Service dog for bipolar

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How a Psychiatric Service Dog Can Help Bipolar Symptoms

By bp Magazine

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    Service dogs can help in important ways; here are just three:

    #1 Assists during hallucinations

    For those who struggle with hallucinations or paranoid delusions brought on by severe manic episodes, a service dog can provide a link to reality. Most psychiatric service canines are trained to alert their owners to anything that is unusual or out of the ordinary around them; so even in the midst of visions/hallucinations, the owner can realize there is nothing happening because their dog is not alerted, because there is nothing to see.

    #2 Interruptions and distractions

    Trained service dogs can interrupt harmful behaviors, such as self-injury. They can also do a great job at interrupting the negative thought loops that can be prevalent in bipolar mania. Same thing for people struggling with obsessive compulsive disorder: the service animal could be the only thing able to provide a distraction from this sometimes debilitating behavior.

    #3 Grounding the owner during a panic attack

    Service dogs are trained to be physically comforting to their owners in times of extreme stress. Some will drape themselves across the lap of the person. They can also serve as a brace if their owner becomes disoriented or dizzy. These dogs are able to preemptively guide their owners away from situations that are possible triggers to having a panic attack for their humans. When their owner starts to feel unsafe, the dog will automatically start guiding away.

    resources: caninejournal.com

    • Dogs are man’s best friend, the old saying goes.

      But now there is scientific evidence that dogs – and cats, birds and even Guinea pigs – not only serve as a best friend to many people with bipolar or schizophrenia, but may also be a critical component to their recovery and mental stability.

      Research published in December in BMC Psychiatry showed that most people with bipolar and schizophrenia placed their pets in “the central, most valued circle of support,” per the paper.1 “Pets constituted a valuable source of illness work in managing feelings through distraction from symptoms and upsetting experiences, and provided a form of encouragement for activity.”

      The researchers, psychiatrists from the University of Manchester in England, said that despite their findings, “Pets were unanimously neither considered nor incorporated into individual mental health care plans.”

      The sample of 54 adults, 25 of whom had pets, all had a diagnosis of bipolar disorder or schizophrenia. The researchers conducted interviews with the subjects and also had them map their relationships with others.

      It’s just the latest study to demonstrate the emotional support pets offer people suffering from mental illness. Increasingly, pets are even being “prescribed” to people in the U.S. suffering from post-traumatic stress disorder, or PTSD. The pets often are highly trained to perform a variety of tasks to help people with PTSD manage anxiety.

      Of course, pets also require a considerable degree of care and responsibility from their owners. But it’s that responsibility, as well as the pride of providing care to another living being, that conveys many of the therapeutic benefits that people with mental illness are sadly not getting from their fellow humans.

      Pets Offer Responsibility, Purpose

      In various interviews, people in the study described how their pets made them feel. Sixty percent of the subjects placed their pets inside the circle of those considered most vital to their emotional stability.

      “It was often the case that where relationships with family and friends were seen to be good, animal-human relationships were perceived to be of secondary importance,” the authors reported. “However, the majority of people reported either having difficult relationships with other network members including friends and family or had little or limited other network support in addition to their pets.”

      Said one subject in the study, “Although my mum and dad are very significant figures, they’ve also got their own lives and lots of others things going on so I’m only one aspect of that life, and I feel that the pets I suppose, they depend on me, and also I have daily contact with them, and they also give me a sense of wellbeing.” She placed all 10 of her birds in her inner circle.

      Many subjects reported that if it weren’t for their pets, they might not even get out of bed some days. But they know they must feed and tend to their animals, particularly those that require going outside.

      “And I just try and make sure that I walk him…but sometimes I can’t be bothered to do that, but then I think…I…I think about, you know, that’s not fair ,” said another subject.

      In a story reported by CNN, Lori Marino, a psychology professor at Emory University, said she has worked with a homeless pet rescue. It was her job to decide whether a person would be granted a pet. She said if someone said, “I want this dog because I am depressed and need a pick-me-up,” she would “always decline that person,” adding “It’s not fair to the dog to go to a home that’s not emotionally healthy. A dog shouldn’t be used as medicine.”2

      Pets Help People in Recovery ‘Get Out of Self’

      Few would argue that making sure a pet goes to an owner who takes care of it is vital. But the Manchester study, although the sample was small, demonstrated that most people with mental illness who had pets had them because they loved and appreciated them. Only one subject expressed some dismay about her pet, saying he was “blocking the achievement of aspirational goals associated with recovery, such as travel,” the authors wrote.

      “The only thing is, my future plans revolve around saving up as much money as possible and traveling for as many years as possible which means dogs and cat that I’ve got I won’t be able to keep,” the subject reported.

      A person in mental health treatment considering getting a pet may want to talk about it first with their physician or therapist if they have any doubts. Caring for a pet is essential and not doing so is not only irresponsible and not fair to the pet, but can also lead to criminal charges.

      However, most people in the Manchester study said again and again that the pets gave them purpose, and that they gained a sense of pride from providing excellent care for their animals. In other words, pets gave people in recovery “something bigger than themselves,” as they say in 12-Step circles, which can be critical to getting out of “self” and remaining focused on recovery. Other people have cited caring for their young children or their elderly parents in such ways that helped motivate and sustain their recovery.

      Pooches Bring Peace to People with PTSD

      Increasingly, pets – dogs, in particular – are being found to be highly effective mental health treatment for American veterans returning from war with PTSD.

      Recently, a video went viral on the Internet of a veteran with PTSD lighting up and even breaking into tears when he is presented with a beagle puppy. The video had more than half a million page views, and can be viewed by clicking here.

      The owner of the pet is Peter Coukoulis of Tallahassee, Florida. Like many veterans, he recently returned from war with PTSD. Even Peter’s homecoming celebration and the media hype surrounding his puppy video were triggers.

      Peter, like many people with PTSD, cannot handle large crowds. As a result, he largely sticks to himself, which has been concerning for his family and friends. So, they got him the beagle.

      When Peter returned from Afghanistan, he learned the longtime family beagle that he grew up with had died. At the same time, his marriage ended, as do so many military marriages do when a veteran returns with PTSD.

      Some veterans and even civilians with PTSD and other anxiety disorders are being “prescribed” highly trained dogs by their doctors. For example, the dogs can be “trained to provide tactile and pressure stimulation” for their owners and “block off people to separate them from the veteran when that’s needed,” reported Lee Enterprises, which owns newspapers across America.3

      “They can sense when you’re having a trigger (a PTSD episode) before you know you’re triggering,” explained Denise Wenz, a Wisconsin National Guard veteran who trains the dogs. The dogs even can be trained to nibble at a veteran’s feet when they begin having seizures or nightmares.

      “What’s really great in the dogs is they give you a break in the timeline,” Wenz told Lee. “They can pull you back into reality.”

      Laws Restricting Service Dogs for Those with Mental Illness in Some Areas

      Unfortunately, the notion of taking dogs into public places for emotional support is still being challenged in some courts around the country. While the Americans with Disabilities Act does provide protections for people who use service animals, the law pertaining to what a “service animal” entails is not written in such a way that gives legitimacy to the use of the dogs beyond more established purposes, such as to help the blind.

      A website called Service Dog Central provides extensive information for those seeking legal permissions as it pertains to service dogs. The site has a search tool and can provide state by state information.

      Another organization called Heeling Allies explains how service dogs can be used to help teens and adults with Tourette Syndrome.

      It can cost between a few thousand to several thousand dollars to train a dog. Some communities have local veterans’ organizations and other groups that can pick up the tab.

      But for others, simply obtaining an animal from a shelter at little or no cost may offer tremendous mental health benefits, so long as the prospective owner is ready for the responsibility.

      “Successfully caring for a pet could provide a source of validation,” the authors of the Manchester study wrote. “Pet owners talked about the pride associated with having a pet that was seen to be well loved and well cared for. Given the high levels of unemployment and isolation within the sample, participants had limited other opportunities to develop this form of validation.”

      Written by David Heitz

      Psychiatric Service Dog

      A Psychiatric Service Dog is like any other service dog. It is specially trained to do very specific tasks for the person with a mental illness.

      It’s important to note that the Psychiatric Service Dog may also be called an Emotional Service Dog, but they are not the same as an Emotional Support Animal. Psychiatric service dogs are there to perform tasks that enable its handler to function in a normal ordinary fashion.

      In this post, we will cover what you need to know about the Psychiatric Service Dog, the most common conditions these dogs can help with and how they can assist their handler.

      Overview of Psychiatric Service Dogs & Access Rights
      To be eligible for a Psychiatric Service Dog you must have a mental disability as defined by the Americans With Disabilities Act. The ADA defines a mental disability as;

      “Any mental or psychological disorder, such as mental retardation, organic brain syndrome, emotional or mental illness, and specific learning disabilities.”

      Once you have been accepted and have obtained your PSD, you are not required to disclose your disability to anyone OR provide proof. This is different from the ESA where you may be asked for proof under Federal Law.

      Service Dogs for Post Traumatic Stress Disorder (PTSD)
      Post Traumatic Stress Disorder is classified as an anxiety disorder. It may affect those that have gone through an extremely stressful or life-threatening situation. PTSD has been successfully treated with the aid of a Psychiatric Service Dog. Some of the tasks these specially trained canines can do are;

      • Help block person in crowded areas
      • Calm the handler using deep pressure therapy
      • Retrieve medications
      • Provide security enhancement tasks (such as room search)
      • Interrupting destructive behaviors

      Service Dogs for Depression
      People who suffer from severe depression often times do not want to leave their home. They have constant negative thoughts and are sometimes suicidal. A PSD can help the depressed person get back to living a normal life by;

      • Providing comfort and support
      • Retrieving medications
      • Providing tactic stimulation by licking the face
      • Recognize the signs of a panic attack
      • Gives the person a sense of purpose (dog must be fed, walked, etc.)

      Service Dogs for Anxiety
      Anxiety can strike us at any time, but for those that have chronic anxiety, life can be difficult. This condition can create excessive uneasiness and apprehension and will typically lead to compulsive behavior or panic attacks. A PSD can be trained to help this condition by;

      • Keeping the person grounded by licking or pawing
      • Applying deep pressure therapy (dog lies across the handler’s body)
      • Recognizing the signs of a panic attack
      • Retrieving medications
      • Leading person out of a building
      • Alerting a loved one
      • Finding/bringing a telephone
      • Blocking people from crowding you

      How Do I Register My Psychiatric Service Dog?

      Step #1 – Train your dog to provide a psychiatric service dog task

      Your PSD can be trained to perform a number of different tasks (we touched on some of these earlier) and it is dependant on your individual needs. The most common tasks the Psychiatric Service Dog performs are;

      • Guide the handler – this may be required if the person suffers from a dissociative disorder.
      • Find a person/place – people who suffer from severe anxiety may become disorientated in a large crowd, The PSD is trained to locate a people and places.
      • Room Search – the PSD can be trained to perform a room search to help those that suffer hypervigilance caused by PTSD.
      • React/Alert to specific sounds – alert the person to smoke or security alarms.
      • Interrupt and Redirect – obsessive compulsive destructive behaviors
      • Balance Assistance – for those that may need the added security when walking (eg. those that may have to take tranquilizers to stay calm).
      • Retrieve Medications

      Register Your Service Dog

      Once your dog is trained you may want to register it with a service dog registration organization. Although it is not legally necessary to register your PSD, there are benefits to doing so. These organizations can provide you with the proper identification for your Psychiatric Service Dog like vests, ID badges and a certificate of registration. These all come in handy when taking your service dog into public places as you may be asked for proof of your service dog certification. In addition, be sure to only register your service dog with a reputable organization to ensure your service dog certification is legitimate.

      Get Back to Living
      Having a trained service dog means you can get back to living. You can travel with confidence knowing your canine companion will be there to help you through any situation you may find yourself in.

      PSD or ESA?
      If you suffer from a mental or emotional disability and don’t have the resources to train a canine for service, you may be eligible for an emotional support dog/animal. The ESA is there to provide you with comfort and unconditional love, but will not be trained to do any specific task. Ask your mental health professional if an ESA may be right for you and your treatment plan.

      Psychiatric Service Dogs Work
      Don’t live another day with a severe mental or emotional disability when Psychiatric Service Dogs work! They are so much more than “just a pet.” The PSD is there to calm you down, retrieve your medications and allow you the freedom you need to live a normal life.

      Can animals get mental diseases like bipolar disorder?

      The biggest indicator of neuropsychiatric diseases to which you refer (i.e. bipolar disorder) comes through speech and personality. It’s very hard to gauge these things in animals, much less diagnose them for a household pet. These are mainly human diseases, because they affect the social aspects of personality–aspects that are absent in animals. Studies of depression in animals abound–most basic science research for clinical depression (the neurological basis, that is) stems from an animal model called Social Defeat–whereby the animal (usually a mouse) is consistently beat up by an aggressor mouse. Some mice eventually become “defeated,” and show trademark signs of Social Defeat–decreased exploratory behavior, reduced eating, timidness, etc. Some mice show resilience to Social Defeat (i.e they can become normal again), others show total resistance (i.e. they never become defeated), and others become more or less defeated for life. The neurological basis for these disorders is an ongoing area of study. Changes in Dopamine levels in the striatum have been implicated, and electrophysiologists have begun to look for changes in firing patterns of neurons in key areas (i.e. the nucleus accumbens). But the jump from mouse depression to human depression is a very large one obviously–the underlying cause may be the same, and perhaps the drastic increase in complexity of the resulting phenotype in humans as opposed to mice simply reflects the complexity of our social lives.

      There are indeed many animal models for neurodegenerative disorders, such as Alzheimer’s Disease, Parkinson’s Disease, Dystonia, etc. Most involve either a specific part of the brain degenerating (i.e. the dopaminergic cells of the Pars Compacta region of the Substania Nigra in Parkinson’s) or more general loss of function due to things like buildup of plaques (i.e. Amyloid Beta plaques in Alzheimer’s) or neurofibrillary tangles (when the part of the neuron that maintains its internal structure breaks down). All of these are observed in animal models (mostly mice) and have a large genetic basis, which would probably leave animals susceptible as well.

      One thing to note is that most of these neurodegenerative diseases such as Alzheimer’s usually don’t occur until much later in life–it’s sometimes accidentally called “Old Timer’s Disease” for a reason: it occurs primarily in the elderly. Whether it’s a function of total age, in which case few animals measure up to our lifespan, or whether it is of relative age to your species, is not really known, but it’s something to think about. Alzheimer’s is a relatively “new” disease, because people didn’t use to live long enough to actually get it.

      I’ve never heard of a dog having classic dementia, but in part because dogs are already of such low intelligence compared with humans that it would be difficult to tell. Does a dog ever remember what year it is, or what they had for breakfast? The only thing we could measure would be general decreases in cognitive function, and isolating the regions of interest to better determine the specific neurological disease would be pretty much impossible without a full autopsy.

      EDIT: see my comment below. There is a well-known form of dementia in canines known as canine (and presumably feline in cats) cognitive dysfunction.

      Hi, I’m Brooke Alexander and thanks for joining us on Spotlight on Bipolar. On this episode, we are talking about pets and bipolar disorder.

      We’ve all heard that dogs are man’s best friends. Well, doctors are now finding that dogs and other animals help therapy, too.

      Across the country, trained volunteers are finding success with Animal Assisted Activities known as AAA for short.

      This program involves bringing docile animals such as dogs, cats, rabbits and even pigs in the hospitals and nursing homes.

      Volunteers say interaction with other living creatures helps decrease aggressive behaviors in patients while also improving their social interactions in the outside world.

      Animals are also being used at the Mayo Clinic and other institutions as part of more formal therapy sessions known as Animal Assisted Therapy or AAT.

      These programs have shown that the presence of an animal can make the therapists and the therapy process seem less threatening to a patient.

      Sometimes a person that’s extremely depressed doesn’t want to talk. A great way to help them through this is to bring an animal into the room

      and if you can get this person to discuss how the animal feels, they can start to open up about their feelings and this is a great door opener up for the therapist.

      The Delta Society, founded in 1977, is one of the largest organizations facilitating both Animal Assisted Therapy and Activities.

      Their pet partners program now offers over 10,000 human animal teams in the US and 13 other countries.

      For information on their programs, check out their website at www.deltasociety.org.

      Not only are pets helpful in treatment but pet ownership can also bring everyday social and emotional benefits to people with bipolar disorder.

      Based on a study of farm life, one prominent mental health journal reported that routinely caring for animals can boost self-esteem and promote confidence.

      But occasionally, it gets you to a certain point. It doesn’t give you a reason to live. It doesn’t get you out of bed in the morning but having a dog does.

      By taking a dog out helps take you out of yourself and no other treatment can do that.

      In a 2002 survey conducted by the American Animal Hospital Association, 76% of pet owners claimed their pets significantly lowered their stress levels.

      And according to experts, low stress are a big plus for managing BP. Pet ownership additionally teaches you to love and care for another creature.

      When I first got Ozzy or my furry anti-depressant as I’d like to say, he needed to be walked, he needed to be fed. The only side effect that came was unconditional slobbery love.

      And to ensure that everyone can benefit from animal companionship, highly trained therapy dogs are available for special needs pet owners from the ASPCA among other animal organizations.

      These therapy dogs can assist people with mental health disorders by reminding you when to take your meds or alerting you to door bells, phones or smoke detectors when you are sedated.

      And even recognizing signs of an oncoming panic attack and preventing others from crowding you so that you can calm down.

      In many cases, therapy dogs are covered for people with bipolar disorder under the American with Disabilities Act.

      To find out if you qualify, visit the ADA website at www.ADA.gov. And that is it for this episode of Spotlight on Bipolar. We’ll see you next time.

      Bipolar Disorder and Psychiatric Service Dogs—Things to Consider

      By Brooke Hilton

      • Post Views: 15,923 Views

        While there are many benefits of psychiatric service dogs, there are also a lot of factors to consider.

        I recently read a report by BBC from last year, which noted that Dr. Iris Schobarl, of the University of Vienna, discovered “both owners and dogs influenced each other’s coping mechanisms, with the human partner being more influential than the dog.”

        In theory, that all sounds great. Dogs are always there for you, they can help you calm down when anxious and help you not feel so alone. In fact, my dog is my best friend and confidant. He loves my writing, he’s actually my biggest fan. He snuggles with me when I’m sad and hugs me when I need it. These lovely creatures truly have been man’s best friend for 30,000 years!

        But, considering the research… what happens if you decided to get your trusty pup when manic out of your mind?!? In my case, I bought Lefty, my left hand man, at the peak of a manic state. I just HAD to have a German Short Haired Pointer! If you aren’t familiar with this breed of dog, it’s probably because they aren’t recommended as inside pets. They have boundless energy and can most likely be found hunting birds in the middle of Tennessee, not in a one bedroom apartment in East L.A. These dogs may even remind you of… that’s right… someone suffering from a manic episode!

        I absolutely adore Lefty, but he is challenging for sure. However, he gets me out of bed on days when I don’t want to see anyone and he forces me to engage with life. He is also a constant reminder for me to TAKE MY MEDICINE. He is absolutely, off the wall, bonkers, and I love him to death. I would recommend that anyone get a psychiatric service dog, but I promise you, you’ll be much better off if you do so when not in a manic state! What’s your experience with psychiatric service pets and bipolar disorder?

        Learn more:

        VIDEO: Bipolar Impulsivity—The Power of Now versus the Problem with RIGHT NOW

        • Psychiatric Assistance Dog Use for People Living With Mental Health Disorders

          Introduction

          Dogs and other animals have been helping people with physical disabilities and providing emotional support for centuries, with the first therapeutic use reported in the ninth century (1). Nowadays, assistance dogs (or service dogs) are trained to perform tasks to mitigate a range of physical, psychiatric, or intellectual disabilities for their handlers (owners) (2) as well as being trained for public access. A psychiatric assistance dog (PAD) is a specific type of service dog that is trained to assist its owner who has been diagnosed with a mental health condition, such as post-traumatic stress disorder (PTSD), schizophrenia, depression, anxiety, or bipolar disorder. In Australia, PADs, like other assistance dogs including guide dogs and hearing dogs, are covered under the Commonwealth Disability Discrimination Act 1992 that guarantees public access for all dogs trained as assistance dogs. PADs are distinct from emotional support dogs (ESDs) (sometimes called therapy dogs). An ESD (or other animal) is a pet that provides emotional support to an individual to relieve various disabling conditions. However, the animal is not necessarily trained to do so, and service dog legislation in Australia does not permit an ESD to access public areas where dogs are normally prohibited.

          PADs can be of any breed or size suitable for the intended purpose of helping people to access public places, travel on public transport and take part in social activities that are “closed off” to them. PADs can be trained by the person who will become the dog’s handler (owner-trainer) or in combination with a qualified trainer, while others are trained exclusively by assistance/service dog provider organizations. In Australia, anyone who has been diagnosed with a mental health condition by a medical doctor or other suitable health care professional is eligible to apply to accredit such a dog. However, literature searches reveal that little is known about the population of people who own PADs inclusive of mental health diagnoses, origins and types of dogs used or the functions they provide. A better understanding of peoples’ needs and the relationship between owners and their dogs will help inform the appropriate choice, training and use of assistance dogs for people living with mental health issues. Hence, PAD owners (clients) registered with the charity “mindDog” were invited to participate in an anonymous on-line survey to explore these matters.

          mindDog is an Australian not-for-profit organization that helps people who have been diagnosed with a mental health condition/s procure, train and accredit PADs. Information on the mindDog accreditation process can be found in Box 1 (the application form) and Figure 1 (assessment, training and follow-up of the person-dog team). More information on mindDog, including the training standard and the Public Access Test (PAT), can be found at www.minddog.org.au/.

          Box 1. Summary of the mindDog application form.

          The application form for accreditation of a mindDog is in three parts and includes:

          Part 1: Details about the applicant and the dog: Ensuring dogs are of an appropriate age, desexed, microchipped, registered, vaccinated, and have access to suitable veterinary care.

          Parts 2 & and 3: The opinion of the applicant’s health care provider, and other referee, regarding the applicant’s ability to care for a dog and how the dog might assist the applicant.

          The application form also seeks information on assurance of care for the dog if the owner was unable to do so.

          FIGURE 1

          Figure 1. The mindDog accreditation process (www.minddog.org.au/the-process).

          Materials and Methods

          All active clients (N = 600) registered with mindDog in February 2018 were invited to participate in an anonymous survey via SurveyMonkey cloud-based software. Questions were forced-choice, multiple-choice, “other” (for free-text to be inserted) or binary (yes/no). Comments on peoples’ relationships with their dogs were also sought. Chi-square tests for independence were performed to assess potential associations between owner diagnosis and: the tasks the dog performed, the type of dog used, and the likelihood of changes to health service utilization.

          The descriptive results of the survey are presented below. The data obtained from the open-ended (comments) section on peoples’ relationships with their dogs was coded into categories and themes, as per Wang and Park process of qualitative coding. While a full thematic analysis is outside the scope of this article, and will be published elsewhere, a synopsis of this preliminary data is presented below.

          Results

          Owner Demographics

          Depression (84%), anxiety (social 61%; generalized 60%), PTSD (62%) and panic attacks (57%) were the most self-reported mental health diagnoses of this population (Figure 2), with many clients citing multiple diagnoses. Frequently reported mental health diagnoses in the “other” category included Obsessive-Compulsive Disorder, Autism Spectrum Disorder (ASD) and eating disorders.

          FIGURE 2

          Figure 2. Percentage of participants (N = 199) diagnosed with specific mental health conditions.

          Dog Demographics

          The breed of dogs in the sample varied widely with several dozen purebred and crossbred breeds identified. Age ranged from around 1- > 10-years; gender was evenly distributed. Most dogs were acquired from a registered breeder (48%) followed by an animal shelter (21%) and non-registered breeders (16%).

          The most common reasons for people to choose a dog to be a PAD were temperament (60%) followed by size/weight (48%), with only 15% of participants saying that they chose the dog based on its physical appearance. Just under half (48%) of the dogs had been acquired by the owner specifically to be trained as a PAD, and the rest were existing pets.

          All the dogs were trained by either the owner or a combination of the owner and a qualified trainer; none were trained exclusively by assistance/service dog provider organizations.

          Tasks

          FIGURE 3

          Figure 3. Tasks performed by the psychiatric assistance dogs for the participants (N = 199).

          The most common tasks listed in the “other category” were: “making” the owner leave his/her bed/house; “reminding” the owner to take his/her medication; keeping the owner “safe”; “sensing” owner’s emotions and behaviors and thus preventing manifestation of an undesirable behavioral state; and providing a “reality check” from anxiety or dissociation/hallucination.

          Outcomes

          PAD usage decreased (46%), increased (30%), or did not change (24%) participants’ use of psychiatric or other health care services. An analysis of the accompanying narrative pertaining to changes in the use of psychiatric or other health care services revealed that reductions in use of services were mainly due to reduced suicide attempts, less need for hospitalizations, and less requirement for medication. Increased service use was mainly due to enhancement of the owners’ ability to attend appointments, as the presence of the dog increased peoples’ confidence—both in venturing outdoors and in interacting with others.

          No statistically significant associations were found between the owners’ mental health diagnoses and: the tasks the dog performed, the type of dog used, and the likelihood of changes to health service utilization. No other relationships within the dataset were found.

          Owner-Dog Relationship

          Several themes emerged from the preliminary thematic analysis of the owner-dog relationship including: Independence; Confidence; Social function; Companionship; Safety and Hope. Every pertinent response (n = 198) to the question: “What does your mindDog mean to you?” indicated a positive partnership, as exemplified by the following quotes:

          “Before I had I was so anxious I couldn’t even leave the house and I had never had someone to look after before. She has changed my life so much; everyone I know says it and my psychiatrist thinks she’s amazing. Once became qualified as a minddog I have been able to travel to so many more places and be able to do things independently. I don‘t think I could have done that without her. This also means that I can do things on my own now that in the past I would have needed more help with or been in hospital. But I still definitely need also other health services to help me. She is very good but she can’t replace everyone! But I really hope your research shows how great they are because I don’t know how I would cope without her.”

          “My assistance dog has allowed me to become more social and allowed me to do some of the most basic life necessities ie: go shopping, leave the house, do university, feel safe when out and about and reduce my anxiety and panic attacks. By having my dog, I have managed to reduce my mental health inpatient stays to just stabilisation admission rather than crisis admission. I can now go out and be active with my children and live a fairly normal life.”

          Other data showed that the publics’ attitude could be a cause of stress for the owner:

          “When I’m with her I don’t worry that I’m out, because it’s like I have my home with me so it’s okay. So I can only say that I am so grateful that psychiatric dogs are now recognised and I hope it only spreads more. That being said, sometimes I find having her with me stressful because sometimes other people start challenging me about having her, even though I have all her certification and ID and vest, and that’s really stressful for me when people pay attention to me in such a negative way. So I hope it becomes more widely accepted and less criticised by other people who don’t really understand.”

          Discussion

          The results of the present study indicate that PADs assist people of all ages, including children, with a range of mental health problems, whose lives are often severely compromised by anxiety and fear, to access public places, travel on public transport and take part in social activities that may have been closed off to them. Although the study was a self-report measure and therefore limited by selection-bias and subjectivity, every relevant comment (n = 198) regarding the meaning of the person-dog relationship (i.e., response to the question: “What does your mindDog mean to you?”) was positive. Thus, suggesting that sound conclusions can be drawn about their efficacy.

          A plethora of dog breeds were used by the participants in this study—from the Chihuahua to the Irish Wolfhound, illustrating that a PAD does not need to be a certain size or breed (or gender). Indeed, only 15% of participants chose a dog based on its physical appearance. Because PADs come in many shapes and sizes, they can look different to other assistance/service dogs such as the Labrador or Golden retriever commonly used as guide dogs (4). As indicated in the present study, this can lead to stress-provoking attention from the public, as unlike some people who are blind or vision-impaired or have mobility issues, there may be no outward sign of disability. Mental illness frequently carries a heavy social (and self-) stigma (5), and the owner may be reluctant to explain the dog’s role. Public education regarding the expanding roles of contemporary service dogs and associated etiquette would help to alleviate social issues with accessibility.

          It is noteworthy that over a fifth (21%) of dogs in the study were acquired from an animal shelter suggesting that “rescue” dogs can be an important source of successful PADs. Sourcing dogs from animal rescues or shelters is beneficial in reducing the number of animals killed due to overcrowding and opens up shelter space for another animal who might desperately need it.

          The authors hypothesized that there might be an association between the owners’ mental health diagnoses and the tasks the dogs performed, but no relationship was found. This is likely due to the variables “diagnosis” and “tasks” being highly confounded as, for example, the majority of people (84%) identified as being diagnosed with depression, and almost all (94%) dogs performed the task of “grounding” for their owners. Future research with only open-ended questions for these variables, rather than forced-choice options as per the present study, which can lead participants to make certain choices, would be valuable. While it is not yet understood what cues, whether behavioral, olfactory, or other, PADs may be responding to when performing tasks, it is clear that the relationship between individual owners and his/her dog is a personal one, influenced by each owner’s diagnosis and needs.

          As part of the mindDog application process (Box 1), the applicant’s health care practitioner completes a form that expresses how the practitioner expects a mindDog might assist the applicant. However, some health care practitioners may not be aware of the roles the dogs can provide, and it is likely that the functions are greater and more varied than are those predicted. Findings from the present study supports the view of the Psychiatric Service Dog Society (PSDS) in the US (6) that PADS be used as an adjunct to ongoing standard-of-care mental health treatments, and not as a substitution. These findings can be used to inform medical doctors and other health care providers, who play a pivotal role in their patients’ application process for a “mindDog,” about how the dogs may be of assistance.

          A review on the effectiveness of a range of assistance animals (AA) for Australia’s National Disability Insurance Agency (NDIA) (7) concluded that there may be large economic benefits to AA ownership, including the ability to work, attend school and concerning services no longer required (e.g., a non-verbal child with ASD who now speaks). Although evidence is limited, the results of the present study support this conclusion in that nearly half (46%) of participants said that their use of psychiatric and other health services had decreased—mainly due to reduced suicide attempts, and less requirement for hospitalization and medications. Public hospital spending in Australia has been the single fastest growing area of government spending over the past decade or so (8). From a health economic perspective, judicious decreased use of services and hospitalizations/use of medications is likely to save money.

          Howell et al. (7) also recommended that should AAs be provided by the NDIA, the standard for assistance dog training (inclusive of PADs) should adopt the model of the AA provider organization selecting/breeding and training dogs for AA roles—a process that typically takes around 2 years. However, the findings of the present study suggests that successful working partnerships does not require the PAD to have been bred and/or raised specifically for the role, as every participant considered their personal and working relationship with their dog to be effective despite no dogs being acquired/trained by this method. The so-called “human-animal bond” is the dynamic relationship between people and animals that influences the psychological and physiological states essential to the health and well-being of both (9). Unlike many service dog organizations, mindDog works with existing pets so a strong owner-dog bond is likely to be already in place. Thus, it is the authors’ opinion that while many assistance dogs (such as guide dogs, hearing dogs and others trained to assist individuals and their families impacted by disability) be exclusively acquired and trained by AA provider organizations, this approach may not be necessary for PADs. This could have far-reaching consequences for people who wish to use such a dog as waiting times and financial costs for a trained dog could be dramatically reduced.

          There appears to be a growing need for PADs to help individuals with psychiatric disabilities. A recent study by Walther et al. (10) showed that PADs placed fourth in North American accredited placements of various assistance dogs, surpassing the number of hearing dogs placed. Indeed, the number of applicants to mindDog has doubled at the time of writing this article (9-months since gathering the data), resulting in the organization having to limit when it can accept applications. When thinking about the direction the field may take in the future it seems unlikely that PAD activities are likely to end, therefore steps must be taken to ensure the well-being of the dogs as well as the handler in this remarkable example of the human-animal bond in action. Responsible pet ownership requires a commitment to provide for all the requirements of one’s pet—food, exercise, housing, reward-based training, love and affection, grooming, and veterinary care. While mindDogs only works with positive force-free training methods , it is imperative for all owners to understand how animals communicate and learn, and to thoroughly research the basics of pet care before acquiring any new pet to ensure she/he has the capacity to meet the physiological, behavioral and social needs of the animal. Future research should focus on Shubert’s (2) advice whereby handlers (and trainers) become adept in canine body language, recognize signs of stress in dogs, have realistic expectations, and ensure only dogs with the appropriate temperament be trained as PADs.

          Conclusion

          This study has contributed to the small but growing body of research on PADs including the demographics of people who use these dogs in Australia, the origin and type of dogs used and the functions the dogs provide. PADs can be all shapes and sizes and perform a plethora of roles that provide substantial benefits to a broad range of people. In addition to training, it appears that for a satisfactory relationship, PADs do not require to have been bred or raised specifically for the role, but that success hinges on the human-animal bond. An understanding of the relationship between owners and their dogs will help inform the appropriate choice of dog, training and use of assistance dogs for people living with mental health issues to better support the needs of both species.

          Ethics Statement

          The study was carried out in accordance with the recommendations of James Cook University Human Ethics Committee (Ethics Approval Number H7210) with informed consent from all subjects. The participants in the study were clients of mindDogs, and had been diagnosed with a mental health condition by a qualified health professional.

          Author Contributions

          JaL, LJ, and JuL contributed to the design, delivery and analyses of this work. JaL wrote the article with the approval of LJ and JuL, who have critically revised the content. JaL, LJ, and JuL agree to be accountable for the content.

          Conflict of Interest Statement

          LJ is a board member of the charity mindDog.

          The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

          Acknowledgments

          The authors wish to thank the people who participated in this study (and their dogs). The authors also wish to thank the staff and board of mindDogs for their support throughout the process, in particular Cath Phillips and Gayl O’Grady. The views in this publication do not necessarily reflect the views of the charity mindDog.

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          How Pets Can Help Bipolar Disorder

          People struggling with bipolar disorder might be able to find four-legged solace from their depressed lows and manic highs through service animals and even regular pets.

          Pet therapy, also known as animal-assisted therapy, is often recommended for people with bipolar disorder or other mood disorders. Service animals, such as psychiatric service dogs, provide companionship and are trained to work with a specific patient to help that person deal with his disabilities, including specific bipolar symptoms.

          However, you don’t need a specially trained animal to get psychological benefits from having an animal nearby. Recent studies have shown that simply owning a pet can help someone who is recovering from a serious mental illness.

          Bucky: A Special Service Dog

          Donna Dykstra, 54, of Seattle, owns a service animal, a 10-year-old Shetland sheepdog named Bucky. Bucky has been trained to help Dykstra deal with problems related to her health and her bipolar disorder.

          During severe manic mood swings, Dykstra sometimes hallucinates. Bucky helps her sort out what’s real and what is not. “Seeing and hearing unusual things was really scary sometimes,” Dykstra recalls. “I used to see dead people — people around me would dead. Then I would start seeing dead bodies lying around. is trained to alert to anything that is unusual around him. If there really was a dead person lying on the sidewalk, he would be responding to it.” Once Dykstra is reassured by Bucky that what she is seeing isn’t really there, she is able to perform stress-reduction techniques to calm herself down.

          Bucky also is trained to help Dykstra deal with the social withdrawal that can result from a depressive episode. “When I am feeling particularly depressed, I want to withdraw and interact with absolutely nobody,” she says. “Part of my self-care and wellness plan is taking Bucky for walks in a very busy park. I have no choice then because he will interact with other people and draw me out. Little kids come up and say, ‘Can I pet the baby Lassie?'”

          Bucky also helps Dykstra deal with another problem she has, a partial seizure disorder. Earthquakes sometimes happen in Seattle, but Dykstra can’t always trust her senses. “I experience earthquakes that aren’t really happening,” she says. “Bucky alerts to earthquakes. So if I feel an earthquake, I look at him. If he’s alerting, then it’s really an earthquake. If he’s relaxed, then it’s a seizure.”

          Other Benefits of Pet Ownership

          Having a service animal specially trained to deal with your symptoms can be a huge help. However, Fido the mutt or Zsa Zsa the rescued cat also can help soothe bipolar symptoms. Doctors have found that pets are of tremendous benefit for people recovering from serious mental illness:

          • Pets provide a sense of being known and understood, with a sense of unconditional love that can restore a person’s empathy.
          • Pets enable bipolar patients to feel more connected with the world — they may feel a connection with the pet or, like Dykstra, find that the pet forces them to connect with other people.
          • Pets create a comforting sense of family for the person with bipolar disorder.

          And they can help build your sense of self-worth and confidence. You might feel more in control of your life because you are taking good care of your dog or cat. Pets also can provide a sense of purpose to a patient in particularly bad shape. “I couldn’t commit suicide, back when that was an issue, because I had to take care of my dog,” Dykstra says.

          FAQs

          • What is a service dog?
          • What is a disability?
          • What is the difference between a Psychiatric Service Dog (aka Mental Health Service Dog), a Therapy Dog, and an Emotional Support Dog?
          • What are some tasks that service dogs can be trained to perform?
          • What can a service dog do for you?
          • How much will a service dog cost?
          • How can I recoup some of the cost of acquiring, training and caring for a service dog?
          • How do I apply or find out more?
          • Where can I find out about the laws and regulations that apply to service dogs?

          What is a service dog?

          As defined by the Americans with Disabilities Act (ADA), “Service animals are defined as dogs that are individually trained to do work or perform tasks for people with disabilities. Examples of such work or tasks include guiding people who are blind, alerting people who are deaf, pulling a wheelchair, alerting and protecting a person who is having a seizure, reminding a person with mental illness to take prescribed medications, calming a person with Post Traumatic Stress Disorder (PTSD) during an anxiety attack, or performing other duties. Service animals are working animals, not pets. The work or task a dog has been trained to provide must be directly related to the person’s disability. Dogs whose sole function is to provide comfort or emotional support do not qualify as service animals under the ADA.”

          What is a disability?

          A disability is a physical or mental condition that substantially limits a major life activity. Most people are familiar with the use of service dogs to assist blind and deaf individuals, however service dogs can also be trained to assist individuals with less obvious psychiatric disabilities such as bipolar disorder, depression, autism, post traumatic stress disorder (PTSD), and generalized anxiety disorder.

          What is the difference between a Psychiatric Service Dog (aka Mental Health Service Dog), a Therapy Dog, and an Emotional Support Dog?

          “A Therapy Dog is a dog trained to provide affection and comfort to people in hospitals, retirement homes, nursing homes, schools, people with learning difficulties, and in stressful situations, such as disaster areas.” – Wikipedia Though it is not a requirement, customarily these dogs are well trained enough to pass a Canine Good Citizen test.

          An Emotional Support Dog provides therapeutic benefit to an elderly individual or individual with a disability. Their primary purpose is to provide affection, companionship, and provide motivation. The hallmarks of an Emotional Support Dog are trustworthiness and a friendly disposition. They should be well trained, although they need not be trained to perform tasks. There is no category for Emotional Support Dogs in the ADA, however, these dogs are covered under the Fair Housing Amendment Act or FHA and Amended Air Carrier Access Act or ACAA. Though it is not a requirement, customarily these dogs are well trained enough to pass a Canine Good Citizen test.

          A Psychiatric Service Dog (PSD), also known as a Mental Health Service Dog, is a category of service dog that is individually trained to provide an individual assistance with a mental impairment that rises to the level of a disability. This is a form of service dog and is therefore guaranteed the privileges enjoyed by other service dogs, like the more well-known guide dogs. These privileges include accompanying their handler almost everywhere, including restaurants, airplanes, and schools. There are no formal, government sanctioned certification process for service dogs, though they are required to be trained to perform a minimum of three tasks for their handlers that directly assist with their disability. It is extremely important that psychiatric service dogs/mental health dogs be trained well enough to not be burdensome or disruptive to other members of the public or the facilities they are allowed to enter, as such behavior can create a backlash that poses a risk to all disabled individuals losing the priveledges currently afforded to all service dogs. Psychiatric service dogs/mental health dogs have only gained widespread support and use fairly recently, yet much of the population is still unaware of their effectiveness and use. Individuals who do not train their PSDs well enough to ensure they are not disruptive or burdonsome to the general public make it much harder for psychiatric service dogs/mental health dogs to gain the widespread acceptance they deserve. Such acceptance is critically important to eliminating the social stigmas and negative responses that individuals with disabilities accompanied by service dogs to often are forced to deal with.

          What are some tasks that service dogs can be trained to perform?

          Service dogs can be trained to perform an amazing variety of tasks to assist individuals with disabilities, depending on their needs.

          Please see our ‘About’ page for descriptions of the types of service dogs we place.

          What can a service dog do for you?

          We work closely with all individuals that we train service dogs for in order to ensure that we understand the individual’s needs and train the service dog accordingly. Our dogs are trained to meet each of our client’s specific needs. We specialize in training and providing medical-alert, psychiatric and mobility* service dogs. (*Our mobility dogs are non-load-bearing. We do not put weight on our service dogs.)

          How much will a service dog cost?

          It is accepted in the service dog industry that the true cost of a service dog, to the organization that produces them, is $25,000. However, this would be beyond the reach of so many, so Diggity Dogs are placed for a fee of $10,000. In order to make up the difference, our organization fundraises extensively annually and is supported by several generous major donors and organizations.

          How can I recoup some of the cost of acquiring, training and caring for a service dog?

          When doing your taxes, you can include the costs of buying, training, and maintaining a guide dog or other service animal in your medical expenses. In general, this includes any costs, such as food, grooming, and veterinary care, incurred in maintaining the health and vitality of the service animal so that it may perform its duties.

          For more information download this PDF from the IRS website.

          How do I apply or find out more?

          If you are interested in applying for a service dog or service dog training for an existing dog, please carefully complete the application by clicking the link below.

          Diggity Dogs Application
          *If the application PDF opens in your browser window instead of downloading, simply save it from that window to your computer, then complete.

          Where can I find out about the laws and regulations that apply to service dogs?

          Learn more about the specific regulations pertaining to service dogs by clicking the following links.

          U.S. Department of Justice ADA
          Americans with Disabilities Act information, resources, and updates U.S. government web site containsa vast array of resources for individuals with disabilities, including information about health, housing, education, transportation, recreation, and employment. See Commonly Asked Questions about service dogs in places of business.

          Changes to the rules of the Americans with Disabilities Act (ADA) which pertain to service animals (Section 35.136) took effect March 15, 2011.
          Part 35 Nondiscrimination on the Basis of Disability in State and Local Government Services
          Part 36 Nondiscrimination on the Basis of Disability in Public Accommodations and Commercial Facilities

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