Last week I had the pleasure of speaking to about fifty Firefighters in the County (Arva) with a co-worker and a Peer Support Worker (volunteer) about how we can work with people who have clutter and hoarding issues. They said that this is an issue that they are seeing more and more, however, they also said it is fairly new to them. Unfortunately, the resources are few for those in the County, as well as for those of us in the City of London.
One firefighter asked if individuals are sometimes relieved or happy to be identified. I would say that if a Fire Inspector is at your door and needs to do a walk through and issue a clean up warning then likely that individual is not in a good space. This is a crisis situation and would produce a lot of anxiety for an individual. However, if a client came to me with this crisis, I would try to reframe this by saying “yes, this is a crisis, but lets look at it as an opportunity for you to get some help”. So there are things that an individual can do. In London there is Extreme Cleaning through VHA Home Health Care who will come in and help to clean up over two to three days and help to get the place more safe and clear. A referral can be made to attend the next Clearing Clutter Support Group which is an eight week intensive program which helps people to start to really look at their own behaviours and to start making some positive choices about their environment and their behaviours.
We talked about the challenges that we are all seeing especially in light of the new psychiatric designation of “hoarding disorder”. There continues to be a lot of myths and stigma associated with people who struggle with clutter and hoarding issues. It can be very challenging for an individual to openly say “I am someone who has challenges with hoarding” or “I have “hoarding disorder”. How does someone get assessed and start to get some help? Landlords and property managers now have a duty to accommodate or to make sure that a tenant is aware of options that will help them to make improvements and to keep their housing. The problem is there are very limited resources for people when they are in crisis situations, people cannot afford to pay for treatment (which generally takes at least 20 sessions) and mental health workers are not always trained or willing to go into clients homes that may be unsafe or unsanitary.
If a person is forced to get rid of their possessions with little or no compassion, unfortunately that person will be traumatized and without any therapy or treatment the recidivism rate is 100%. So even if someone is evicted, basically they will just move to another location where they will acquire more stuff and likely be back in the same unsafe situation a year later.
We do encourage a harm reduction approach to helping individuals which includes:
- Do no harm.
- Realize it is not necessary to stop all hoarding behaviour.
- No two hoarding situations are alike.
- The individual needs to be involved as a Team Member and needs to have some control.
- Change is slow but may pick up speed.
- The individual probably has other more pressing issues happening in his or her life.
- Help the client to eliminate the safety and health risks that may be present in their home.
These were some of the suggestions we had for the Firefighters who could be the first responders in an individual’s home:
- Be respectful and show concern for the person’s safety.
- Match the language of the person. If the person talks about his “collection” or her “things”, use that language. Avoid using derogatory terms, such as “junk”, “trash”, or “hoarding”.
- Focus on safety issues, such as fires, fall hazards, and avalanche conditions. Note possible ignition sources or trip hazards and try to build support for addressing these issues instead of insisting on an immediate and overwhelming cleanup.
- Show empathy by indicating that while you understand that your presence is upsetting for the person, some kind of change is necessary.
I welcome any additional thoughts or suggestions that would be helpful to those in crisis. Thank you
Stay tuned for weekly updates on the Clearing Clutter Support Group!!