by Daniel Maigler LCSW, Paws for Patrick

Bringing the love of animals to the people who need it the most

Sometimes there are no words.  Sometimes the feelings are too big, complex, or contradictory to share with another person. 

Sometimes all you want is to be with another creature who doesn’t care what you look like, how much money you make, or what anyone else thinks of you. 

Sometimes the only thing that can make you feel better is the love of an animal. 

Often when Patrick Roemer would come to my office he couldn’t speak

I would ask him questions about how he was feeling, and what he needed, and his body language was our only conduit for communication.  Having worked with him for years I knew that typically what he wanted was to go home and be with his CiCi.  They would lie in his bed and his heart would stop racing, his throat would open, and he could cry, or laugh, or simply exist. 

I have been a therapist and school social worker for over 20 years and I have worked with over a thousand teens.  I’m good at connecting, supporting, reframing, and caring but on my best day, I can’t hold a candle to the power of the most mediocre cat, bunny, dog, or even guinea pig when a person has a bond with that animal and they have learned how to tap into that connection.  And, as much as I love my clients I can’t share my warmth with them at 3 AM when the thoughts won’t stop and the world is a terrifying menacing place. 

CiCi wasn’t mediocre, she was beautiful and fantastic and it seemed like she was made for Patrick. 

Patrick struggled with anxiety and depression for much of his life

When I met him during his freshman year, the act of simply being in school felt like climbing a mountain.  Patrick was highly intelligent, and athletic, and had kids who liked him, but he also had kids who went out of their way to judge him and made him feel pathetic and “crazy.” Consequently going to school was a constant struggle.  His parents tried everything, therapy, and medication–they agreed to let the school send him to a smaller therapeutic school, and when that wasn’t enough to a wilderness program. 

As much as Patrick hated the way he felt in school at least he could go home to CiCi, his ESA, but at the wilderness program, he was cut off from her love.  Still, she remained his inspiration and he used his desire to be reunited with her to motivate him to finish the program and get back as soon as possible.  When he did come home he did what it took to make sure he would never be parted from her again, and he had his most successful academic year as a junior. 

Patrick came to my office radiating a level of anguish I had never seen from him before.

It was the first day of his senior year. CiCi, who was only 6 years old, became suddenly sick and died.  He was inconsolable. 

His family, after waiting a respectful couple of months, got a new dog to try to fill the void but the bond was not comparable.  In May of his senior year, we lost Patrick to suicide and, although I know it isn’t helpful, I cannot stop wondering if the story might have been different had CiCi lived. 

Patrick’s connection with CiCi, his emotional support dog, was profound, but not unique

A pilot study performed by Dr. Janet Hoy-Gerlach of the University of Toledo found that ESAs significantly reduced anxiety, depression, and loneliness in the population studied.  For Patrick and so many people struggling with mental health challenges, an ESA is more than a pet to enjoy, it is a therapeutic intervention.  It is the best possible kind of medicine, pure innocent love. 

Regardless, Patrick’s family wanted to do something to make sure Patrick’s legacy was not about how he died but how he lived.  Patrick was multifaceted, he was a talented creative artist and an obsessive workout fanatic, but everyone agreed that you saw the purest version of Patrick when he was with animals. 

His family knew that if they could bring the love of animals to the people who needed it the most Patrick’s spirit would be alive with every connection.  In August of 2020 they gathered their friends, family, and some of us who had been lucky enough to work with Patrick, and shared this dream, which has become our mission.

Paws for Patrick has two main methods of connecting young people with emotional health challenges to animals 

Our therapy dog program and our Emotional Support Animal (ESA) program.  We have a team of volunteer therapy dog handlers who visit schools and treatment programs around Lake County, Illinois.  Not only do therapy dogs help people who have emotional disabilities but every person who interacts with them derives a lift in their spirits.  Perhaps more importantly, they help reduce the stigma of talking about mental health challenges because when the dogs are around it is easy to share how good they make you feel, and how much we all need that. 

boy with an emotional support animal
One of the proud owners of a Paws for Patrick ESA

Emotional Support Animal vs. a Therapy Dog. What’s the Difference?

I became a mental health advisor and immersed myself in the world of ESAs.  I found out that unlike therapy dogs, who are required to have a significant amount of training and pass tests to make sure that they are not distractible or aggressive, an ESA requires no training at all. 

An ESA is simply a companion animal whose presence may reduce the frequency, intensity, or duration of symptoms related to an emotional health disability. 

People often contact us wanting to get their animal “registered” as an ESA.  With ESAs, it is not the animal who is “registered” it is the person. Often people think, well I have some anxiety or depression but I’m functioning pretty well so would that really count as a “disability?” 

For the purposes of an ESA, the level of impact does not have to be as severe and profound as it would be if a person were applying for social security disability or workman’s compensation.  Simply having a diagnosis of the majority of mental health disorders (Anxiety, Depression, OCD, PTSD, Bipolar, Schizophrenia, Autism, etc.…) means that most people would automatically qualify. 

What do you need to qualify for an ESA?

First, you need an Emotional Support Animal Letter

As a clinician in order for me to ethically write an emotional support animal letter, which would allow a person to have their animal in their apartment/dorm/dwelling without having to pay pet fees, I must form a relationship. I have to get familiar with the person’s history and the impact of their condition AND I must believe in my clinical judgment that they do have a disability that MAY be benefited by having an animal living with them. 

That’s it.  That’s all it takes. 

So if a person with a history of OCD has difficulty sleeping but sometimes sleeps more easily if he can have a tarantula in his apartment then he would qualify for an ESA. 

His tarantula does not need to be certified because it is his disability that matters.  Just as if a person qualified for a disabled parking space it would not matter what car they drove. 

We tend to think of ESAs as dogs, and they are certainly my favorite, but the research of Dr. Janet Hoy-Gerlach suggests that cats are actually slightly more effective than dogs in remediating the symptoms of depression. 

So dog, cat, lizard, penguin, it doesn’t really matter as long as being near that animal makes a person feel better. 

what is a support animal

Why does having an emotional support animal work? 

Well, we know that on a chemical level, stroking a furred animal reduces cortisol (the stress hormone), and making eye contact with our pets (particularly dogs) can stimulate the release of oxytocin (the love/bonding hormone).  We also know that loneliness makes virtually all disorders, from hypertension to diabetes, worse. 

In addition, the act of caring for an animal helps people to establish healthy routines and makes them more likely to be more active and engage in their own self-care.  It also helps them to see themselves as a caretaker and not just the person always needing support. 

So how does Paws for Patrick actually help people get ESAs? 

  1. A person starts by going to our website and filling out the help request form. 
  2. They are then assigned a wish granter who will meet with them virtually and find out what they need.  That wish granter stays with them through the process until we help them connect with their animal.  Some people already have an animal and they simply need an emotional support animal letter, others are not even sure what kind of animal would be the right fit so they may spend more time working with their wish granter.  We encourage help seekers to adopt animals from shelters and the wish granters connect seekers to shelters in their area. 
  3. We can typically help to pay the adoption fees and can even provide some funding for basic training (sit, stay, etc..…)
  4. Paws for Patrick does not have the resources at present to help people acquire service animals.  A service animal has been trained to provide very specific services for a particular disability.  The training of service animals is typically over $10,000.  Service animals are the only animals that are allowed to be with their humans wherever they go.  A common misconception is that people get ESA letters so they can take their animals with them to work, school, and out in the community.  The ESA only applies to the person’s dwelling in most states (although some states like California do allow limited access for ESAs to some workplaces). 

As a therapist volunteering with Paws for Patrick, I will get an email from a wish granter to see if I have availability to meet with a help seeker. 

I am typically performing two roles 

  1. I am vetting the seeker to make sure that they do indeed have a disability that can be benefited by an animal (and they are not just someone looking to get a free dog) and that they are healthy enough to have a pet.  At Paws for Patrick, it is very important for us to never put an animal in a situation that is unsafe or has a high likelihood of it needing to be re-homed. 
  2. The second part of my role is to build a relationship solid enough to be able to write an ESA letter.  Based on my experience that typically only takes me one session but each clinician is different and none of our volunteers would write a letter unless they felt like they could ethically and professionally stand behind that letter.  

I tend to get most of the information I need from simply asking the seeker to tell me how having an animal impacts their mental health.  So far that has always led to stories that motivate and inspire me by hearing how the love of animals impacts people.  If I had doubts about the fit and moving forward, I would consult with the seeker about other options, and potentially with the wish granter, the seeker’s therapist (if they have one), and any other people (parents, roommates, etc.…) connected with the potential adoption. 

At Paws for Patrick, we don’t generally believe in saying no, but we might say, not yet, if we had a sense this might not lead to a successful pairing. 

In return for our help, I ask each seeker to

  1. Spread the word about Paws for Patrick
  2. Share pictures of them with their ESA with us if they are comfortable. (which you will see throughout this post.)
  3. Consider volunteering with us if they come to a place in their life where they have the energy
  4. If they are working with a therapist, encourage their therapist to contact us to learn how to write ESA letters.   

Paws for Patrick is growing and we need wish granters, and volunteer therapists to write an emotional support animal letter

Over 75% of the people I have written emotional support animal letters for have a therapist who will not write the letter.  Some are prevented from doing so by the organization they work for, some are afraid to try because they have never done it before or have a misguided fear of liability. 


The best and most defensible emotional support animal letters come from therapists who have a long-term connection with the client.  I can literally write an ESA letter for a client I know well in under 15 minutes.

So if you believe in the power of animals to help people, join us. 

If you are reading this, spread the word that we exist to every animal lover and/or person connected to mental health that you know. 

If you can donate, that is always appreciated, but what we need more is for people to have open conversations about mental health to reduce the stigma. 

ESAs have become a bit of a punchline in some circles of how emotionally fragile the current generation is.  Nothing could be further from reality.  Animals and humans have been helping each other survive since the dawn of our species. 

It is only in the last 100 years that we have moved away from the vast majority of people having daily contact with animals.  Our dogs help us connect with neighbors and break the tension of an introduction.  If they do this for people without mental health challenges it should be obvious to see the benefit to people who feel trapped by social anxiety. 

young lady with her emotional support dog on a porch
One of the proud owners of a Paws for Patrick ESA

There are two kinds of organized groups pushing against the wider acceptance of ESAs

One is ESA lovers who fear that there are too many people who don’t really have disabilities who are taking advantage of the system and they fear this may lead to the rights of legitimate ESA owners being taken away. 

At Paws for Patrick, we do not believe we can operate out of fear.  We want to make sure every person who could benefit from an ESA gets one.  Accordingly, we try to remove barriers.  We respect the concern that ESAs should only be provided to those who merit them, but we think it is very dangerous to ever assume that those outside of the therapist-client relationship could know whose disability is impactful enough that they merit an ESA. 

The other group is landlords.  They want to continue to charge pet fees, and anyone who has ever tried to get the smell of cat pee out of an apartment can sympathize with their concerns.  That being said, we believe that the right to an animal should be as ubiquitous as the right to have music in your life. 

If you are blasting your music at 3 AM there should be consequences.  In the same way, people who allow their animals a nuisance to their neighbors or landlords should not be allowed to do so, but creating legislative barriers to people having ESAs is denying the most cost-effective mental health treatment to so many people who could benefit.

teen of color holding her emotional support animal
Young lady cuddling with her Paws for Patrick ESA

When a person becomes a therapist the worst thing that can happen is to lose a client to suicide

Paws for Patrick has helped me to heal and shift my focus from what I lost to what I gained. 

Patrick gave me the greatest gift a person can by sharing his trust with me. 

For the rest of my life, I will carry with me his smile, his stories, and the inspiration of the power that the love of animals can bring.  For that, I will be forever grateful.     

owner and his dog, an emotional support animal
Patrick with his emotional support animal, CiCi