Flipping the script on hoarding

A three-pronged approach helps people with hoarding tendencies and gives them back their self-worth.

Reality TV may have raised the profile of hoarding, but behind the TV spotlight is a debilitating disease and people who need help.

Catholic Healthcare’s Hoarding and Squalor Team provides support to people with hoarding tendencies to address the underlying issues that lead to hoarding.

The team grew out of a program run in around 2010 that assisted public housing tenants who were at risk of losing their tenancy.

In 2015, the program changed into person-centred case management that focused on the person behind the behaviour, which is often missed in reactive approaches to hoarding.

Mercy Splitt, business development manager – vulnerable communities at Catholic Healthcare, told Pro Bono News that people who exhibit hoarding behaviour might have suffered trauma, grief or loss in their past.

The basis of the initial program, she said, was to work out how each individual got to that point and link them with a professional like a GP or psychologist who could help further.

It also focused on supporting people to reintegrate back into the community, giving them back their self-worth and working to reduce the stigma attached to hoarding.

The Hoarding and Squalor Team offers a holistic service now and has connections with other groups that can help those with hoarding tendencies, Splitt explained, including housing and health providers and even handymen who can repair damaged properties.

Little things like damaged plumbing can get missed when the focus is purely on the “amount of stuff”, Splitt said, and fixing those little things can alleviate a major stressor for people.

Buried in Treasures

Catholic Healthcare’s program evolved again in 2019 to include a 15-week support group based on the Buried in Treasures model.

The Buried in Treasures Support Groups are facilitated by qualified case managers and equip people with strategies to overcome the desire to excessively accumulate items.

“It’s just about changing your behaviour and it takes a lot of work, it can take years, but it’s just constantly working through it,” Splitt said.

“But the real benefit of Buried in Treasures is that you’re actually in a group with about 12 other participants who all are struggling with the same. So it’s that feeling of acceptance [and] no judgement, that ability to finally be able to talk about your hoarding tendencies and know that others in the group are going to understand and support you.”

The program is run twice a year and is currently in its sixth round, and Splitt said participant evaluations consistently showed that it gave people hope.

“[They say] things like ‘I feel so much lighter, I can see that there is light at the end of the tunnel’,” she said.

At the end of the sessions, participants often want to share their strategies and resources with others.

As a result, Catholic Healthcare now also runs declutter groups twice a week to keep the conversation going.

Sometimes, participants share things completely unrelated to hoarding; they’ll swap recipes or gardening tips instead. But that’s part of the point, Splitt stressed: it means people are feeling comfortable and accepted.

“It’s not just about the stuff, it’s about the person,” she said.

Another unique program, set up around June this year, addresses the final missing piece of the puzzle for older people with hoarding tendencies.

Often, the trauma that led to hoarding tendencies occurred decades ago, and people feel that it’s too late to get help for those feelings, Splitt said.

The new program, which received federal funding and receives referrals from My Aged Care, sits down with people and shows them what services they can access to address their trauma, whether through a mental health care plan or counsellors.

Through the ten-week program, Catholic Healthcare staff can also assist with cognitive assessments and help people put into practice new behaviours to move forward.

There is another gap yet to be filled: that of how to help younger people with hoarding tendencies.

Catholic Healthcare’s programs are focused on older people over the age of 50, and Splitt said she would like to see similar programs set up to help younger people, to stop them from falling through the cracks and to avoid exacerbating the problem.

“That’s a real problem. How do we work proactively when we’re constantly in a reactive mode? We’ve got to wait till the person gets to our age group, basically,” she said.

Flipping the script

Another part of the team’s work, Splitt said, is shifting the community mindset around hoarding behaviour.

The organisation steers clear of the term ‘hoarder’ and instead uses ‘person with hoarding tendencies’ to put the focus back on the person at the centre.

There is also a recognition that hoarding behaviour can vary and doesn’t have to fit the extreme floor-to-ceiling case studies shown on TV.

A key part of Splitt’s role is to combat that stigma through education. She regularly holds programs for stakeholders who might come into contact with hoarding situations, like local council staff. Her advice to them is to focus on the person’s safety and wellbeing, rather than passing judgement.

Avoiding trigger words and phrases like ‘maybe you should throw some things out’ can damage the relationship, Splitt said, and should be avoided in an effort to build trust. Instead, cleaning is framed through welfare through phrases like ‘why don’t we clear some space in the hallway, in case of an emergency’.

Building trust in this way facilitates further help in future.

Catholic Healthcare’s approach to people with hoarding tendencies is a finalist in the upcoming HESTA Excellence Awards.