19 May 2023

It’s quite fitting, I think, that National Hoarding Awareness Week and Mental Health Awareness Week both started this week on Monday 15 May, because obviously there’s a lot of crossover between mental ill-health and hoarding.

P3’s Hoarding Support Service is quite new; it only started pre-Covid. Hannah Scott and I created and piloted the model in Buckinghamshire and it’s now expanding out to other areas including Warwickshire. We could see there was a gap in provision for this kind of support, but that’s not surprising. Hoarding is still very much under the radar generally. It’s not well understood and there’s a lot of stigma attached to it.

But it’s a real issue that affects many people. And it can make a home very dangerous, through blocked exits and the risk of fire, pest infestations or making it impossible for tradespeople to carry out essential work. It can also lead to homelessness, because it goes against the terms of a tenancy, making it impossible for a person to properly maintain their home until they can’t live there.

Hoarding is complicated. People who hoard don’t all do it for the same reasons and support needs to be very very personalised, with patience and no judgement.

We hope that you find this blog useful in understanding more about hoarding. And if this is something you do yourself, or someone you love does, we hope it will show you that you are not alone and, despite how it may seem, support is out there. And it really can work 🤗

Fiona Hall

Operations Manager

How do we work alongside a person who has a hoarding disorder?

One technique we use is working on a Clutter Rating Scale together with the people we’re supporting. It can really help them to see the progress they’ve made and inspire them to keep going. When you’re actually living in the space it can be difficult to see how far you’ve come – you’re literally too close to it. But the photos and the scale show how well people are doing.

We’ve had really positive results, as you can see from this table that shows the average progress score for each room:

Next we began to work with local housing organisations, Paradigm and Fairhive – and continued to have great success in our support. In three months, we had removed 133 bags of items cluttering people’s homes from Paradigm and 93 bags from Fairhive.

But don’t just take my word for it – here’s what some of the people we’ve supported have to say!

“I’m now moving forward with clearing stuff out, albeit slowly, with a view to using leave and a better work/personal life balance to make significant steps forward.”

“I’m feeling more positive. I want to continue sorting out the hoarding issue. I understand that need to take small steps rather than look at it as a whole, but P3 have encouraged me to try and sort my hoard.”

“I’m feeling less overwhelmed and more organised.”

“I can’t thank P3 enough for what they are doing for me, they have done so much already and every time they are here, I thank them because they are fantastic.”

“The service has been amazing, and everyone involved has been more than helpful at a difficult time for me.” 

“They were very personable, friendly, well informed. They kept me in the loop every step of the way.” 

And from our referrers:

 

“I met B and C in 2017. Their living conditions had become problematic due to excessive gathering of possessions and self-neglect. For the last three years I have worked with different agencies but we never got to the bottom of the issue due to the lack of engagement, i.e., giving entry for assessments/ execution of necessary work.

“The landlord has a legal responsibility to ensure properties are safe to live in and if there is health and safety risk, preventative measures must be put in place to reduce risks to tenants and others. When necessary, the landlord will take enforcement action regarding any breaches of the tenancy agreement but will always take vulnerability of the tenant into account.

“If the landlord had taken legal action for breach of tenancy, an estimate of around £1,500 would have been spent which would cover staff time and the basic court costs. In relation to clearance and cleaning I would estimate this at around £2,500, which would include two skips, staff costs and cleaning fees.

“Due to their vulnerability, I referred B and C to P3 in 2020. I had heard so much about their success in what they do, and they haven’t disappointed. Working alongside P3 has been brilliant. They built a great relationship and have worked very well with B and C. They involve them in everything they do and update everyone involved regularly.

“I would recommend P3 service to anyone and I look forward to working with them in the future.”

– Additional Housing Management Advisor

 

“Hannah and the P3 Hoarding Service came along just at the right time for this person.  At the time of my referral to their service, they were experiencing a mental health crisis and did not wish to fully engage at first.  However, Hannah’s approach of a gradual introduction, providing A with opportunities for change and control, enabled and encouraged A to make positive changes. 

“Hannah has been fantastic in the support she has provided, regularly visiting Adam* and proactively being involved with the organising of the clutter which has resulted in their flat being cleared in a very short space of time. This has not only provided Adam with a safe and hygienic living environment, but has also helped to improve his mental health and emotional wellbeing.  

“Without this service I am unsure which direction I could have taken or what alternative support could have been provided for Adam.  I have recommended the service to my colleagues and to personal friends. There was certainly a gap for this type of resource previously and I am very thankful it was available to support us … I will definitely refer again when in future when people are in similar situations.”

– Social Worker

 

Hannah Scott

Service Coordinator

*Name changed

We find people with our hoarding support service are often very lonely. They don’t have visitors – they won’t let people in, or sometimes they can’t because there just isn’t room to do anything. We’re often the very first people they’ve let into their home for a long time and even that might take a couple of weeks. Sometimes they haven’t actually left their home for years.

So we are very patient and non-judgemental. The hoarding support service in Warwickshire went live last July and we planned to work with ten people over year – but we’ve exceeded that! We work with agencies like housing and fire safety and environmental health, but everyone we work alongside needs to be referred by adult social care.

When we have our first meeting with a person and their social worker, we’ll have an introduction and assess the property. Like I said, it’s about trust and you need to be so careful because possessions are very personal. It might look like a load of clutter but to them it isn’t. We’ll mirror their language, so if they describe it as “trinkets”, we’ll do the same.

We can really see the difference it’s making. One couple joined us in September and their house was three bedrooms and fit to burst, like a tinder box. Electric sockets running off all over the place. But we worked alongside them at their pace and built up a really strong relationship. Now they trust us enough to get rid of certain things without checking, like clothes that are the wrong size. We’re getting there!

We’ll take photos step by step as well, as it can really help people to see the progress they’ve made and what it’ll be like when we’re finished.

But we aren’t just a clearing out service. We’re about properly supporting people in overcoming this and learning management skills for the future.

The service is growing – I’m on the steering group for expansion! When I first heard about this, I wasn’t sure if it was for me, but now I’m in the thick of it – it’s really great.

Watch this space as a new P3 hoarding service could be opening near you soon!

Clare Harris

Service Coordinator

It sounds a bit cheesy to say it, but everyone is so individual and as a Home Coach you really do have to build up trust with someone. The process takes longer than you might imagine and sometimes on TV I see things that I don’t approve of, like rushing people. Sometimes I’ll only see someone for two and a half hours in a fortnight.

It’s so hard sometimes. People might be facing losing their tenancy, or they can’t sleep on their bed, or they can’t eat properly because they can’t use the kitchen. There can be a lot of embarrassment and shame. Our job is to make sure nobody feels pressured or judged and to earn their trust.

The root causes of hoarding are often mental health issues such as trauma, bereavement, awful childhood, loss or separation, or might be related to something like ADHD. It all comes down to being overwhelmed and it can become a form of self-soothing…except it doesn’t soothe. Items might represent what someone wants in their future, like sports equipment, or something sentimental like a gift from years ago from a deceased parent. There’s also eco-hoarding, where people are worried about the planet and won’t get rid of even a bottle top unless it’s washed and categorised.

For some people, the items they have represent so much for them that the collection becomes like a person. It isn’t materialism; it’s really more like the opposite. If it was materialism, people would actually use the things they’ve acquired.

I’ve really learned how difficult it is for people to let someone in when they have an issue like this and how important it is to build up the trust. Belongings are very personal. But it can be done.

Jane Coltman

Home Coach, Buckinghamshire