Psychological Non Epileptic Seizures
Northeast Regional Epilepsy Group

Service animals for people living with psychogenic non-epileptic seizures (PNES): some thoughts

I get asked about service dogs for PNES quite a bit and over the last few years, I have had the opportunity to observe my patients’ service dogs and emotional support animals in action. The ones who are really well-trained have left me very impressed at how useful they are in ensuring safety and also for some patients, their seizures have been significantly reduced after the dog was brought on board.
So, here are some thoughts on this subject.

What can service animals do for someone who has seizures/PNES? They can:

  • Detect physiological changes the patient is experiencing before she/he is even aware they are occurring
  • Guide the patient to safety
  • Go get help
  • Apply pressure on the patient’s chest or lap to assist in grounding and emotional regulation
  • Stay with the patient until help has arrived and/or the seizure has run its course

They also help reduce anxiety through touch and distraction and provide comfort and loyal companionship.

Keep in mind that the cost for a dog that has been bred and trained for these purposes can be elevated (although there are some foundations that might help cover some of the cost) so, when obtaining a service animal, make sure to do so from reputable therapy and medical alert dog trainers in the US.

Alternatively, some people decide to buy their own dog (certain breeds are thought to be more amenable to this type of work) and hire a reputable trainer to work with the dog and owner directly. However, and this is key, going this route requires extreme dedication and consistency for the dog to become a truly reliable and useful service animal.

You should also know that there are several classifications for service animals (emotional support animals, psychiatric service dogs, therapy service dogs, and seizure response dogs) and some of these are especially important because they may affect where the animal can go or not.

Emotional support animal: a type of animal that assists with psychological symptoms and disorders, including depression, anxiety, and PTSD.
How would you get your animal classified as an emotional support animal? A licensed mental health professional prescribes the animal as part of an individual’s treatment plan by writing an emotional support animal letter (ESAL). This entitles you and your animal to certain rights under federal law. It must be printed on the licensed provider’s letterhead, signed and dated, includes all licensing information, and explains why the animal is necessary based on the patient’s diagnosis.  Beware of some online scams offering ESALs and keep in mind that not all mental health providers feel comfortable writing this type of letter.

Psychiatric service dog (PSD): a type of assistance animal that is trained to perform specific and unique tasks for certain mental illnesses (e.g., PTSD, agoraphobia, autism, etc.).  They may assess for triggers and threats, provide tactile distraction, help when nightmares occur.
Service animal: is highly trained animal that provides specialized services [e.g., mobility assistance dogs for a person who is a paraplegic or a seizure response dog] and who has a specific designation and rights under federal regulations)

Seizure response dog: is trained to respond when their patient is having a seizure and/or alert the individual when a seizure is going to occur.  The animal may be trained to alert families when the individual has a seizure, and to break the individual’s fall or lie next to the individual to prevent injury. A letter from the patient’s clinician (mental health professional or neurologist) can be used to certify the animal and gain access to certain rights afforded working animals.

Take note: Although the American with Disabilities Act (ADA) guarantees someone who is disabled the right to be accompanied by the certified animal in public spaces, it is absolutely necessary that the animal is well behaved, wears an identifiable harness, and must abide by public health rules (e.g., cannot enter a surgical room in a hospital).

So, in conclusion, when someone with PNES asks me whether I think they should get a service animal or not, I tend to be supportive of this decision, as long as we recognize that bringing an animal home is a big responsibility and commitment, it is not necessarily a solution to all the person’s problems, it will not make things better overnight, and only as long as the animal is either coming from a reputable breeder/trainer or the person is definitely willing to put months if not years into training the animal.

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