Location:
MENTAL HEALTH;
Scope:
Other States laws/regulations;

OLR Research Report


December 2, 2010

 

2010-R-0483

HOARDING

By: Veronica Rose, Chief Analyst

You asked for (1) a statutory definition of hoarding (other than animal hoarding), (2) information on responses to hoarding in other states, and (3) any related information to help a group establishing a hoarding task force.

SUMMARY

The only statutory definition of hoarding (other than animal hoarding) we found was in Illinois law, which defines “hoarding” as the “acquisition and retention of large quantities of items and materials that produce an extensively cluttered living space, which significantly impairs the performance of essential self-care tasks or otherwise substantially threatens life or safety” (320 Ill. Com. Stat. 20/2).

Hoarding is often cited as a mental health issue, affecting some two to five percent of Americans, according to some studies. But it is also a public health and safety issue with social and financial implications, affecting not just the hoarder but the wider community as well. Increasingly, communities nationwide have been establishing task forces to respond to hoarding issues and provide care and treatment for hoarders. This approach is viewed as more compassionate and effective than the more punitive approach (e.g., evictions) that typically characterizes responses to hoarding.

According to Christina Bratiotis, member of Boston University's Compulsive Hoarding Research Project team, at least 75 communities nationwide have formed hoarding task forces since Fairfax, Virginia, established the first such task force in 1989 (http://www.ocfoundation.org/hoarding/print.aspx?id=697). The Fairfax model (discussed below) is an on-going task force involving a variety of agencies (e.g., public health, public safety, and housing) and service providers, including housing code and public safety officials, social workers, and medical and mental health professionals. But task forces vary in their goals, composition, functions, and termination deadlines. A San Francisco task force worked on the hoarding issue for 19 months. Its comprehensive report is described below.

HOARDING

Hoarding is generally defined as the excessive collection of large quantities of things, often of little or no value, and the inability to organize or discard them. It is a complex, debilitating disorder, which can impair normal functioning. Though often cited as a mental health illness, compulsive hoarding is not listed in the current issue of the psychiatric profession's standard Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). (It is proposed for inclusion in DSM-5, due for release in 2013. Under the proposal being discussed, hoarding disorder symptoms would include struggling to part with personal possessions; accumulating objects to the point that they clutter living space, preventing normal use; and suffering social, work, or other distress as a result of hoarding behaviors.)

The number of compulsive hoarders in the country is unknown because many hoarders do not seek treatment. But some studies estimate that two to five percent of Americans exhibit hoarding behaviors. A comprehensive 2009 San Francisco hoarding study estimated that 12,000 to 25,000 people in San Francisco struggle with hoarding behaviors.

Hoarding behaviors pose hazards to hoarders and others, including families, neighbors, and service providers. Accumulated clutter from hoarding can increase the risk of (1) falls and other accidents; (2) fires; (3) eviction for code violations; (4) social isolation; and (5) health problems from dirt, mold, mildew, pest and insect infestation, among other things. Hoarding has financial implications as well. The San Francisco study cited above estimated that it cost service providers, landlords, and others in the city $6 million annually.

TASK FORCES

In 1989, Fairfax County, Virginia, established the first hoarding task force in the country. As public recognition of the hoarding problem has grown, other communities have followed suit. Massachusetts, for example, currently has task forces in more than 10 communities, including Beverly, Boston, Framingham, Gloucester, Merrimack Valley, and Newton.

According to Bratiotis, the typical task force consists of many agencies working together with the common goal of providing “a directed and managed response to hoarding cases.” But their “mission, goals, and functions . . . are as different as the communities in which they operate [and] how they are formed, organized, and maintained vary greatly” (http://www.ocfoundation.org/hoarding/community_services.aspx). For example, some task forces consist solely of public agencies; some consist of public and private entities. Some task forces are formed to respond to hoarding cases that affect a specific population, such as the elderly (e.g., the Merrimack Valley task force in Massachusetts and Dane County task force in Wisconsin); others are established to achieve set goals and commit to a specific timeline for meeting those goals (e.g., the San Francisco task force).

FAIRFAX COUNTY TASK FORCE

The Fairfax task force is an ongoing interagency team responsible for providing a coordinated response to cases of residential hoarding threatening life and property. Representative entities include the departments of Health, Fire and Rescue, Family Services, Housing and Community Development, Planning and Zoning, Public Works, and Environmental Services; Fairfax County Police Department; Church Community Services; County Attorney's Office; and the Sherriff's Office. The full task force meets quarterly; a sub group representing several key agencies meets monthly.

According to the March 2009 task force report, Fairfax County jurisdictions can expect approximately 350 cases of hoarding per 100,000 people.

A copy of the report is attached and also available at:

http://www.fairfaxcounty.gov/dpwes/trash/hoarding/hoarding_annual_report.pdf

SAN FRANCISCO TASK FORCE

One of the more comprehensive hoarding studies was conducted by the San Francisco Task Force on Compulsive Hoarding and Cluttering. The task force was established in 2007 as a public-private partnership with representatives from major city departments, nonprofit housing entities, service providers, landlords, and individuals with hoarding behaviors. The task force was a joint initiative of the Department of Aging and Adult Services and the San Francisco Mental Health Association.

Its specified goals were to:

1. assess the needs of and services required by hoarders and identify service gaps and barriers,

2. identify best practices to improve service delivery and prevent evictions,

3. raise public and policy makers' awareness of the issue,

4. facilitate information exchange among various service providers to improve service linkages and coordination, and

5. recommend policies addressing the issue.

Over a 19-month period, the task force collaborated with private and public agencies as well as hoarders. The task force found the following:

1. Based on the 2006 census data, between 12,000 to 25,000 people in San Francisco struggle with compulsive hoarding.

2. Hoarding creates many serious safety concerns, such as risk of fire, falls, and pest infestation.

3. Hoarders use a wide range of public and private services, including behavioral, mental and public health, fire and police, building and housing, environmental, cleaning, and legal.

4. Responses to hoarding behaviors cost service providers, landlords, and others in the city of San Francisco approximately $6 million annually.

Task Force Recommendations

To improve local response to compulsive hoarding, the task force recommended that the appropriate entities undertake the following activities:

1. establish an assessment/crisis team to respond to hoarding reports and coordinate steps to facilitate meaningful, long-term improvement for hoarders;

2. increase hoarders' access to treatment, therapists, organizers, coaches, and peers by creating hoarding treatment groups;

3. expand local support groups for hoarders;

4. create a service guide for hoarders and their families, service providers, and landlords and establish a single referral form and a single point of entry into the system;

5. develop health and fire code compliance guidelines for property managers and tenants and develop training for landlords on how to use the guidelines;

6. hire clinical social workers to provide intensive case management and supportive services to clients in their homes and provide long-term case management services to supplement initial assessment and treatment;

7. offer training in hoarding issues for hoarders' relatives, mental health personnel, landlords, and specified others; and

8. name a paid “hoarding and cluttering czar” to, among other things, coordinate and evaluate the effectiveness of hoarding programs, ensure that resources and services are accessible to hoarders and and others, and track implementation of the task force recommendtions.

To view the report, visit:
http://www.mha-sf.org/documentSharing/BeyondOverwhelmed.pdf

LINKS TO HOARDING TASK FORCES

Arizona Task Force:
http://wallacewatchers.com/azho
arding/

Arlington Task Force: http://www.hoardingtaskforce.org/taskforces/arlington-county-hoarding-task-force

Atlanta Task Force: http://www.atlantahoardingtaskforce.com/aboutus.htm

Cape Cod Task Force:
http://hoardingcapecod.org/

Framingham Task Force:   http://www.framinghamma.gov/index.aspx?NID=1345

Long Beach Task Force: http://www.hoardingtaskforce.org/taskforces/long-beach-hoarding-task-force

Merrimack Valley Task Force: http://www.esmv.org/specializedservices.asp

Orange County Task Force: http://www.hoardingtaskforce.org/taskforces/orange-county-hoarding-task-force

Newton Valley Task Force: http://www.ci.newton.ma.us/hoarding/protocol.htm

Princeton Task Force:

http://www.hoardingtaskforce.org/taskforces/princeton-seniors-hoarding-task-force

San Diego Hoarding Collaborative:

http://www.hoardingtaskforce.org/taskforces/san-diego-hoarding-collaborative

LINKS TO HOARDING REPORTS AND NEWSLETTERS

Dane County Task Force report:
http://danedocs.countyofdane.com/webdocs/PDF/aging/pdf/hoardingtaskforcereport.pdf

Fairfax County Task Force report:
http://www.fairfaxcounty.gov/dpwes/trash/hoarding/hoarding_annual_report.pdf

New England Hoarding Task Force newsletter: http://www.harthosp.org/Portals/1/Images/29/NEHC-Newsletter.pdf

San Francisco Task Force report:
http://www.mha-sf.org/documentSharing/BeyondOverwhelmed.pdf

Washington Council of Governments hoarding report: http://www.mwcog.org/uploads/pub-documents/zllWXQ20061121162353.pdf

Hoarding in the news media:
http://www.hoarders.org/news.html

LINKS TO WEBSITES WITH HOARDING INFORMATION

Boston University School of Social Work:
http://www.bu.edu/ssw/research/hoarding/team/index.shtml

Fairfax County: http://www.fairfaxcounty.gov/dpwes/trash/hoarding/

The International Obsessive Compulsive Disorder (OCD) Foundation: http://www.ocfoundation.org/hoarding/

Understanding OC Hoarding: http://understanding_ocd.tripod.com/index_hoarding.html

Psychological condition, “Why & What do People Hoard”
http://understanding_ocd.tripod.com/hoarding1_why.htm

Clutterers Anonymous:
www.clutterersanonymous.net

STUDIES

Coles, M. E., Frost, R. O., Heimberg, R. G., & Steketee, G. (2003). Hoarding behaviors in a large college sample. Behaviour Research and Therapy, 41 (2), 179-194;

Samuels, J. F., Bienvenu, O. J., Grados, M. A., Cullen, B., Riddle, M. A., Liang, K. Y., et al. (2008). Prevalence and correlates of hoarding behavior in a community-based sample. Behaviour Research and Therapy, 46, 836-844.

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