Will A Service Dog Help Your PTSD?

Back in October of 2017, President Trump’s daughter-in-law Lara Trump held a meeting in the White House to promote an initiative that would pair shelter dogs needing homes with veterans. The initiative is based on the popular idea that trained service dogs can improve the quality of life for those suffering from post-traumatic stress disorder (PTSD) and other mental-health conditions, stated a recent report by The New York Times.

Trump lobbied the leaders of the Department of Veterans Affairs and the Humane Society of the United States and also showed her support for the Puppies Assisting Wounded Servicemembers (PAWS) Act — a piece of bipartisan legislation first introduced in 2016 that would establish a grant program that would  pair veterans with psychiatric service dogs, trained to help their owners cope with stress, anxiety, or fear.

The powerhouse meeting, which included multiple top White House officials, lawmakers, two cabinet secretaries, and at least one service dog, has still failed to make much impact. Soon after, the V.A. formed a partnership with the Humane Society — but by May of 2019, nearly a year and a half later, the program had only provided of 19 dogs to dogs veterans in need. Despite Trump’s exhaustive efforts before and following the meeting, the PAWS Act never went to a vote and has faced stiff resistance from Veterans Affairs. V.A. officials stated the bill could “result in unintended and negative consequences” for veterans entrusting their well-being to “this unsubstantiated treatment regime.”

Currently, the V.A. covers the costs of veterinary care and equipment for the service dogs of veterans with certain physical disabilities, such as vision impairment. However, V.A. leaders have long argued that there isn’t enough clinical data to prove the viability of treating mental-health issues with service dogs. 

“I would say there are a lot of heartwarming stories that service dogs help, but scientific basis for that claim is lacking,” said Dr. Michael Fallon, the V.A.’s chief veterinarian, during an interview on National Public Radio in 2017. “The V.A. is based on evidence-based medicine. We want people to use therapy that has proven value.”

So, where’s the research? The V.A. is currently conducting research into the effectiveness of service dogs for PTSD and other mental health issues, but progress has been excruciatingly slow. A study that began in 2011 and was supposed to wrap up by 2015 has repeatedly been stalled by internal issues regarding its design and execution. It wasn’t until May of this year that the V.A. announced that the findings of the study (which, so far, has cost $16 million) wouldn’t be released to the public until 2020. A long time to wait for a veteran suffering from daily panic attacks and depression.

With a growing mental-health crisis in America’s veterans community, many lawmakers are growing impatient with the V.A. In June, Representative John Rutherford, a Florida Republican, reintroduced the PAWS Act to establish a $10 million grant program through the V.A. The bill would give qualified nonprofit organizations up to $25,000 for each veteran they pair with a service dog, which would cover training costs for the dog and its new owner. The PAWS Act is supported by both Democrats and Republicans. This pits lawmakers against the V.A., which is currently refusing to endorse any new service-dog program before its internal research is completed in 2020.

And what about the actual veterans? More than one out of five veterans currently disability benefits from the V.A. suffers from PTSD. Veterans who have responded poorly to conventional treatments for their PTSD have had to sometimes shell out thousands up front to acquire service dogs, not to mention the significant costs of feeding and caring for them. In addition, many veterans seeking service dogs without support from the V.A. are forced to often get unreguated service animals that haven’t been fully or properly trained for their specific needs. Advocates say access to a psychiatric service dogs without a significant financial burden is essential. And it’s needed now.

This wasn’t the first time the issue has been pushed—and received pushback. Back to January 2009, moved by a particular veteran’s story, Senator Al Franken introduced his first Senate bill, which called for the V.A. to do a three-year pilot study into the benefits and feasibility of using service dogs to treat PTSD and other injuries and disabilities. The bill received bipartisan support and was incorporated into the 2010 defense budget.

The bill’s passing initially appeared to be a huge victory for service-dog advocates, but it almost immediately encountered problems. The V.A. initially partnered with vendors with poorly trained animals and did not supervise the screening process for health problems or aggressive behavior. When it was all said and done, about a quarter of the dogs developed hip dysplasia, two had bitten children, one dog died of an undiagnosed disorder, and another had to be euthanized due to a spinal tumor. In addition, contractors had discouraged participants from reporting problems with their dogs to the V.A., which compromised findings in the study. Ultimately the agency suspended its trial twice in 2012, just months after it began.

“We relied upon the organizations themselves, all of which professed to be very experienced and to be able to produce high-quality dogs, and unfortunately that did not turn out to be true,” Fallon told lawmakers in a 2016 congressional hearing. “We were not familiar enough with the service-dog community when we embarked on the pilot study. There’s no question that we’ve made mistakes.”

Recently in Washington, Representative Jim McGovern, a Massachusetts Democrat,expressed his frustration, saying he has been pushing V.A. officials for years on this issue. 

“What I usually hear is, ‘We are looking into it,’” McGovern said. “I’ve never gotten the sense it’s been the priority it needs to be. I haven’t checked in this year with V.A. folks, because I’ve just kind of given up on them.”

However, some other recent studies have produced promising findings. A small 2018 study from Purdue University of 73 veterans found that participants with service dogs produced significantly higher levels of cortisol, a hormone involved in processing stress. Participants also experienced a 12-point drop, on average, on the V.A.’s standardized PTSD symptom checklist, said Dr. Maggie O’Haire, the study’s lead author. Kerri Rodriguez, one of O’Haire’s co-authors on the study, said in the Times report, “While not a cure for PTSD, we found service dogs are an effective complementary treatment that have significant effects on multiple areas of life.” Purdue is now engaged in a three-year clinical trial funded by the National Institutes of Health, to monitor the long-term effects of service-dog therapy on veterans.

And what about non-veterans with mental health issues, or, say, veterans living with HIV? Could this type of research help move along service dog programs for others in need as well? A study completed in November of 2017 found that service dogs could be extremely beneficial to those living with HIV, especially long-term survivors.

“We know that stigma is still very much real for many people affected by HIV, and that stigma can lead to feelings of isolation, loneliness or depression,” said Dr. Robert Garofalo, of the Division of Adolescent Medicine at Ann & Robert H Lurie Children’s Hospital of Chicago, to MD Magazine. “While doctors cannot readily write a prescription for a dog for their patients, this study suggests that dog ownership or aspects of unconditional love and social engagement that may come with having a pet, could be beneficial to patients who are isolated or depressed as a result of their HIV infection.”

Only time will tell if the V.A. will deliver its findings next year as promised — but advocates warn time is of the essence in this situation and we’ve wasted too much already. If the final reports are released to the public in 2020, it will have been more than a decade since Franken first conceived of the legislation after meeting veteran Luis Montalván and his dog, Tuesday. Sadly, Montalván will never see the completion of the work he inspired though Franken. In December of 2016, he died by suicide in a Texas hotel room after undergoing a leg amputation that year, without Tuesday by his side.