TOMS RIVER, New Jersey − Before Anthony Certa began talking about his three deployments in Iraq as a U.S. Marine and military police officer, he gave a gentle command to his service dog.

"Mando, on my lap," the veteran said. Mando, a black 2 1/2-year-old England Labrador, hoisted his massive paws onto Certa's legs, then Certa lifted the dog all the way into his lap and began petting the dog, who remained still and quiet.

It was obvious the effect the dog had on Certa, who recalled his experiences guarding convoys and protecting explosives ordnance disposal (EOD) personnel as they worked. Emotional as he spoke of losing comrades, Certa remained calm and spoke softly, in measured tones.

While for years there has been anecdotal evidence of the benefits of emotional support dogs for veterans such as Certa, a new national study offers more definitive proof.

Maggie O'Haire, one of the study's co-authors and a researcher with the University of Arizona College of Veterinary Medicine, and her colleagues followed 156 veterans over three months. The study, funded in part by the National Institutes of Health and released June 4, found veterans with dogs reported decreased severity of PTSD symptoms, anxiety and depression and higher psychosocial functioning. The dogs were provided by a nonprofit, K9s for Warriors.

"We know veterans are struggling," O'Haire said. "They have much higher rates of depression, anxiety and suicidal thoughts (than the general population)."

'Really rough coming home' after combat in Iraq

Certa, who enlisted shortly after the terrorist attacks on Sept. 11, 2001, was just 19 when he was first deployed to Iraq in 2003. He was in Fallujah during the most intense fighting of the war; his final deployment ended in 2005.

After seeing the human cost of war, from service members killed by improvised explosive devices (IEDs) to urban warfare and house-to-house "cordon and knock" operations, Certa found it difficult to adjust to civilian life.

"It was really tough coming home," he said. "You had certain expectations. When you’re in the Marines, you don’t really talk about things."

He struggled, engaging in what he called "reckless behavior" and leaning on alcohol. "You mask a lot of the problems," Certa said, petting and squeezing Mando. "You get reckless; you feel invincible. You feel like, well, you didn't die (in combat), but you also feel guilty that you didn't die, and other guys did."

The 40-year-old, who was worried about becoming a statistic, is not alone. According to a 2023 report by the U.S. Department of Veterans Affairs, suicide is the second-leading cause of death among veterans under the age of 45. In 2021, 6,392 veterans died by suicide – an average of more than 17 lives lost per day.

'Something in me wasn't right'

In 2007, Certa followed the advice of concerned family members and stopped drinking. It helped. He went back to school, earned a graduate degree in education and began teaching.

But a few years ago, he found himself struggling again. The then-superintendent of the Matawan School District, Joseph "Jay" Majka, was a himself a Marine Corps veteran and understood the struggles vets sometimes face.

"I didn't realize how far I was spinning out of control," Certa said. "But my colleagues saw something in me wasn't right, and (Majka) came to me and said, 'Let's get you some help.'"

Mighty Oaks, a faith-based program for military veterans, helped Certa get his life back as he reconnected with his Christian faith. He learned to forgive himself and let go of past mistakes. He still gives back through his church and charities such as Semper Fi & America's Fund and Dylan's Wings of Change.

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Saving lives 'on both ends of the leash'

K9s for Warriors, which paired Certa with Mando, is one of several nonprofits that helps veterans obtain service dogs. It was founded in 2011 by a mom who saw her son struggle with PTSD when he returned from Iraq – but she also noticed he seemed more relaxed when he was with his dog.

Most of the animals K9s for Warriors pairs with veterans are rescue dogs, spokesperson Dani Bozzini said.

"We say we are saving lives at both ends of the leash," she said. "(Rescue dogs) have so much love to give; they're smart and cuddly and we believe in second chances, for the veterans we serve and the dogs."

Dogs are screened for temperament and their ability to obey commands and trained for six to eight months.

The dogs' training includes three main cues: "Look," which tells the dog, in military parlance, to "watch my six," helpful for people wary of enclosed spaces or being unable to see all around themselves; "on my lap," in which the dog acts as a comforting weight and calming presence; and "front," which tells the dog to form a buffer between the veteran and others, mitigating hyper-vigilance they might feel in crowds.

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Veterans, too, go through a screening process, Bozzini said. Once they're matched, veterans and dogs spend three weeks at one of two K9s for Warriors sites, in Florida and Texas, bonding and learning to work together. There's no cost to vets; the expense of training the dogs (around $70,000 for each dog, Bozzini said) and hosting veterans is supported by donors and philanthropic organizations.

Mando and Certa have been together for a year, and Certa said they're nearly inseparable. Mando accompanies him to work each day – the dog has his own school ID card – and he's a hit with students at the middle school where Certa teaches and members of the church youth group Certa leads. About the only time they're apart is when Certa, an ultramarathon runner, is on a long run.

"He helps me so much and it’s awesome that he brings such a positive element to wherever he’s at," Certa said. "There’s no crummy attitude around a dog, you know? He's the best."

Positive outcomes for veterans with dogs

O'Haire said using dogs to help people with physical challenges is nothing new, but having dogs ease mental health conditions such as PTSD and anxiety is a relatively recent innovation. That's part of the reason it hasn't really been studied in depth, she said.

But research was needed, O'Haire said, because funding sources, policy makers and insurance companies all rely on evidence and data. The dogs might not work for everyone, she noted, and they're not the only intervention – talk therapy, medications and continued support also help people struggling with mental health – but dogs can be part of the solution, the study shows.

"As I reflect on almost a decade that I've been studying veterans and service dogs, it's not uncommon for me to hear veterans tell me they wouldn't be alive if not for their dog," O'Haire said.

Certa, who married and became a stepdad to two boys in 2022, said Mando is more than a pet. The dog, along with faith and family, helps sustain him.

"The way he looks at me, the way he nudges me," he said, his voice trailing off a bit. "He needs me as much as I need him."

If you or someone you know needs help, the national suicide and crisis lifeline in the U.S. is available by calling or texting 988. There is also an online chat at 988lifeline.org. Veterans can also visit www.veteranscrisisline.net/ or text 838255. You do not need to be enrolled in VA benefits or services to receive help.

Contact Phaedra Trethan by email at [email protected], on X (formerly Twitter) @wordsbyphaedra, or on Threads @by_phaedra