‘The role of encourager’: Exploring the experiences of mental health professionals working with older adults with hoarding disorder

Abstract

Hoarding disorder affects 2–5 per cent of the population, with older adults making up a substantial proportion of that due to the chronic nature of hoarding behaviours and consequent clutter. Multiagency hoarding frameworks are being developed all over the UK, with mental health services working alongside other agencies to support an individual with hoarding difficulties holistically. Mental health clinicians have previously reported finding their role in this difficult. Therefore, this study recruited 30 clinicians working in an older adult mental health team and explored their experiences through a questionnaire. Thematic analysis identified six key themes detailing the clinicians experiences of working with hoarding: (1) contextual factors (time constraints, scale of clutter, previous negative experiences influencing current treatment, lack of skills); (2) assessment (risk, life story, beliefs and motives, MDT); (3) formulation (co-creation, motives and beliefs, helping staff understanding); (4) treatment (values based, support systems, discarding, meaningful activity, monitoring progress); (5) therapeutic relationship (trust, making the time, reinforcement); (6) multiagency working (skill profile, differing perspectives, coordination). The data highlighted the need for staff training and support, providing the necessary tools to deliver evidence-based assessment, formulation, and intervention. The challenges described suggest better links between different agencies is required. Meaningful interactions and success stories were linked to developing trusting relationships, introducing values and needs based approaches, and making use of the skill mix with the mental health team. Keywords: Hoarding; Older Adults; Multidisciplinary team; Multiagency working.