In the United States, trained service dogs are permitted in public places that do not allow pets. In contrast, emotional support animals are not trained and only have access to no-pet housing such as apartments, condos, and dorms. One in four emotional support animal owners obtained their ESA letters through internet sites rather than from personal health professionals.
Herzog, H. 2023. The Use and Misuse of Emotional Support Animals, Psychology Today, 12 February https://www.psychologytoday.com/intl/blog/animals-and-us/202302/the-use-and-misuse-of-emotional-support-animals