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Are we doing the right thing to help people with Hoarding Disorder?

The recent case of a Nottinghamshire man jailed for hoarding brought into sharp focus the issue of how best to deal with persistent hoarders. The man was taken to court by the local authority for breaching an injunction to ensure that the property was maintained "in a clean and tidy condition free from excessive accumulation of belongings or rubbish that could cause a health and safety risk". He was jailed for 28 days.

I know nothing of the case or the information available to the judge. However, the press headlines are in themselves revealing. ITV News said, "man jailed because he didn't keep his house tidy", the Mirror On-line said, "man jailed after council claims his untidy home is 'health and safety risk" and the Guardian said, "man jailed after breaching tidy home injunction". 

Clearly hoarding of possessions, rubbish or animals does represent a health and safety risk and is a real concern for the person, their neighbours and their landlord. However, it raises a question of whether a health and safety approach is the best approach. These headlines reflect a widespread belief that hoarding is a lifestyle choice. 

There is now a much greater understanding of hoarding as a mental health condition and we have seen the introduction of a new concept of Hoarding Disorder as a distressing condition in which the individual has extreme attachment to a large number of objects which would normally be considered worthless or of low value. Hoarding is now recognised to be one of the most common mental health conditions affecting between 1% and 5% of the adult population. Too often agencies feel that they have no option but to address this via a legal approach which is distressing to all involved.

On July 6th, HACT is holding a workshop which aims to demystify Hoarding Disorder and suggest ways in which agencies can work together to tackle it. Dr Lynne Drummond (Consultant Psychiatrist in Obsessive Compulsive Disorder and Body Dismorphic Disorder at SW London and St George's Mental Health Trust) will explore how we work to address Hoarding Disorder and how housing associations, working together with NHS Mental Health Trusts and professionals, can best address this issue for the individuals concerned and the wider community.

Hoarding Disorder can be very distressing and is particularly important as, left untreated, patients can place their lives at risk as well as that of neighbours due to risk of fire and structural damage to property as well as the risk of being crushed and the effect on general health of living in often unsanitary conditions of squalor. However, it does not seem that traditional health and safety approaches to the issue are serving us well and it's time we adopted a new approach.

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