Supporting Rights to Emotional Support Animals as an Accommodation: A Scoping Review of Professional Guidelines for Verifying Eligibility

When the emotional support provided by a person’s animal helps to mitigate an aspect of a disability, that person has a right to have their animal, typically referred to as an emotional support animal (ESA), within their housing as a disability accommodation under the Fair Housing Act (FHA) in the United States. Health and mental health care professionals (henceforth referred to as “health-care professionals”) are considered a reliable source for verification of eligibility for ESAs as a disability accommodation, and guidelines have emerged within and across professions to help guide assessment and documentation. These guidelines are published in the form of peer-reviewed journal articles and position statements from professional groups, such as primary care physicians, nurse practitioners, psychologists, counselors, social workers, and psychiatrists. We used scoping review methods to identify guidelines across psychiatry, medicine, nursing, counseling psychology, and social work, then analyzed the guidelines using a competency-focused framework. and compared them to the legal requirements of ESA documentation. Guidelines often reflected the values underlying the profession, but agreement was generally seen in most areas of knowledge, skills, and attitudes. Recommendations for integrative best practice guidelines, across professions, are proposed along with specific recommendations for writing ESA letters.