Rising scrutiny over service dogs

The Washington Post Adam Fuller credits a simple, oneword command — and a black Lab mix named J.D. — for helping to save his life.

“Cover,” he tells J.D., who is sitting to his left in a grassy field next to a park playground. The dog calmly walks to Fuller’s right then sits facing backward. Were someone coming up from behind, he’d wag his tail. The signal quells the sense of threat that plagued Fuller after serving in Afghanistan, that at one point had him futilely popping medications and veering toward suicide.

“Yes!” he praises J.D. as four women watch closely. They, too, are veterans with post-traumatic stress disorder who are here to be trained and to leave with canine support of their own. All seem to appreciate the strategy behind “cover,” as their goateed instructor demonstrates with J.D. “I wouldn’t be here without him,” Fuller says.

Every month, a new cycle of training begins with yet another class of veterans in a program run by the northern Florida K9s for Warriors. The 7-year-old nonprofit is one of dozens of private organizations that offer “psychiatric service” dogs to address the military’s mental health crisis — enabling desperate vets to function in society, proponents say.

Yet even as success stories allow these groups to briskly expand their work, their approach faces growing scrutiny from researchers and debate among veterans groups, politicians and the Department of Veterans Affairs. At issue is whether the dogs truly help, what they should be trained to do and who should pay for them.

The VA has covered veterinary care for service dogs that assist veterans with physical disabilities for more than 15 years. It has declined to do that for PTSD service dogs, however, citing a lack of empirical evidence for their therapeutic value. The agency is now conducting a $12 million multiyear study on the topic, even as it opposes legislation that would require it to pay for dogs in a separate pilot program.

“The numbers are startling on veteran suicides, and this is working,” said Rory Diamond, a former federal prosecutor who quit to become chief executive of K9s for Warriors, where he had been providing pro bono legal services.

On a table in the organization’s cheery lobby these days is a flyer that says “research proves” the dogs save lives. It cites a recent first-of-its-kind study out of Purdue University that used standard questionnaires to assess PTSD symptoms and other aspects of mental health among 141 K9s for Warriors applicants, half teamed with a service dog and half on a wait list. Those with dogs showed significantly lower levels of posttraumatic stress, depression and social isolation, with higher levels of psychological well-being.

Still, lead author Maggie O’Haire, an assistant professor of human-animal interaction, emphasizes the study’s “preliminary” nature and the need for more research on how service dogs might fit into treatment plans. “There is so much political agenda behind this topic,” she said.

Other investigations are underway, including a clinical trial that O’Haire is conducting with funding from the National Institutes of Health. The VA’s remains the biggest in scope, though, as well as the study that has drawn the most criticism.

Its 2011 start was rocky: Dogs, provided by contracted groups, bit participants’ children, and trainers were “biasing” veterans with talk of the dogs’ healing powers, said Michael Fallon, the agency’s chief veterinary medical officer. The project was halted and redesigned to include VA-hired dog trainers and a control group of veterans provided with emotional-support dogs — what Fallon calls a “very well-trained pet.”

All 220 subjects were enrolled and matched with pooches by late 2017. Initial results are expected in 2019. Officials insist they’re doing the kind of rigorous, controlled research that the field has been lacking.

“We really want to know the answer,” said Patricia Dorn, director of VA’s rehabilitation research and development service. “We want to know for the veterans and the public at large.”

Long history

Dogs have provided services to humans for millennia, often as hunting and herding partners. But not until World War I were they systematically trained to assist people with disabilities, as guides for the blind. Service dogs now prompt deaf people when a doorbell rings, retrieve pills for people in wheelchairs and alert people with diabetes to blood sugar spikes.

Psychiatric service dogs are forging a new frontier in this field, and their mission blends those of task-oriented service canines and animals seen as providing emotional support. While the dogs paired with veterans with PTSD commonly are trained to wake them from nightmares and to “block” the space between their owner and another person, advocates also laud their ability to soothe a panicking vet and provide companionship and a tailwagging reason to get out of the house — if only for walks.

“Being able to go to a store — and not just hate it and drop everything and walk out — is phenomenal,” explained the 29-yearold Fuller, a K9s for Warriors graduate, as the women he was helping to train did laps with their dogs beneath the park’s tall pines.

Living proof

Cross, a floppy-eared black Lab mix, was a shelter mutt — nothing like the fluffy golden retriever Tammie Gillums pictured when she headed from her Gainesville, Va., home to K9s for Warriors last summer.

Gillums, a 39-year-old Army veteran and mother of six in a blended family, came home in 2008 with crippling migraines. She couldn’t sleep or concentrate. She started lengthy therapy with a VA psychologist and psychiatrist and at one point was on a halfdozen prescriptions simultaneously. She stayed home whenever possible.

One thing made the difference, she said: Cross.

Gillums had never owned a dog, and she admits she was skeptical. But it has been months since she has needed any medication.

Cross jumps on the bed to wake her from restless dreams. After a decade of dropping out of classes because of panic attacks and anxiety, Gillums for the first time completed a semester of courses at the community college where she is studying.

Her relationship with Cross, she said, “is some type of magic.”