Policy Memo: Policy Memo: VA Coverage of Service Dogs for Veterans

with PTSD

To: Department of Veterans Affairs

Subject: VA Coverage of Service Dogs for Veterans with PTSD

From: Jeff Fernandez

Date: 11/18/2016

Introduction
Veterans throughout the country suffer from many health complications through line of
duty events. While most of the care and benefits regarding these issues are covered by Veterans
Affairs, some are not. With the large number of veterans diagnosed with PTSD, one would think
it would be appropriate to cover the expenses for long term treatment for the mental disorder.
That long-term treatment, in this case, is the use of a therapy dog. Although the VA covers 100%
of the veterinarian expenses, they do not cover the cost of acquiring a fully trained therapy dog.
It may cost a veteran somewhere between $10,000 and $60,000 for a therapy dog (Paws and
Stripes, 2015). Considering the service these men and women have contributed to our country, it
is unacceptable to disregard such an expense for those veterans who seek treatment for PTSD.
Background
The men and women of our armed forces make the ultimate sacrifices in order to serve
our country and protect its citizens. Not all are fortunate to come back home from deployment,
but those who do may face serious health complications. Many war veterans are forced to live
their lives with permanent physical and mental disabilities. The most prevalent mental health
illness among combat veterans is post-traumatic stress disorder.
Post-traumatic stress disorder is a serious condition that an individual may develop after
experiencing or witnessing a traumatic event in which the individual was physically harmed are
threatened. The prevalence of PTSD is especially high in military service members who have
been deployed overseas. Individuals with PTSD experience symptoms such as depression, social
isolation, aggression, and nightmares. These symptoms prevent them from living a normal life
and they may not return to the same quality of life as before the development of the mental
disorder. The following statistics are provided by the US Department of Veterans Affairs.

Operations Iraqi Freedom (OIF) and Enduring Freedom (OEF): About 11-20% of
veterans have PTSD in a given year.

Gulf War (Desert Storm): About 12 % have PTSD in a given year.

Vietnam War: About 15% have had PSTD in their lifetime

Policy Memo: Policy Memo: VA Coverage of Service Dogs for Veterans

with PTSD

Another cause of military related PTSD is sexual trauma. This includes any sort of sexual
assault or sexual harassment while in the military. Both men and women experience this and it
can occur during peacetime, combat, or during training.

23% of women in the military reported sexual assault

55% of women and 38% of men in the military have experienced sexual harassment (US
Department of Veterans Affairs, 2016).
A psychiatric service dog is specially trained to perform tasks that mitigate their handlers

disability. A dog trained for PTSD handlers can help them overcome their mental disability by
providing a sense of security and calming effects. These dogs undergo training to assess
environments, interrupting injurious behaviors, reminding their handler to take medications,
guiding their handler away from stressful situations, help lower serotonin levels, low blood
pressure, help with episodes of depression and provide companionship (Canines 4 Hope, 2015).
According to Craig Love Ph.D., after a survey was conducted within the Army, a
reduction in symptoms was evident in 82% of soldiers diagnosed with PTSD. Another 40% of
them reported a decrease in medication use (Pawsitivity Service Dogs, 2011).
The following is a list provided by Pawsitivity Service Dogs containing PTSD symptoms
and the assistive behaviors and physical tasks a service dog can perform.

Reclusiveness: Canine accompanies handler outside the home.

Night Terrors: Canine wakes handler.
Startle Reaction: Canine-defined personal space perimeter.
Neuro-chemical Imbalance: Team walks to stimulate endorphin production.
Dissociative Flashback: Tactile stimulation mediates sensory re-integration and

orientation to time/place.
Startle Response: Alert to presence of others (i.e., 'pop a corner' or 'watch my back)

work--leveraging a dog's natural senses.

Emotional Regulation: Canine as therapeutic distraction.
Sensory Overload: Canine as alternate focus.
Social Withdrawal: Canine-facilitated interpersonal interaction, which helps with

community integration.
Lack of Insight: Canine alert to emotional escalation, by leveraging a dog's natural
senses.

Policy Memo: Policy Memo: VA Coverage of Service Dogs for Veterans

with PTSD

Hyper-vigilance: Canine environmental threat assessment work by leveraging a dog's

natural senses
Hallucinations: Canine-facilitated reality testing by leveraging a dog's natural senses.

Recommended Solutions
While veterans with physical disabilities may acquire dogs through accredited agencies, free
of cost, the VA should establish its own program that specifically trains dogs to serve eligible
handlers diagnosed with PTSD and other mental health illnesses. The program will utilize
rescued dogs from animal shelters. According to the ASPCA, 1.2 million dogs are euthanized
each year. Not only will the program provide therapeutic companionship for a veteran, it
provides a second chance at life for dogs who would otherwise be on death row.
The dogs will be thoroughly examined to determine the potential of being a PTSD service
dog. The dog trainers will be working on a fixed salary. Through a third party agency, the dogs
and the training costs anywhere between $10,000 to $60,000 which could equal the yearly salary
of a trainer. Ultimately, having a program with trainers on pay roll will be cheaper than acquiring
dogs individually through third party agencies. The dogs will be trained to:

Remindthehandlertotakemedication.

Improveorganizationbyremindingthehandlertoperformherorhisdailyroutines.

Wakethehandlertopreventhimorherfromsleepingtoomuch(hypersomnia).

Providetactilestimulation.Reassurehandler,bothathomeandinpublic

Facilitatesocialinteractionsandreducefearassociatedwithmeetingnewpeople

Assisthandlerincreatingasafepersonalspace.Assisthandlerwhendealingwithmood
swings

Policy Memo: Policy Memo: VA Coverage of Service Dogs for Veterans

with PTSD

Serveasabuffertocalmhandlerandreducefeelingsofemotionaldistressincrowded
places.Reorientingandgroundinghandlertocurrentplaceandtimewhenstruggling
withPTSDepisodes

Inadditiontoaidingwithclinicalsymptoms,theseservicedogscanhelpwithmoregeneral
symptoms,suchassadnessandloneliness,byinitiatingwalksoutsidethehome,andshowingthe
childaffection.Thedogscan:

Assistthehandlerwhenheorshetriestotorelax(selfsoothe)inordertocomplete

uncomfortabletasks.
Providecompanionshipwhileinstoresandotherenvironmentscanreducestress
associatedwithdailyactivities.

Alertwhenthehandlerisstartingtoexperienceanxietyproblemsremindingthehandler
totakehisorhermedication.

Encouragethehandlertobemoresocialbygettinghimorheroutofthehouseforwalks.
Walksalsoincreasetheamountofexercisethehandlergetsandimproveshisorher
abilitytoselfsoothiftheyarestrugglingwithinsomnia,orhavinganxietyissues.

Helpthehandlerkeepaconstantscheduleandwillbeareasontogetoutofbedinthe
morning(walks,relievethemselves)(Pawsitivity Service Dogs, 2011).

Based on numerous evidenced based studies, the presence of a service dog drastically
decreases the symptoms of PTSD. Veterans Affairs medical department should conduct multiple
evidence based studies to determine the effectiveness of service dogs in decreasing PTSD
symptoms in combat veterans. Short term and long term benefits should be evaluated and
weighed against financial expenses. With those results, another study should be conducted
evaluating suicide incidences with veterans who were diagnosed with PTSD. Depression goes
hand in hand with PTSD. Studies that emphasize PTSD as the precipitating factor of suicide,
state that PTSD symptoms such as intrusive memories, anger, and impulsivity can predict suicide
risks. The suicide rate among male veteran VA users was 38.3 per 100,000, compared to 12.8 per
100,000 in females (US Department of Veterans Affairs, 2016).
The 2017s Presidents budget provides $78.7 billion for the Department of Veterans Affairs
to provide qualified veterans and their families with benefits and care. $65 billion goes toward

Policy Memo: Policy Memo: VA Coverage of Service Dogs for Veterans

with PTSD

VA medical care (US Department of Veterans Affairs, 2016). By making known the effects of
PTSD on our veterans and by providing hard evidence, we can stop the decrease of VA funding.
For example, The Veterans Affairs Funding Bill of 2015 cut $700 million from the VA medical
budget. The main goal is to remove the perception of mental illnesses as complications that
arent actual illnesses or conditions that are not as serious as physical illness. Mental illnesses are
in fact serious complications and deserve greater attention in order to treat those affected.

References
Aspca. (2106). Shelter intake and surrender. Retrieved from
http://www.aspca.org/animal-homelessness/shelter-intake-and-surrender/pet-statistics
Canines 4 Hope. (2015). Post-traumatic Stress Disorder, PTSD service dogs. Retrieved from
http://www.canines4hope.com/post-traumatic-stress-disorder-dogs-ptsd-dog-trainingflorida.htm
Paws and Stripes. (2015). Who we are. Retrieved from www.pawsandstripes.org/who-we-are
US Department of Veterans Affairs. (2016). How common is PTSD?. Retrieved from
http://www.ptsd.va.gov/public/PTSD-overview/basics/how-common-is-ptsd.asp
US Department of Veterans Affairs. (2016). The relationship between PTSD and suicide.
Retrieved from http://www.ptsd.va.gov/professional/co-occurring/ptsd-suicide.asp
US Department of Veterans Affairs. (2016). VA Budget Fact Sheet. Retrieved from
https://www.va.gov/budget/docs/summary/Fy2017-VAsBudgetFactSheet.pdf