“Her home contains tens of thousands of pieces of clothing…”

By Christiana Bratiotis

Sharon is a 53-year-old white woman who is unmarried and lives alone in a multi-family home in a northeastern suburb. Sharon recently lost her job due to her multiple mental and physical health disabilities.  Because of her job loss, Sharon is unable to afford her rent. She is now 3 months arrears and her landlord is demanding payment.  He recently stopped by to talk with Sharon.  She was home but did not answer the door.

Sharon struggled with gathering free things and saving too many objects for most of her life.   Her home contains tens of thousands of pieces of clothing, paper, and miscellaneous objects ranging from empty food containers to small appliances and collections of tea pots, dolls, and cuckoo clocks.  Sharon owns every issue of Newsweek and Time magazine dating back to the early 1980’s.  Her hoarding behaviors have led to a life of social isolation; Sharon never has friends to her home because she’s embarrassed by how it looks and worries about what other people will think.

Sharon is certain that she will be evicted if the landlord learns of her hoarding problem and the ways in which the amassed clutter has taken a toll on the house.  Sharon’s refrigerator hasn’t worked in over 2 years and the floorboards seem to be giving way beneath the stacks of magazines and paper.  The ceiling in the dining room leaks during rainstorms and is covered with mold in one corner. The window in the back bedroom is broken and squirrels and other rodents began entering the home some time ago. Sharon didn’t know what to do, so she closed the bedroom door.  It’s been over 9 months since Sharon entered that room.

While Sharon’s is not the most sensational or egregious case of hoarding, it absolutely highlights the more common scenario and the fact that hoarding is a mental health disorder which often results in situations that compromise a person’s physical health and housing stability. In addition, hoarding may create circumstances that put family, friends, animals and the surrounding community at risk of neglect, fire or infestations.  In Sharon’s case, being one of three residents in a multi-family home means that there is risk for Sharon and her immediate neighbors.

Many domains of human service are touched by the problem of hoarding.  In approximately 80 communities throughout the U.S.—large and small, urban and rural—human service professionals are joining networks where there is coordination and support for cases of hoarding with which they’re involved—cases like Sharon’s.  Recognizing that hoarding is not the primary domain of any one discipline (protective services, animal control, mental health or first responders) alone, there is an ever-increasing prevalence of community-level hoarding response mechanisms.

Brave and devoted human service professionals from disciplines such as public health, housing, nursing, occupational therapy and many others are coming together to form hoarding task forces, where they can problem solve, discuss and intervene with hoarding cases.

While attending a hoarding task force meeting on the West Coast, I observed first-hand this unique cross-disciplinary collaboration.  As the meeting was winding down, I noticed that a visiting nurse and an environmental health officer were gathering their things to leave together.  Through the task force, they realized that they were both working with the same person with a hoarding problem in a nearby town.  They decided that if they went together to the client’s home, they could more easily communicate both what needed to be done so the client could come into compliance with housing regulations and what supports could be offered to the person in order to help them achieve the goals.  When I asked the environmental health officer about this decision, her response both surprised and delighted me.  “Well, we know that we need both the big stick and the carrot.  I’m the stick and I can’t do my job effectively without a carrot.  I know because for 20 years I tried and got nowhere with people who hoard.  I need to do something differently and this seems to work.”

These human service workers do this not because hoarding is sexy or because there is fame or fortune promised to them but because they are deeply devoted to finding compassionate, effective and timely solutions to assist those, like Sharon, who struggle mightily with hoarding.

Inspired by the commitment of the human service professionals that volunteer time to lead and participate on community hoarding task forces, The Hoarding Handbook was conceptualized and written to assist diverse disciplines in understanding their role and the role of others in hoarding intervention.  Through the book’s case studies and practical tips and strategies, my co-authors and I sincerely hope that we are promoting movement from individual human service silos to collective community hoarding solutions where clients like Sharon are assisted effectively and empathically.

Christiana Bratiotis, Ph.D., LICSW, is a post-doctoral fellow at the Boston University School of Social Work. She is author, with Cristina Sorrentino Schmalisch and Gail Steketee, of The Hoarding Handbook: A Guide for Human Service Professionals.

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