to be forced to live around them is invalid, no matter how much you want it to be.

 

[Stagg737]

Uh yeah cause there is no tenant right for other tenants to not have pets, no matter how a complex was advertised as “allowing” pets or not. The info about when animals become disruptive is right there in black and white. But hey let me know when you find that right spelled out somewhere.

There are a lot more persuasive arguments against ESAs than “other people who thought an apartment complex wouldn’t have pets in it have some “right” to live in a pet free environment”….including that ESAs are an overly broad concept that has no evidence behind it.

I mean, peanut butter is basically outlawed in many pre-schools and elementary school classrooms because kids are allergic. I can't make my kid a PB&J because another kid in another classroom might get a whiff of it and go anaphylactic. It's a pretty congruent analogy to pets in an apartment building. Pretty sure if this goes to court those advocating ESAs are going to lose if the plaintiff has any kind of medical condition...

 

[Mass Effect]

Actually, there is a process with EBT to raise the amount of food stamps to accommodate medical need in diet for more expensive food, including for more produce. It's pretty onerous though.

I would only wonder about the landlord's intent in gauging how much I'm trampling the rights of other tenants, which if people are going to say that's a factor in NOT writing these letters, seems only fair to factor in, in the decision TO write the letter.

Doctors do factor in people besides the patient in making decisions for a patient all the time.

There are good alternatives to gym membership for fitness (except for maybe a pool, sometimes there are ways to get a patient subsidized/cheaper access). The shoes and shirt analogy is ridiculous.

There is not a good substitute for some kind of pet ownership.

It really does help keep people on this planet, like having a child might be protective to suicide.

If as a society we are going to make home ownership so impossible to attain for so many, then I think we need to reconsider the place of pets and how to keep greedy landlords from making the housing market a pet-free place or charging the poor pet rent.

But I may take the controversial view of pet ownership being a human right like healthcare (also controversial). That doesn't mean I think people should take every kind of pet everywhere.

There are literally plenty of places people who want pets can rent an apartment. Why insist on "keeping greedy landlords from making the housing market a pet-free place or charging the poor pet rent"? Sorry, but no. Landlords are not greedy for wanting to protect their property from damage or provide a place for those who don't want or can't be around pets to live. If animals were so great at curing mental health, there would be more evidence for it. There isn't.

 

[Crayola227]

Sure, but has that ever happened?

Not sure, digging around

3 Reasons Your Landlord Can Prohibit Your ESA From Living with You

Legally, landlords must not factor your ESA into a renting decision. However, there are certain provisions you must follow if you want to rent with an ESA.

mooshme.com

It might have to go to court. The landlord would have to take action against you, and then one or both parties go to court and the judge looks at the situation. I don't see why the landlord, if they had evidence, would have trouble with it. But that would probably be up to the judge to decide.

From what I can tell, these things usually don't go in the pet owner's favor if the animal is some kind of nightmare.

Also note there is an exemption landlords can deny ESA for a single family dwelling not rented by a realtor, and if there are less than 4 units, or 4 units and the landlord lives in one.

 

[Mass Effect]

Because not being able to have your animla in your place of residence is different than having to leave them at home to go to the convenience store.

Then I suggest finding a place to live that allows pets. There's plenty of them around. I shouldn't have to change my wants to accommodate your problem.

 

[Crayola227]

I mean, peanut butter is basically outlawed in many pre-schools and elementary school classrooms because kids are allergic. I can't make my kid a PB&J because another kid in another classroom might get a whiff of it and go anaphylactic. It's a pretty congruent analogy to pets in an apartment building. Pretty sure if this goes to court those advocating ESAs are going to lose if the plaintiff has any kind of medical condition...

OK, well, it goes to court and they lose. Problem solved. But the point is it actually has to be a problem for it to be a problem, which sounds fair to me.