Housing officers need better training or even specialist anti-hoarding teams to deal with hoarders–according to new research from the University of East Anglia.
From environmental health and fire risks to dealing with often complex mental health needs, a new study reveals the challenges faced by housing officers supporting people who hoard.
At present there is no established national guidance for managing hoarding behaviors.
The research team recommend that housing officers are given better training–particularly to deal with hoarders with mental health disorders and underlying trauma–and that specialist teams could help hoarders reduce their clutter.
Lead researcher Dr. Sarah Hanson, from UEA’s School of Health Sciences, said: “People who have a hoarding disorder have trouble throwing things away, they collect and accumulate belongings, and their living spaces become very unmanageable.
“It’s hard to know how many of us are hoarders because it’s so stigmatized and people with the disorder are likely to feel embarrassed or ashamed. But it’s thought that about two percent of the adult population are affected.
“Hoarding behaviors are associated with a higher rate of healthcare utilization, chronic and severe medical concerns, a higher rate of mental health service use and housing insecurity due to the threat of eviction.
“As well as affecting the individual’s health and wellbeing, hoarding often affects relationships and family life.
“It can also cause a significant fire and environmental health risks and a significant economic burden to housing providers and emergency services.
“Working with hoarders presents many challenges to housing providers, who need to balance the care of their properties with the care of their tenants.
“Dealing with the results of hoarding can be traumatizing for the person who hoards and the hoarding behaviors usually re-occur.
“We wanted to find out more about the nature and extent of hoarding, about the challenges faced by housing officers, and how they could be better equipped to deal with hoarders.”
The research team worked with housing officers from Norwich City Council and developed a database for the officers to log hoarding cases.
A total of 38 cases were recorded between May and August 2021 and each was assigned a clutter rating. Other information–such as the vulnerability of the tenant, safeguarding issues, referrals to other agencies, tenancy duration, and environmental health and fire risks–was also logged.
The research team found that the majority of hoarders lived alone (87 percent) and almost half (47 percent) had a known vulnerability or disability. Around 60 percent of cases lived in flats and just over a third (34 percent) posed an environmental health or fire risk.
Dr. Hanson said: “We interviewed 11 housing officers and they were each working with up to 10 problematic hoarders.
“The officers felt very conflicted about how to best protect the property, whilst acting in the best interests of the tenant and their mental health issues and vulnerabilities.
“We found that hoarding often presented alongside other support needs, for example substance misuse, trauma, and depression.
“But housing officers are not mental-health trained so many of the problems they’re dealing with go beyond the boundaries of their role and expertise.
“Overall, we found that housing staff are very committed to finding person-centered solutions.
“But building relationships and finding solutions to manage hoarding to levels that are safe and acceptable to the tenant, the property and neighbors is very time-consuming.
“Housing officers need long-term, ongoing support and specialist training to manage hoarding cases, but this is often challenged by other demands of the job, which are often emergency situations.
“It’s really important that housing officers should have stronger links with mental health providers be able to refer hoarders for further support packages.
“Managing hoarding cases is emotionally demanding for staff, and they may require additional support themselves,” she added.
“Our research shows that there needs to be a greater focus on a holistic and community-based approach to hoarding cases.
“Training up dedicated hoarding teams or ‘hoarding champions’ to manage cases of hoarding could work really well,” she added.
Rachel Omori, Independent Living Manager at Norwich City Council, said: “This collaboration with UEA helped us raise the profile of tenants with complex self-neglect and hoarding behaviors and explore more deeply how we might best support tenants and staff.
“Staff welcomed the opportunity to share their experiences with the researchers who were independent from the council and were comfortable to share how they felt about working alongside people with very entrenched behaviors alongside their other day to day work.
“The research highlighted a number of issues which we will explore further via an action plan. This includes a more systematic approach to data collection, holding regular workshops to share good practice, implementing a trauma informed approach with a special training program, reviewing our internal process and guidance, assessing the prevalence of cases across the county, and exploring approaches to case management.”
“Council tenancies and hoarding behaviors: A study with a large social landlord in England” is published in the journal Health and Social Care in the Community on March 21, 2022.
Bryony Porter et al, Council tenancies and hoarding behaviours: A study with a large social landlord in England, Health & Social Care in the Community (2022). DOI: 10.1111/hsc.13779
University of East Anglia