Sunday, April 17, 2011

Tackling Mental Illness Through Teamwork

For over 20 years, Richard O’Donnell has been constantly reminded of his experiences as a soldier in Vietnam. He would have difficulty leaving the house, whether from being exhausted by his nightmares or feelings of social anxiety.
Like many war veterans, O’Donnell suffers from Post Traumatic Stress Disorder, or PTSD. Individuals with PTSD experience a multitude of symptoms ranging from nightmares to depression. Feelings of social anxiety and difficulty reacclimating to civilian society often exacerbate the effects, with veterans struggling to maintain relationships with family and friends.

O'Donnell and Smokee
According to an Army report cited by the New York Times last year, nearly one-third of Army forces or veterans are on at least one type of psychiatric medication. However, a growing number of veterans are turning away from pharmacology and to another form of therapy: dogs.
While the use of dogs to treat physical disabilities has been around for decades, it was only within the past 14 years that dogs have been used to treat mental illness. In 1997, Dr. Joan Esnayra coined the term Psychiatric Service Dogs (PSD’s) and began advocating for the use of dogs to treat a variety of mental illness. She created the Psychiatric Service Dog Society as a way to both educate individuals with mental illness on the benefits of service dogs and to create a community where people can connect with each other.
Dr. Esnayra, who uses her own dogs to treat her PTSD and depression, advocates that veterans train their own dogs, an approach she says is central to the success of the therapy.
“When you train your own Psych dog, you get a better Psych dog. And that will always be the case,” Dr. Esnayra explained.
By self-training a dog, she claims, veterans form a relationship with their animals where dogs are better able to pick up on their owner’s emotional state and anxiety level. PSD’s are able to remind their owner’s to take medication, watch their back’s to prevent them from being surprised, and be a social ice breaker.
O’Donnell recalls the initial difficulties of making his 3-year old Weimaraner named Smokee behave. Smokee was extremely energetic, trying to run at full speed while on a leash or running off when he was loose. In order to correct Smokee’s behavior, O’Donnell was forced to leave the house and maintain a schedule. “I had to become more consistent which is a feat by itself. But it gave me a mission, or a job, to do something,” stated O’Donnell.
Margarita Brunke, an Iraq war veteran, had similar benefits with her Bichon Frise, named Camron. “When I got back, I didn’t want to leave the house. I couldn’t deal with anybody, not even my own family,” she says, “and at least I can go out a little bit at a time with Camron.”
Since PSD’s are first and foremost service animals, they are with their owners close to 24 hours a day. This companionship helps many veterans overcome their social anxieties and open up to strangers. “I call him my ‘chick magnet’ because the ladies just come to him,” O’Donnell says. He says he often finds himself talking to strangers about veteran’s issues, PTSD, and service dogs. “I find myself becoming an advocate for my disability.”

While PSD's are able to help their owners just by giving them responsibility and a schedule, the dogs can also perform many tasks that require a deeper level of understanding and training. When O’Donnell experiences nightmares, Smokee is there to wake him up and comfort him. “I think it’s because, in my nightmare, I’m going someplace, you know? And he wants to go. He wants to be there with me, you know?”
Brunke attests that Cameron can tell when she is zoning out and remind her to take her medication. Brunke and Camron.
But despite the success stories of these veterans, many people within the medical and military establishment are reluctant to acknowledge the use of dogs to treat psychological disorders. The U.S. Department of Veterans Affairs does not provide reimbursement or benefits to veterans using PSD’s. According to the VA, the efficacy of PSD’s must be scientifically proven before funding is allocated, a claim Dr. Esnayara rebukes. She asserts that there is a double standard when it comes to PSD’s because the VA continues to provide assistance to those using physical service dogs for disabilities ranging from blindness to limited mobility, despite the lack of scientific study on their effectiveness.
Critics of PSD’s are skeptical regarding the amount of help a dog can provide to someone with mental illness. In a May 2010 letter to then-Congressman John Tanner (D-TN) regarding federal assistance for individuals using PSD’s, the IRS wrote that “an expenditure that is merely beneficial to the general health of an individual is not for medical care.”

For Dr. Esnayra, this response is nothing new. “They say ‘everybody gets emotional support from their pets or their service dogs. That’s just a given. Therefore, it cannot be legitimate disability related assistance,’ ” Dr. Esnayra says. “But just because people get emotional support from their dogs doesn’t mean that the emotional support that someone with a mood disorder or an anxiety disorder get from their dog is in any way remotely connected to what non-disabled Joe Blow gets from his pet dog. That’s apples and oranges.”
The IRS letter further claims that “A taxpayer who claims that an expense of a peculiarly personal nature is primarily for medical care must establish that fact.” This, aaccording to Esnayra, is another example of the double standard seen between PSD’s and physical service dogs.
The future of funding for PSD’s relies on the results of The Franken Study, named after Sen. Al Franken, which seeks to evaluate the efficacy of the therapy. Sen. Franken is an advocate for PSD’s, stating in an op-ed that “it is my strong belief that a service dog will more than pay for itself over its lifetime.” Dr. Esnayara hopes that more peer-reviewed scientific analysis can help more people accept the benefits of PSD’s. Although, she believes that the aversion to the treatment “boils down to two things: not understanding mental illness, and not wanting to be associated with mental illness.”

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