Packed to the Rafters

The house is no different to any other, but as you approach it, you notice that the yard is cluttered with “junk” – broken furniture, metal drums, boxes, plastic bags, and empty bottles. After carefully navigating a path to the front door and entering the house, you are greeted with an unpleasant odour. You venture further, struggling down a corridor that has been significantly narrowed due to piles of newspaper that reach the ceiling. Rooms are cluttered with more furniture, old appliances, books, and rubbish. There is no real place to sit. The bath is stacked with boxes of used sanitary products, the kitchen benches, stove, and fridge are stacked with newspaper, and you can’t bring yourself to open the fridge. A large rat scurries across the floor…

Hoarding disorder is characterised by a need to retain things that have personal value to the individual and emotional difficulty associated with discarding these possessions. They may fear losing items or believe that they may be required at a later time. It differs from normal collecting in that the collected items clutter living areas to such an extent that the intended use of these areas is significantly compromised.

Mental health professionals have known about this disorder for some time but more research, media attention, and popular television series have revealed more about this subject. We have seen images on television of defiant hoarders battling with local authorities for years and eventually having their possessions removed under court order. However, some people with the disorder remain more isolated in their environments, with people putting up with their “eccentric” neighbours, or family members not feeling able to enforce change in their loved ones who are often elderly. Such hoarders often remain hidden from mental health services.

Failure to address this disorder can have significant ramifications. Due to the extent of clutter, cleaning is usually compromised, leading to unhygienic conditions. This is fuelled by insects and vermin that make their homes among the stored articles and poor hygiene that comes from not using bathroom facilities because they are used to store items. Food preparation is conducted on unhygienic surfaces and may not be cooked due to stove tops being cluttered. Paper and the likes becomes a fire hazard and lack of easy escape from the house makes it possible for hoarders to be injured or die during fires, as well as endangering fire-fighters. Items may also fall on people and the structure of houses may become compromised. Not surprisingly, hoarders tend to be socially isolated.

Difficulties with local councils and the police are more likely to occur when a hoarder’s property is considered unsightly, unsafe, or unhygienic. This often arises due to animal hoarding – possession of a very large number of pets in overcrowded conditions, often not fed adequately, their droppings not disposed of, and the hoarder not realising the health implications for themselves, their neighbours, or the animals. Authorities have the power to enforce legislation when a household is considered to be a health risk but orders are often fiercely contested. Some people are involuntarily placed under mental health legislation.

Not surprisingly, some hoarders have co-existing mental disorders like dementia, depression, trauma-related disorders, and schizophrenia, but it is most commonly associated with obsessive-compulsive disorder. As such, hoarders may ironically be quite perfectionistic, but also struggle with indecision, organising ability, avoidance, and forming emotional attachments. Help with such difficulties is available through psychological intervention and medication. The difficulty comes with getting people who are often lacking in insight and motivation to address their difficulties. The earlier that difficulties are identified by family members, health nurses, general practitioners, and others, the better the chance of identifying and treating this significant disorder. It also means that councils, tribunals, courts, and other authorities can make informed and sensitive decisions before things get out of hand.


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