by Lindsay Russell // March 2, 2020
WASHINGTON – The House of Representatives passed a bill in early February that would launch a five-year pilot program to make federal grants available to nonprofits that train service dogs for veterans with post-traumatic stress disorder. As part of the pilot program, the Department of Veterans Affairs would assess the effectiveness of using service dogs to treat PTSD in veterans.
The Puppies Assisting Wounded Servicemembers for Veterans Therapy Act, known as the PAWS for Veterans Therapy Act, was authored by Rep. Steve Stivers, a brigadier general in the Ohio National Guard.
The grants would be available to accredited nonprofits. Training a service dog costs an average of $25,000, and most nonprofits provide the dogs to veterans free of charge.
The bill comes at a time when the nation is calling for an increased focus on veterans’ mental health treatment. Veterans are not receiving the care they need, and suicide rates are climbing.
On average, 20 military personnel die by suicide each day in the United States, when accounting for veterans, reservists, and those on active duty. This is nearly twice the suicide rate among those who have never served in the military.
Veterans experiencing PTSD can face symptoms including panic attacks, nightmares leading to insomnia, flashbacks, outbursts of anger, hypervigilance and a loss of interest in activities or social interaction. PTSD can ultimately lead to depression, substance abuse and suicide.
“Our nation has an obligation to protect those who have served us, and that’s why suicide prevention is my top clinical priority,” David J. Shulkin, then-Secretary of the Department of Veterans Affairs, wrote in a letter published to the American Association of Medical Colleges website in November 2017.
Since 2017, the VA has trained more than 12,700 mental health clinicians in evidence-based practices like prolonged exposure therapy and cognitive processing therapy, which the VA refers to as the most effective methods for treating PTSD in veterans.
Janice Krupnick, Ph.D., is the director of the trauma and loss program in the psychiatry department at Georgetown University Medical Center. Krupnick says the VA-endorsed PET and CPT methods have high drop-out rates, creating gaps in care.
“What is particularly pronounced in veterans is a lot of social isolation and avoidance of things that remind them of trauma,” Krupnick said.
Many veterans experiencing PTSD feel that they should always be on high alert, which makes it hard to enter crowded spaces like grocery stores, shopping malls and movie theaters. That fear keeps them inside their homes.
Service dogs are trained to interrupt the anxiety and redirect the veteran. They will lick, nudge or paw at the veteran to force them to focus on the dog instead of panic. The dogs are trained to create space for the veteran by putting their bodies in between the veteran and the crowd.
If the veteran is feeling anxious about leaving their back exposed, the dogs can position themselves to watch the veteran’s back. The comforting presence of the service dogs allows veterans to sleep more soundly.
“A service dog provides what [veterans’] prescription medications and any other methods they’ve tried to alleviate their PTSD doesn’t,” said Brianna Bentov, public relations manager for K9s for Warriors. They allow the veterans to regain their independence and their confidence.
K9s for Warriors is a nonprofit that adopts and trains service dogs to pair with veterans experiencing PTSD, a traumatic brain injury or military sexual trauma. The organization has matched and graduated 612 veterans and service dogs from their three-week training program.
“Most of our warriors who come here say that this was their last resort, and they wish it had been their first,” Bentov said. After just a few weeks with their new service dogs, Bentov says many of the veterans in the K9 program reduce the pharmaceutical drugs they take to manage their PTSD symptoms.
The House passed the PAWS for Veterans Therapy Act two years after the first quantitative research results were released on the effectiveness of service dogs for veterans experiencing PTSD.
At Purdue University’s Center for the Human-Animal Bond, Dr. Maggie O’Haire and graduate researcher Kerri Rodriguez are working to put scientific data behind the anecdotal evidence that service dogs reduce PTSD symptoms in veterans.
O’Haire and Rodriguez partnered with K9s for Warriors in 2015 to conduct a series of studies. The research team studied the K9 for Warriors program graduates who had been paired with a service dog and the veterans on the K9 for Warriors waiting list who had not yet been paired with a service dog.
In 2018, they released two promising pilot studies which show that based on both self-reporting and a physiological test, the group of veterans with service dogs had a better quality of life than their counterparts on the waiting list.
“It seems that one of the big benefits to having the service dog is getting out of the house and having the freedom to go into public,” Rodriguez explained. “There were amazing stories of veterans being able to go to their son’s soccer games for the first time or to the movies.”
The first study found that the veterans with service dogs reported lower levels of overall symptoms of PTSD, lower levels of depression and higher levels of overall life satisfaction.
The second study measured veterans’ levels of salivary cortisol, a stress response hormone, and found that veterans with service dogs had more normal cortisol levels, which indicates lower levels of chronic stress and anxiety. The veterans without service dogs had more abnormal cortisol levels, revealing the toll of years of chronic stress and anxiety as a result of PTSD.
“We did find significant evidence that there is something happening physiologically, as well as psychologically,” Rodriguez said.
This study, published in June 2018, is the first physiological evidence to support service dogs as an effective solution for managing the symptoms of PTSD. It is important to understand, however, that the service dogs do not completely eradicate the symptoms, Rodriguez noted.
O’Haire and Rodriguez are currently working on a clinical trial to track the effects of service dogs over time. Those results are expected next year.
“I hope we’re giving veterans a voice through science,” Rodriguez said. “We hear these really incredible stories about how these service dogs are saving veterans’ lives, but there is now finally data to start to show that that change can be real.”
As the PAWS for Veterans Therapy Act awaits its future in the Senate, Stivers is “cautiously optimistic,” says AnnMarie Graham, communications director for Stivers’ office. “Everybody has kind of gotten on board that this is the [bill] that we’re actively pushing.”
A vote has not yet been scheduled in the Senate.
If you or someone you know needs support, the Veterans Crisis Line is available by dialing 1-800-273-8255 and pressing 1 or by texting 838255.
Advanced Reporting Times, Spring 2020 