Emotional Support Animal (ESA) Letters

What They Are, How They Work, and What to Know Before Requesting One

Emotional Support Animals (ESAs) can play a meaningful role in mental health by providing comfort, companionship, and emotional stability. As interest in ESA letters continues to grow, so does confusion about what they are, who qualifies, and how to obtain one legitimately. This guide explains ESA letters clearly and responsibly, so you know what to expect and how to avoid common misconceptions.

What Is an Emotional Support Animal?

An Emotional Support Animal is an animal that provides emotional or psychological support to an individual with a diagnosed mental health condition. Unlike service animals, ESAs are not trained to perform specific tasks. Their therapeutic benefit comes from their presence and the emotional comfort they provide.

ESAs are most commonly dogs or cats, but other animals may qualify depending on the situation and housing policies.

What Is an ESA Letter?

An ESA letter is a formal document written by a licensed mental health professional stating that:
• You have a qualifying mental health condition
• An emotional support animal is part of your treatment plan
• The animal helps alleviate symptoms of that condition

A valid ESA letter is typically used to request reasonable accommodations for housing under federal fair housing laws.

What Conditions May Qualify for an ESA Letter?

There is no single diagnosis required to qualify for an ESA letter. Eligibility depends on whether an emotional support animal helps alleviate symptoms of a mental health condition that substantially impacts daily functioning. Conditions that may qualify include:
• Anxiety disorders
• Depression
• Post-traumatic stress disorder (PTSD)
• Panic disorder
• Adjustment disorders
• Other clinically diagnosed mental health conditions

The key factor is medical necessity, not the diagnosis alone.

ESA Letters vs. Service Animals: What’s the Difference?

Understanding the distinction is important.

Emotional Support Animals:
• Provide comfort through presence
• Do not require specialized training
• Are not granted public access rights
• Are primarily protected under housing laws

Service Animals:
• Are trained to perform specific tasks related to a disability
• Have public access rights in most settings
• Are protected under disability laws

An ESA letter does not grant permission to bring an animal into public places like stores, restaurants, or workplaces unless otherwise allowed.

What ESA Letters Do and Do Not Cover

What ESA Letters May Cover:
• Housing accommodations, including “no-pet” housing
• Waiver of pet fees or deposits in many housing situations
• Permission to live with an emotional support animal when medically necessary

What ESA Letters Do Not Cover:
• Public access (airports, stores, restaurants)
• Automatic workplace accommodations
• Exemption from local animal laws or lease responsibilities

Housing providers may still enforce reasonable rules related to safety, behavior, and care of the animal.

How to Get a Legitimate ESA Letter

A legitimate ESA letter must come from a licensed mental health professional who has evaluated you clinically. The process typically includes:
• A mental health assessment
• Discussion of symptoms and functional impact
• Determination that an ESA is therapeutically appropriate
• Proper documentation on professional letterhead

Be cautious of online websites that offer instant ESA letters without a real evaluation. These letters are often invalid and may be rejected by landlords.

What to Expect During an ESA Evaluation

During an ESA evaluation, a provider may ask about:
• Your mental health history and current symptoms
• How symptoms affect daily life, housing stability, or functioning
• Your relationship with your animal and how it provides support
• Whether an ESA fits appropriately into your overall treatment plan

An ESA letter should never be guaranteed. It is based on clinical judgment and medical necessity.

Can a Provider Say No to an ESA Letter?

Yes. A provider may determine that:
• An ESA is not clinically indicated
• Symptoms can be managed more effectively with other treatments
• The request does not meet medical or ethical criteria

This does not invalidate your experience; it simply reflects responsible clinical care.

How Long Are ESA Letters Valid?

ESA letters typically need to be updated periodically, often every 12 months, depending on housing requirements. Landlords may request a current letter but cannot demand details about your diagnosis.

It’s important to keep documentation up to date and communicate professionally with housing providers.

ESA Letters and Ethical Considerations

ESA letters are intended to support individuals with legitimate mental health needs. Misusing or misrepresenting ESA documentation can:
• Create barriers for those who genuinely need accommodations
• Lead to stricter policies and increased scrutiny
• Undermine trust between providers, patients, and housing entities

Responsible use protects access for everyone.

ESA Evaluations at Nebraska Peace of Mind Behavioral Health

At Nebraska Peace of Mind Behavioral Health, ESA evaluations are conducted thoughtfully, ethically, and in accordance with clinical and legal guidelines. Our providers focus on whether an emotional support animal is truly beneficial as part of your mental health care—not simply on issuing documentation.

If you’re considering requesting an ESA letter, we encourage an open conversation about your symptoms, needs, and treatment goals. When appropriate, an ESA letter can be one component of a comprehensive mental health plan focused on long-term stability and well-being.