VA Won’t Pay for PTSD Service Dogs. Should They?

Posted by Jason Van Steenwyk

Service dogs for PTSDThe battle’s been brewing for years. Veterans coming back from wars with symptoms of post-traumatic stress disorder, as well as other psychological ailments such as depression and anxiety disorders that may or may not be directly related to trauma, are fighting to claim a benefit: A trained service dog – at government expense.

The problem: The expense is significant. It can cost anywhere from $10,000 to $30,000 to breed and fully train a service dog. And the Veterans Administration says it has more productive uses for the money.

Veterans groups and a loose association of dog breeders and trainers that have formed a small cottage industry providing service dogs to veterans, of course. And the veterans who have them love their service dogs and are grateful for the benefit. But after reviewing the issue, and after a period of public comment, the Veterans Administration has elected not to cover service dogs for PTSD and other psychiatric conditions.

Service dogs have long been used to help vision-impaired and hearing-impaired people and people with mobility issues. And the benefits and cost-effectiveness of seeing-eye dogs for the blind has been accepted for years.

Originally, the VA could only provide seeing-eye dogs to blind veterans. However, President George W. Bush expanded that authorization when he signed the Department of Veterans Affairs Health Care Programs Enhancement Act, which authorized the Veterans Administration to provide service dogs as a benefit for other conditions as well. However, in a 2007 memorandum, the VA concluded that there was not sufficient evidence that service dogs were a cost-effective remedy for vision and mobility-impaired veterans. However, the VA left the door open to providing a service dog on a case-by-case basis to individuals who could show that the therapeutic value of a dog and the potential cost savings over other forms of therapy justified the use.

In 2009, Congress voted to expand authorization of a service dog benefit to veterans with mental illnesses. And in 2010, Congress passed the Franken Amendment, which directed the executive branch to launch a three-year pilot program to study the therapeutic effects of service dogs for PTSD.

So What Can a Dog Do?

According to the Psychiatric Service Dog Society, a trained service dog can help an individual with PTSD or other depressive or anxiety disorders in the following ways:

  • Help overcome reclusiveness by accompanying the individual on trips outside the home
  • Awaken an individual suffering from night terrors
  • Turn on a light to alleviate night terrors
  • Help with hypervigilance by searching a room for intruders
  • Interruption of dissociative spell
  • Alert and intervene or distract in moments of emotional escalation

Benefits of Pet Ownership

There is little doubt that pet ownership correlates strongly with improved mental and physical health outcomes. Studies indicate that pet owners are less likely to commit suicide, get more exercise, are less likely to have heart attacks, and less likely to suffer from severe depression than those with no pets. It is not clear to what extent that relationship between pet ownership and improved health outcomes is causative versus correlative. For example, people who are more active may be more likely to go out and adopt a pet in the first place.

In any event, though, it is not necessary to have a highly-trained service animal with a five-figure price tag to realize these benefits. Most of the beneficial effects can be had with any reasonably well-behaved and affectionate dog, without any specialized training whatsoever.

So the argument for highly trained service animals for PTSD patients at government expense must go beyond the basic therapeutic effects that you can get with any good pet, and address the possible law of diminishing returns. It is possible that the government could spend larger and larger sums for trained service animals for smaller and smaller benefits.

Testing the Theory

It occurred to us that if there is any validity to the use of service dogs to treat PTSD, they would already be in common use among psychiatric patients in other contexts – possibly for rape survivors. Are dogs effective in helping rape survivors recover and function? Do they help with agoraphobia symptoms, and hypervigilance? And if they do, are they typically professionally trained and certified service dogs? What do women do who are survivors themselves but who don’t qualify for VA services? Do they seek out trained dogs? Is the benefit powerful enough that those who can afford it choose to pay for the costs associated with a trained dog with their own money?

It turns out that there is, indeed, a precedent for the use of dogs to help survivors of rape and other violent crimes overcome anxiety and other PTSD symptoms. Service Dogs for Victims of Assault, which is now defunct, was formed in 1999 to help provide dogs to survivors and raise awareness of their value in helping survivors. We spoke to their chief clinical practitioner, Carmen Davis, Ph.D., via telephone.

Dr. Davis’s Portland, Oregon practice centers largely on patients who are struggling with PTSD, often through severe child abuse. Symptoms include dissociative disorders – a psychological phenomenon in which the patient re-experiences the trauma. Other therapists sometimes refer patients to him if there is a potential need or desire for a service dog.

Davis was not familiar with any clinical studies demonstrating the effectiveness of service dogs for the PTSD population, though he did report positive results on an anecdotal basis. However, none of his patients required dogs that needed extremely high-end, specialized training that would result in a five-figure price tag. None of Davis’s clients could afford that, anyway.

“You really just need a dog with good basic obedience training, and public access training.”

However, Davis did point out there were instances where a dog could sense when an owner was going through a dissociative episode and could bring them out of it. In Carmen’s experience, though, the owners would obtain dogs with good temperaments and obedience training, and continue training the dogs themselves. Expense to the government was generally nil in these cases, but these patients did, by and large, believe that the dogs were helpful enough to justify spending their own money.

From the VA’s point of view, absent a solid clinical study demonstrating effectiveness, it would be extremely difficult to justify awarding service dogs as a benefit to treat PTSD – especially when the assumption is that a fully-trained service dog would cost tens of thousands of dollars.

However, there is a whole continuum of needs within the PTSD community. Only a very few veterans will require a high-end service dog for PTSD symptoms. It may make sense to recalibrate our thinking, and scale down the cost assumptions to reflect it.

For example, of the population of veterans collecting 50 percent or greater disability compensation because of PTSD, how many of them would trade 20 percentage points of disability for a service dog? After all, if the dog doesn’t make them less disabled, then you cannot justify the expenditure. But if the dog does result in a significant reduction of disability, then the cost of the dog could be offset by a reduction in VA benefits – perhaps on a sliding scale, reflecting the training cost of the dog. The veteran could select the desired training level himself, though it would affect VA disability compensation benefits.

If enough veterans jump at the chance, even where it costs them money, then we probably have a worthwhile benefit. If nobody takes the dog over the cash, then the whole push to cover service dogs for PTSD appears to be an attempt to latch on to the VA benefit gravy train.

 

Photo credit: Ed Andrieski/AP

 

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5 responses to “VA Won’t Pay for PTSD Service Dogs. Should They?”

  1. Ms Cheryl D. Kopec says:

    Interesting article. However, I was unaware that the VA benefits system is designed to work in the way you describe. For example, would a double amputee’s rating be adjusted if his use of a wheelchair increases his mobility? Or would a blind veteran’s rating be decreased if a cane helps him navigate more easily?  
     
    That said, it’s encouraging to find someone thinking outside the box on sourcing service dogs. The industry wants you to believe that it costs tens of thousands of dollars to train a service dog. But many veterans have experienced great success with choosing and training their own dog, often with the help of private trainers or small organizations set up by fellow veterans or other sympathetic parties. It is a huge myth that a “real” service dog must come from a certain type of organization that typically asks astronomical sums for providing them.

  2. Joan Esnayra says:

    I have been assisting persons (including veterans) with PTSD in training their own Psychdog since 1997. My organization is the nonprofit Psychiatric Service Dog Society. The framework for our intervention model is grass-roots-derived. That is, our framework is informed by those persons who are using these dogs rather than those who are non-disabled service dog trainers lacking a clue about psychiatry. The service dog industry as represented by Assistance Dogs International (ADI) is extremely corrupt. In collaboration with the US Army, ADI destroyed our funded DoD research study on these dogs paired with Wounded Warriors at Walter Reed Army Hospital. Additionally, ADI is behind the destruction of the Congressionally-mandated VA study on psychdogs (Franken Study), also. The VA claims that the dogs in this study were filthy and filled with parasites but this is a complete fabrication on the VA’s part. Nonetheless, the study is now destroyed and VA General Counsel is trying to cover its fanny with the canceled vendor after-the-fact. As if de-railing two research studies on service dogs for PTSD was not enough, the VA is also involved in obstructing a third research study on these dogs that is being conducted by a doctoral student in Nevada who also works as a nurse at a VA facility there. Her job security has been threatened on account of her planned research study. Such bullying tactics!. Wake up folks–the industry that claims it costs a LOT of money to train these dogs is lying to Congress, federal agencies, veterans, and those who care about veterans. ADI is full of lies and its sole motive is MONEY. I have literally been run out of the country on account of this corruption and other ADI-affiliated criminal activities that include breaking into my home five times, poisoning me and my dogs, physical assault & injury, threats upon my life, deep computer hacking and other forms of electronic surveillance, identity theft, etc.

  3. I have Rex’s son Blue who is technically a “Service Dog” I can attest to the value of having such an animal as it relates to affording me opportunities regarding reclamation of some of my life by minimizing the sympthoms of my PTSD. I welcome any and all comments so please feel free to contact me via E-mail xrexusx@aol.com

  4. Michelle says:

    I have a Service Dog who is trained as my medical alert and hearing service dog and is also trained to mitigate my PTSD, Panic Attacks, OCD and Depression, so I know how important these dogs are, as mine has saved my life literally many times. She in fact is Owner Trained with help from a trainer who specialized in Service Dogs and the fee was not very much. 
     
    A couple of things worry me about this article: the “any reasonably well-behaved and affectionate dog, without any specialized training whatsoever” and. “You really just need a dog with good basic obedience training, and public access training.” As Service Dog owners, all know there is so much more than just that. It takes 2 years or more to get a dog ready and that is if the dog has the right temperament, service dogs come in contact with much more than a pet dog and needs to be able to react properly. It worries me that people may think that basic obedience and reasonably well behaved dog is all they need to take their dog or any dog out. I just ran across one like this, while the owners watched and I and my service dog passed in the center of the aisle of a store the other dog started wining, growling and barking and kept it up it made me very nervous and triggered me and they could care less. My service dog has also been very close to being bitten by someone else’s service dog and her comment well he is usually fine it must be your dog. Service Dogs of all kinds need to be able to ignore other Service Dogs and not all dogs; even with extensive training can do that which puts the owner of that service dog and the other in danger. 

  5. jerry says:

    so the VA will give me 2 hearing aids and 3 tests to prove that I have hearing loss the last 2 were after I was issued hearing aids they will have 3 federal employees at this VA to do a one person job 
    I can go further, yet they want to be sure we the veteranare taken care of by not spending the $ on the veteran just give the money to the union that represents the civilain employee.

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