The States That Issued the Most Emotional Support Animal Prescriptions in 2021

In the spring of 2020, not long after curfews and quarantines started to go into effect in the U.S. as a means to combat the spread of the coronavirus pandemic, few could imagine the way social distancing would impact the country’s mental health. However, by late June, 31% of U.S. adults reported struggling with symptoms of anxiety or depression. 

Many turned to canine companionship to help alleviate overwhelming feelings of loneliness, and searches for ‘puppies for sale’ surged on Google, with animal shelters and rescues seeing their adoption rates fly off the charts. Some of these organizations even had to institute a waiting list for the first time ever in the history of their operation.

Still others turned to animals of a different breed: those trained specifically for the purpose of providing emotional support. 

Indeed, according to Google Trends, searches for ‘emotional support animal’ reached the highest peak ever in the past five years in late 2020–a time when many in the U.S. were no doubt feeling the strain of social distancing more than ever. 

So, which states issued the most emotional support animal prescriptions in 2021? And what makes these special animals so unique in the service they provide? 

We teamed up with CertaPet, the leading telehealth platform for individuals interested in animal-assisted interventions, to answer these questions and more. 

To discover what states have the issued most emotional support animal prescriptions, which are issued via special letters signed by a mental health professional, we analyzed CertaPet’s 2021 data to uncover where in the U.S. the most emotional support animal prescriptions were issued by CertaPet’s network of mental health professionals. 

Here are the top 10 states with the most emotional support animal letters issued in 2021: 

1. California

2. Texas

3. Florida

4. Colorado

5. New York

6. Arizona

7. Washington

8. North Carolina

9. Virginia 

10. Oregon 

While some of the most highly populated states make the list (California, Texas, Florida, and New York), the top 10 ranking isn’t exclusive to states with the largest population. 

Oregon, for instance, has a population size that’s nearly ten times smaller than California, and yet still comes in at #10 for states with the most emotional support animal prescriptions. The same holds true for Colorado (population: 5.6 million), which makes the Top 5 in our ranking and beats out even New York (population: 19.5 million). 

According to CertaPet: “An emotional support animal is a type of assistance animal that helps mitigate the symptoms of mental or emotional disabilities such as depression, anxiety, and post traumatic stress. Such assistance animals are typically prescribed by a licensed mental health professional as part of an individual’s treatment plan.”

Emotional support animals are not service animals. Unlike service animals, emotional support animals aren’t entitled to all of the same rights, though they are protected by the Fair Housing Act, which ensures an individual isn’t discriminated against due to their need for an emotional support animal. 

As to whether an emotional support animal truly impacts a person’s mental and emotional health, the science to back up such a notion is certainly prolific, especially when it comes to dogs. 

According to a special health report from Harvard Medical School, interactions with dogs are calming for people, leading to decreases in their levels of cortisol (a stress hormone) and increases in their levels of oxytocin (the ‘bonding hormone’ commonly released when a mother nurses her infant). Dogs can also decrease the risk of cardiovascular disease, support healthy blood pressure, and even lower the risk of an early death by 24%.

Prairie Conlon, LMHP, the world’s leading expert on emotional support animals and Clinical Director of CertaPet, says: “Health and wellness are evolving. More people are seeking out and using holistic and natural ways to improve wellbeing, and animal assisted interventions and therapy are emerging as an incredibly effective resource.” 

Those interested in acquiring an emotional support animal prescription can speak with a licensed mental health professional or general practitioner to discuss whether an assistance animal can prove a beneficial part of their treatment plan. 

However, CertaPet cautions individuals against seeking out emotional support animal ‘registries,’ which are often fraudulent databases on the internet with no grounding in U.S. law. A simple certificate designating a dog as an emotional support animal will not entitle individuals to federally protected rights. Instead, a legitimate emotional support animal prescription must be printed on a licensed professional’s letterhead and include their licensing information. This can be a professional that is visited in-person or one that is seen via a telehealth platform.