Specially trained psychiatric service dogs may help adults living with mental health conditions ease loneliness, rebuild social connections and regain confidence in everyday life, according to a new qualitative study from the University of Cape Town (UCT) published in Frontiers in Psychiatry.
However, the study also highlighted that stigma, intrusive questions and discrimination in public spaces can undermine the support these dogs provide.
For some people living with mental health conditions, everyday activities – from visiting a shopping centre to speaking to a stranger or getting out of bed in the morning – can feel overwhelming. A psychiatric service dog can offer more than companionship: it can provide a calming presence, a reason to establish a daily routine and the confidence to participate more fully in the world.
The study explored the experiences of 22 participants, including 19 psychiatric service dog handlers and three leaders of South African dog-training organisations. Researchers from UCT’s Department of Psychiatry and Mental Health, Professor Jackie Hoare and Dr Fulufhelo Netshifhefhe, examined how these dogs influence loneliness, social functioning and participation in everyday life.
Professor Hoare, who heads the Division of Consultation Liaison Psychiatry at UCT and Groote Schuur Hospital, says one of the themes to emerge from the interviews was the value of having a dependable, non-judgemental companion.
Handlers described how their dogs helped them feel less alone, particularly when mental health challenges made social interaction difficult. Unlike human relationships, which can sometimes feel complicated, the dogs offered companionship without requiring handlers to justify their feelings.
As one participant explained: “She has definitely alleviated feelings of disconnection and loneliness … she’s a constant companion.”
Another handler highlighted the calming effect of simply having the dog nearby: “Most helpful is just having her presence with me. She is my companion. She really keeps me calm. And breathing together with her if I’m feeling overwhelmed at all.”
Hoare says: “The findings suggest that this steady companionship may help handlers feel more secure when managing difficult emotions and navigating situations that would otherwise be stressful.”
The benefits described by participants extended beyond the relationship between dog and handler. The dogs also helped create opportunities for social interaction.
For some handlers, having a dog alongside them made it easier to engage with other people. Dogs attracted attention and prompted conversations, offering a natural starting point for encounters that might otherwise have felt intimidating. These brief exchanges sometimes developed into friendships and wider social networks.
One participant described the difference the dog had made: “I’ve made so many friends because of him … he’s really opened doors for me that before would never have opened.”
According to Hoare, the findings point to the potential role of psychiatric service dogs as social catalysts, helping handlers move from isolation towards greater participation in their communities.
“For people who have withdrawn from social situations because of mental health difficulties, these interactions can provide opportunities to rebuild confidence gradually,” she says.
Participants also described how caring for a dog helped introduce structure and purpose into their days. Feeding, walking and caring for an animal created responsibilities that encouraged them to get up and follow a routine, even when their own mental health made daily activities challenging.
As one handler put it: “You know you have to get up in the morning, you have to feed your dog, so if you feed your dog, you need to eat as well.”
According to Hoare, this sense of responsibility could help handlers reconnect with their needs and establish habits that support their wellbeing.
The dogs also helped some participants feel more confident about leaving home and entering public spaces. One handler described being able to enter a shopping centre alone for the first time in four to five years after their dog qualified.
“Such experiences illustrate how increased confidence and emotional support may translate into greater independence and community participation,” shares Hoare.
Despite these benefits, the study found that navigating public spaces with a psychiatric service dog could bring its own difficulties.
Handlers described being denied access to shops and other public places, facing scrutiny and having to explain why they needed their dogs. “These encounters could be especially distressing for people with mental illness,” says Hoare.
One participant says: “Fighting with people about access has been the biggest one, because very often people will just be like, ‘No, she can’t come in.’”
Another person described the emotional toll of having to disclose personal information: “It’s ironic that sometimes the reason I have my dog is for anxiety, first and foremost to keep me calm, and then being provoked with intrusive questions and having to hand over my diagnosis, having to explain myself — that can get exhausting and that’s very draining.”
Hoare concludes that mental health professionals would benefit from greater awareness of psychiatric service dogs and of the psychosocial benefits and challenges associated with their use.