Hoarding is a complex mental health problem, characterised by a difficulty in making decisions about what to keep and what to throw away. People will have strong beliefs around the value of the items being kept. What might look like rubbish to others will be deemed to be of particular importance or hold great emotional significance to the person. Hoarders tend to avoid throwing things away, and may experience a high level of distress or anxiety. Some people have such a difficulty with collecting items, or hoarding, that their belongings begin to take over their living space. This can result in restricted use of their rooms or even being unable to use their bathroom or kitchen at all. Sadly for some it will lead to increased risk of injuries due to falling objects, or piles slipping, and there is an associated higher risk of household fires which can be catastrophic for the person concerned.
Hoarding is now a recognised mental health problem in its own right following some high profile TV shows being produced. Ch4 ‘Obsessive Compulsive Hoarder’ featuring Richard Wallace and the BBC ‘Britain’s Biggest Hoarders’, by Jasmine Harman, stand out as examples of good reportage. In addition there has been widespread public interest and concern, particularly after news reports of people whose difficulties with hoarding have led to their deaths.
Hoarding is much more common than people think, some estimate that up to 4% of the population may have a problem with hoarding (Samuels et al 2008). In this study by Samuels et al, people who hoard had to acknowledge they had a problem, so it is likely this is an underestimate of prevalence. Many people see their collection as ‘manageable’ or a difficulty with lack of space to store things and it is often other people who see it as a problem. Hoarding has consequences not just for the person who may not be able to use their home properly, but also for those who live with someone who hoards. Hoarding can cause significant distress to relatives, particularly if the person themselves does not see that it is a problem, or if they feel too embarrassed to look for help or treatment. The difficulty in accepting treatment can increase the stress felt by family members.
Research shows that over 80% of hoarders report a family history of the condition, although the exact causes are as varied and complex as people are. Rather than analysing why the problem has come about, treatment involves helping people to address their beliefs about their items and behaviours that keep the problem going. In addition treatment needs to include home visits and involving family members who live with the person or are supporting them. People who hoard should be empowered to instigate change – but at their own pace, as sometimes rapid wholesale clearance can lead to further psychological problems. It’s essential that people with difficulties can dictate the speed at which change happens to maximise the likelihood that relapses don’t occur.