Developing a psychology led multi-agency approach to hoarding disorder in older adults

Abstract

In the past, there was a general belief that hoarding objects was a non-pathological life choice, however over recent years, the literature has highlighted that hoarding is a frequent mental health issue which affects two to six per cent of the population (Iervolino et al., 2009). In May 2013, Hoarding Disorder was included in the Diagnostic and Statistical Manual of Mental Health Disorders (DSM-5, APA 2013) which has helped to raise awareness of hoarding behaviours and their impact on the individual, their family and society.Anecdotally it appears to be exceedingly difficult for a single service to maintain the wellbeing of an individual who presents with Hoarding Disorder, as it is often necessary for their property to undergo extensive clearing and cleaning. Managing this efficiently and in a timely manner, whilst inflicting minimal emotional distress to the affected individual can be very challenging and costly (Neave et al., 2017).These issues appear to be associated with the absence of an established, psychology led multi-agency service that would offer an appropriate and effective pathway when working with a Hoarding Disorder presentation. Hence, in this paper, we suggest that a hoarding presentation requires input from multiple sources, including emergency services, social services and mental health services. We aim to reflect upon working practices of professionals in the relevant services who have experience of working with people who present with Hoarding Disorder. This paper will also outline a professional multi–agency model of work which may be used to support critical discussions with key stakeholders to support future service developments.