The purpose of this study was to explore the experiences of ESA owners, examine how the ESA policy functions in the undergraduate college setting, and analyze how the disability services offices influenced the ESA policy and campus response to ESAs on two residential college campuses. The conceptual framework of the study was systems theory. A case study method was utilized to analyze 17 interviews of ESA owners, roommates and suitemates, and college personnel who engaged with the topic of ESAs. The analysis resulted in the identification of 5 major themes: Personification and High Intensity Relationships with ESAs (the positive bond between owner and animal similar to a human relationship), Caregiving Reciprocity (the mutual benefit of both the animal and student's survival), the Inconsistent Responsibility of ESA Owners (the different levels of care and responsibility from student to student), the Unwieldy Nature of ESAs in Both Policy and Practice (the difficulty of one office creating a policy and another department implementing it), and Prioritization of Student Mental Health (the tendency for others to support this challenging process because of care for mental health needs). Findings suggest there is a case for ESAs as a beneficial mental health solution for certain students who see improved mental health functioning related to daily caregiving responsibilities, but the study found certain distinct differences in how the ESA policy is written and what truly occurs before, during, and after the ESA is approved. Residence life staff have a uniquely challenging role in the process. Implications include fostering stronger ties between disability services and residence life, evaluating and promoting human social support and connection in conjunction with the social support provided by the animal, creating open lines of communication and feedback, and writing or revising the policy with clear recognition of the inherent limitations posed by the ESA system as a whole. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://bibliotheek.ehb.be:2222/en-US/products/dissertations/individuals.shtml.]