Accepting, accommodating and respecting the mental health needs of everyone is one of the stepping stones of building a progressive society. As our understanding of mental health expands and becomes more inclusive, so must our regulatory frameworks. Just as service dogs are rightly welcomed and accommodated in a wide variety of public and private spaces on the grounds that they enable their keepers to live an independent, dignified, more comfortable life, there is no reason to believe that emotional support animals (ESAs) – and the regulation surrounding them - will not follow a similar path.

Clinically defined as “an animal that helps alleviate symptoms of an emotional or mental disability through companionship and affection”, a person is legally entitled to carry an ESA only when they have a disability recognized in the Diagnostic and Statistical Manual of Mental Disorders, certified by a licensed medical professional. The World Health Organisation estimates that one in four people in the world will be affected by mental or neurological disorders at some point in their lives, and today, around 450 million people currently suffer from such conditions.

The scientific backing of how helpful ESAs actually are in relieving symptoms associated with mental health disorders is shaky to date. Some studies have found positive impacts, such as relieving problem behaviours, severity and stress for autism spectrum disorder, or helping PTSD sufferers to feel calmer, less lonely, less depressed and less worried. However, various methodological weaknesses and limited data have rendered the studies mostly inconclusive, and many agree that further research is needed.

While the Americans with Disabilities Act only covers psychiatric service animals, which are prescribed to individuals whose disorder is severe enough to impair their daily functioning, the Air Carrier Access Act (the Federal law that protects the rights of people with disabilities in air travel) explicitly covers “any animal that assists persons with disabilities by providing emotional support.” But ESA owners can still land in trouble, depending on which airline they choose to fly with, as well as their destination.

In general, most airlines who do accept ESAs ask for appropriate documentation to be submitted 48 hours prior to travel, and for the person to be travelling with a trained animal which is not overly large. These stipulations are important, as they bring some definition to what is currently a very grey area. Ensuring that an ESA is vaccinated, hygienic, well-behaved and of a manageable size is of utmost importance, since this is the only way their presence can be ensured. Clearer regulation – as opposed to misinformation, prejudice and an outright ban on ESAs – is therefore urgently needed.

Meanwhile, in the absence of a level playing field, individual airlines often enforce their own rules, which might seem arbitrary. For example, Delta is no longer accepting pit bulls as either service or support animals, while ESAs are not accepted on flights longer than eight hours. American Airlines has an extensive list of banned critters, which includes amphibians, goats, ferrets, hedgehogs, spiders and reptiles. Furthermore, a handful of destinations, such as New Zealand, Hong Kong and St Vincent and the Grenadines, are among those who outright ban ESAs from incoming flights.