Hoarding Disorder

A recent guest on our Not Alone radio broadcast created quite a stir with her comments and insights addressing hoarding, so we wanted to share more of her conversation with us about hoarding disorders, the research that has been underway the past 25 years, and the opportunities she sees for community prevention and intervention.  We are gratified to learn that hoarding disorders will be included in the new DSM – 5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition)

Dr. Christiana Bratiotis, a professor with the Grace Abbott School of Social Work at the University of Nebraska-Omaha, co-authored an insightful book entitled The Hoarding Handbook:  A Guide for Human Service Professionals.  Dr. Bratiotis considers hoarding to be a serious mental health issue; a complex problem that manifests as clutter, difficulty discarding, and even the need for keeping items that are seen as offering comfort.  It begins in teenage years and is challenging to abate.

Biological factors, genetic factors, brain injury, and dementia can all be triggers.  We learned that about 50 percent of the people who hoard have major depressive disorder, with about 30 percent also having anxiety disorders.  Obsessive Compulsive Disorder as well as ADHD can also play a role.

If you are a community health worker sent to confront a person about the condition of their yard or home, Dr. Bratiotis and her colleagues suggests first we “Imagine yourself in the client’s shoes”;   be respectful and friendly, remembering to ask yourself how would you would want others to behave toward you to help you manage the anger, frustration, resentment and embarrassment that is involved?    People who hoard are trapped in a web of collecting, disorganization and difficulty letting go of things.  Plus, Dr. Bratiotis reminded, they often have anxiety and depression, problems with attention and concentration, and perhaps a family history of hoarding.  Many are very isolated people, and their ‘collection’ comforts them. 

There is a very successful Hoarding Task Force Intervention Model that has been developed for helping people, and would usually include representatives from a variety of service providers, including entities such as the Visiting Nurses, the Fire Marshall, The Board of Health or Code Enforcement, Rodent Control, Animal Rescue, Public Housing. Neighborhood Associations, Public Health officials, Mental Health representatives, and of course, Professional Organizers.

We appreciated the emails and phone calls about this particular broadcast (honestly, we appreciate your comments about all of our broadcasts!!) but this particular one seemed to have stirred a lot of interest.   Dr. Bratiotis did promise to visit Not Alone another time, and sends her thanks as well.

Visit The Kim Foundation Not Alone Podcast page to listen to the January 22, 2013 broadcast with Dr. Bratiotis.