Kody Green started having auditory and visual hallucinations, as well as paranoia and delusions, around during his freshman year of college. His symptoms drove him to drug abuse that ultimately landed him in prison. At age 21, he was diagnosed with schizophrenia: a brain disorder that affects how people think, feel and behave.

Although medication and other treatment helped control some of Green’s symptoms, his hallucinations persisted. Little did he know that four years later, a different type of help would give him the confidence he needed to live the successful and fully functional life he knew he, and many others with schizophrenia, deserved — this time it came with four paws and a tail. 

Luna, a Jack Russell terrier mix, helps Green identify his visual hallucinations; if he says “greet” and Luna doesn’t respond, he knows that what he’s seeing isn’t there. She also prevents Green from self-harm during auditory hallucinations. Luna will jump on his lap and put her head against his, preventing Green from hitting his face and bringing him back to the present moment. 

“My wife and I took a chance with Luna because there's no guarantee a dog can learn some of these tasks, but she was great,” Green, 29, told USA TODAY. “People with schizophrenia, we lose a lot of freedom because of our illness. But Luna has helped me be more confident and comfortable in my everyday life.” 

Psychiatric service dogs can be game changers for people with schizophrenia

Dogs have been helping people of all ages with varying disabilities for centuries, boosting independence, sense of safety, peace of mind and confidence. Research has found that service dogs, particularly the psychiatric kind, also help in many ways, such as reducing suicide attempts and improving an owner’s ability to attend medical appointments. 

Dr. Xiaoduo Fan, a psychiatrist and professor at UMass Chan Medical School who studies schizophrenia, said dogs in general can provide the social interaction some people with the illness need but lack. This notion is based on the “biophilia hypothesis,” which states that people are intrinsically drawn to other living things for feelings of safety and connection.

“People with schizophrenia have trouble relating to people so that affects their social relationships,” Fan said. “Humans are social animals with needs for love, friendship and acceptance, and schizophrenia patients are no different. Having an animal around can satisfy those needs with non-verbal communication.” 

Interaction with dogs may also be less stressful than interacting with other people, said Malene Kalsnes Tyssedal, a psychiatric doctor with the University of Bergen in Norway, who studied how dogs help adults with schizophrenia. 

As beneficial as service dogs may be, some people with schizophrenia may not be able “to take care of the physical, cognitive and emotional needs of an animal,” Tyssedal said. 

That could include the potential for harm to the dog, said Fan, who called it “a possible but very rare scenario” considering people with schizophrenia are no more violent than the general population. “This is the most common misconception from society,” Fan said.

Access to psychiatric service dogs is lacking

Green didn’t plan to train Luna to help him better handle his symptoms, but he got her just as his social media presence as a schizophrenia advocate skyrocketed, which connected him to several certified dog trainers who taught Green how to train Luna to be a psychiatric service dog via FaceTime.

Training Luna himself was a more accessible option than buying a dog that was already trained or having a professional train Luna directly. The alternatives were too expensive, plus Green lives in rural Wisconsin where there aren’t many service dog trainers around — a reality that many people with disabilities face when seeking help to supplement their other treatments.

“We really couldn't afford anything else, so having that help for the training was amazing,” Green said. “It was just a lot of luck. If I didn't have social media, none of it would have been possible.”

Psychiatric service dog training can cost anywhere between $20,000 to $30,000 on average. Medicare and Medicaid do not cover service dogs, and most private insurances don’t either. The Veterans’ Affairs Administration and Department of the Army only provide financial support for dogs trained by an Assistance Dogs International or International Guide Dog Federation accredited facility — psychiatric dogs are excluded.

Fortunately, service dogs aren’t required to be certified or complete a professional training program, so people have the right to train their own service animal, according to the Americans with Disabilities Act. Businesses also aren’t allowed to request documentation that a dog is registered, licensed or certified as a service animal, although some airlines may require owners to complete paperwork.

It’s more of a bonding experience to train your own dog anyway, said Julie Morrissette, a training consultant at Service Dog Training School International, which provides online courses for owners for about $300.

Finding opportunities to train your own service dog, however, can be confusing because the U.S. lacks a mandatory process for the selection, training and placement of service dogs, unlike other countries that regulate the industry, a 2017 study in the journal Frontiers in Veterinary Science says. 

That’s where Green hopes to step in. His goal is to work with service dog trainers to help make these animals more accessible for people. 

“People with mental illness have the most trouble getting help, are the ones in poverty, the ones that struggle getting doctors appointments,” Green said. “I always say I'm the luckiest schizophrenic because I had a ton of resources and access to insurance and medication, but other advocates and I are just trying to make the resources we all had more accessible to others.” 

One of the ways to do that, Green said, is to get rid of the stigma associated with schizophrenia and other mental illnesses. 

Even though Green served as caregiver to his mother, who has schizoaffective disorder — a chronic mental illness that causes similar symptoms as schizophrenia — he still didn’t recognize something was wrong when he had his own psychotic break. When Green sought medical attention three years later, his diagnosis “felt like a death sentence,” he said, because portrayals of schizophrenia are often negative. 

Research shows that people who feel their schizophrenia is stigmatized can have worse depression, social anxiety and quality of life, as well as lower self-esteem, social functioning and support from loved ones. Stigma can also lead to social exclusion, fewer education and employment opportunities, and worse housing conditions.

“I just want to be the voice that I needed when I was first diagnosed,” Green said. “I want to be a face to the illness, that way the next time someone hears the word schizophrenia, they don’t think of a corny show or tragic news event, but an actual person. And maybe they'll realize that with the right help, this diagnosis isn't a death sentence.”