When is hoarding problematic?

Everyone has their own preferences and style when it comes to belongings: some people prefer to hang onto things, while others prefer keeping very few possessions. Hoarding behaviour becomes problematic only when it begins to create difficulties in life such as under any of the following conditions:

Click to View Conditions
  • The home is so full of saved items that it is difficult to enter, exit or fully function in the space
  • Bug and/or rodent infestations cannot be treated or re-occur due to the amount of clutter
  • Falls or other injuries are occurring in the home due to clutter
  • Eviction has been threatened, is imminent, or has taken place due to the volume of clutter or associated difficulties with maintaining the structure and cleanliness of the home

The Accumulation of Clutter

All people collect and save things [Leckman, Mataix-Cols, & Rosario-Campos, 2005]. When these behaviours become more frequent or intense, clutter can accumulate, resulting in large, seemingly unorganized piles that crowd living spaces. People with a lot of clutter usually experience some or all of the following:

Common Experiences

A strong drive to acquire items

For example: frequent shopping trips, stocking up at sales, collecting items from the curb or other free things, etc.

Difficulty letting go of items, even those with limited value

The urge to hold onto items can be intense and discarding possessions causes high levels of distress

The clutter causes distress, gets in the way of social or daily living activities, and/or poses a risk to health and safety

Many people feel overwhelmed or embarrassed by the clutter. Some stop inviting others to their home or do not allow repair and maintenance workers inside. Completing daily chores like cooking, cleaning, personal care and sleeping can become difficult.

Living areas so packed with possessions that they can no longer be used

For example: the bathtub is used to hang extra clothes, hallways are limited to small walkways between piles, important paperwork or bills get lost, etc..

Sometimes fatigue, depression, or declining abilities may also get in the way of organizing and maintaining the home.

The Clutter Spectrum

The type of items saved and the reasons they’re kept are the same for people with and without clutter [Frost & Gross, 1993; Petrusa et al, 2008]. These feelings are just stronger and more frequent for people with excess clutter or hoarding.

When difficulties with discarding become very intense and the clutter becomes significantly impairing, it may be identified as a compulsive hoarding disorder.

Compulsive Hoarding Disorder

Compulsive hoarding is a complex mental health disorder. Since the 1990s, mental health professionals have been learning more about this condition. In more recent years, hoarding has been a hot topic on television programs, increasing general awareness of the condition.

The diagnostic criteria for compulsive hoarding are currently under development by experts within the medical community [Petrusa et al, 2010]. A widely accepted definition of compulsive hoarding is as follows:

Excessive collection and difficulty discarding objects of seemingly limited or no value leading to clutter, distress and disability [Frost & Hartl, 1996].

Facts about Compulsive Hoarding:
  • Hoarding can be a standalone disorder or may be a symptom of some other­ condition such as obsessive-compulsive disorder, dementia, schizophrenia, autism spectrum di orders or diogenes syndrome. [Petrusa et al, 2010]
  • Recent studies suggest that hoarding is more common than once believed and occurs in about four to 14 per cent of the general population [Ruscio et al, 2008; Samuels et al, 2008; Mueller et al, 2009]
  • Hoarding behaviour may start in early adolescence and can be a lifelong challenge. The people most likely to seek treatment for hoarding are women in their 50s [Steketee & Frost, 2003]. People who hoard tend to live alone and may have a family member who also hoards [Bratiotis et al, 2009]
  • People who hoard often appear unaware of the severity and consequences of their behaviour [Steketee & Frost, 2003; Tolin, et al, 2010; Steketee et al., 2001]

What is Animal Hoarding?

Pets may be adversely affected by conditions in the home. This could involve either inadequate conditions to support the health of an animal or animals, or in some cases, situations of animal hoarding.

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Toronto Animal Services

Operated by the City of Toronto, Toronto Animal Services (TAS) provides animal care and control services to the residents of Toronto. Core services include: 

  • operation of three animal shelters
  • bylaw and provincial law enforcement
  • emergency response to public safety issues
  • support for injured stray pets and wildlife

The mission of TAS is to help animals and enhance the human/animal bond. Pet owners in Toronto who face significant challenges such as poverty, homelessness and mental illness, can find it extremely difficult to maintain care of their pet(s). Often pets are the only source of emotional connection for people in this demographic.

To support these residents, the City of Toronto has developed a number of barrier-free initiatives:

  1. SNYP (spay/neuter your pet) Truck: Provides spay/neuter services, pet wellness checks, vaccinations and microchip identification implants to residents of Toronto. The truck travels to communities so that mobility is not a barrier to acceptance of services.
  2. Chip Truck: Offers microchip implants and low-cost rabies immunization through a partnership with Toronto Public Health. Also a mobile service, the Chip Truck travels to neighbourhoods across the city.
  3. Community Outreach: Toronto Animal Services staff attend or organize numerous free community events to provide information on important topics such as responsible pet ownership, dog bite prevention, animal-related bylaws and coyotes.
  4. BluePaw Program: Provides exclusive offers and discounts on pet-related products and services for owners who license their dogs and cats.
  5. Affordable fees: Offered to low-income residents, TAS can waive or reduce fees for pet owners who meet specific income criteria.

Through this work, Toronto Animal Services have observed two main challenges for residents struggling with hoarding: 

  • They often have a higher than acceptable number of pets. While pets could be confiscated in some cases, this can be significantly traumatizing for pet owners, who often get new pets quite quickly.
  • They are often unaware of how hoarding is negatively impacting their pets' well-being. By offering some veterinary services, free pet supplies and other support, staff hope to gain trust and help residents see their pets' situation more clearly.

Working with pet owners with hoarding issues can be a complex issue, often with varying degrees of success. In all cases, the goals of Toronto Animal Services are to:  

  1. Ensure the health and welfare of all animals: In low-risk situations, the goal of staff is to gain trust and provide support to pet owners over time. For more serious concerns (i.e. injured or extremely sick animals), staff may work with relevant authorities (Toronto Police Service or OSPCA) to assist with the seizure of animals.
  2. Spaying/neutering and vaccination of all animals: Spaying/neutering is key to ceasing further reproduction. This can be achieved through the SNYP Truck. Spaying/neutering can take multiple days and this can enable staff to build trust with pet owners, which can lead to the surrender of some animals.
  3. Reducing the number of animals to six cats and/or three dogs: This number is more manageable for pet owners, and brings them into compliance with City bylaws.

Learn more about the services offered by Toronto Animal Services.

What Are the Effects of Clutter and Hoarding?

It can be very difficult to live in and enjoy a home when surrounded by clutter.

Extreme clutter also exposes people to falls, fires, floods, infestations, respiratory problems, and difficulty accessing emergency services. Eviction and other court proceedings may result in homelessness, expensive fines, hospitalization or an unwanted move into a long-term care facility. [Damecour & Charron, 1998; Frost Steketee & Williams, 2000; Steketee & Frost, 2003; Thomas, 1997; Tolin, Frost, Steketee & Fitch, 2008].

Clutter can often become a source of frustration and tension between friends and family members concerned about the state of the home and the well-being of the clutterer [Bratiotis et al, 2009; Tolin, et al, 2008].

What Can Be Done?

Firstly, it’s important to recognize that some people with a hoarding problem will not be ready to address their issue; nor will they be interested in help. They may not believe there is a problem. Adopting a sensitive and empathetic approach with these individuals is essential to building a foundation of respect and trust. This also increases the likelihood that an individual with a hoarding disorder will be open to assistance if they choose to address the issues at a later point in time. For a better understanding of what to do in these cases, see How to Make Change: The Stages of Change and How to Be a Helper.

Other individuals with a hoarding disorder on the other hand, will be considering change and looking for help. Formal treatment is available to assist them in identifying the causes and in overcoming them.

Clutter Treatment Strategies Focus On
  • Developing an awareness of clutter-causing thoughts and behaviours
  • Learning skills to re-evaluate beliefs about possessions which may be causing clutter
  • Letting go of possessions with the assistance of a helper or therapist
  • Developing a plan to manage and prevent the accumulation of future clutter

{Steketee & Frost, 2008; Tolin et al, 2007}

Clearing Out Cluttered Homes

In some situations, clearing out the home by a one-time, heavy-duty cleaning service may be useful to prevent eviction or a serious health complication. Research and clinical experience show, however, this approach is best used only with careful consideration [Bratiotis et al, 2009]. When clutterers are pressured to clear out their possessions in a short time frame and they're not ready, they may experience anxiety, dread, isolation, shame, rage and depression. They may lose trust in others and become significantly traumatized. As a result, they may experience heightened difficulty in both accepting help and in discarding and non-acquiring in the future. Despite the clutter being temporarily gone, the condition is still present. These homes typically become recluttered [Bratiotis, 2009]. Therefore, when clutterers choose this approach, it's very important to provide support related to the causes of their condition and ongoing strategies to address it.

Are You a Service Provider Seeking Information

While providing services and supports within the community you may encounter individuals struggling with hoarding. Addressing hoarding with clients with little to no insight about the risks of their current living conditions can be challenging.  This website will provide information and relevant resources to help better inform you on how to approach or support individuals with problematic hoarding.

A Couple of Tips To Consider

1.Consent is Key:  exploring supports and services can be done without sharing any personal identifying information but any referrals made must always be a follow-up action once you have obtained consent from the person in need of assistance.

Tips:

-Encourage client to self-refer

-Obtain consent to make a referral

2.The threat of eviction is often the reason that problematic hoarding is brought to the attention of service providers— at this point, most individuals will experience high anxiety and distress. There is no easy solution or quick clean-out that will effectively address hoarding behaviours. It is important to work in collaboration with housing providers, case managers (if assigned), and additional community supports to help advocate for the client, secure their housing and address the immediate needs of the individual.

Tips:

-Collaborate with client care team

-Address the immediate service need with client

-Discuss a long-term sustainable intervention

3.A combination of services and supports such as clutter coaching, peer support groups, counselling, emotional support is common practice. For more information on community services available, please click here.

4.The stigmatization and lack of understanding by the general public around hoarding may leave individuals reluctant to reach out for help, feeling judged which can lead to further isolation.

Tips:

-It is important to be mindful of the language that you use

-Listen actively and always respect your client’s/individuals level of readiness to accepting supports and services

Wellness Recovery Action Plan (W.R.A.P.)

Wellness Recovery Action Plan (W.R.A.P.) is an intervention that was developed by people who had been dealing with a variety of psychiatric symptoms and who were working hard to feel better and get on with their lives.

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