In 2018 the World Health Organisation (WHO) classified Hoarding Disorder as a mental illness, and it has included it in the ICD-11– the International Classification of Diseases 11th Revision – the Global standard for diagnostic health information.
Whilst The Care Act 2014 recognises hoarding behaviours as one of the manifestations of self-neglect – and requires all public bodies to safeguard people at risk – it’s important to note that living in a chronically disorganised home can be as overwhelming, incapacitating and disabling as living in a hoarded home.
There can be as many environmental, safety or self-neglect issues as with properties where hoarding behaviours are present.
Medical conditions & contributory factors
There are countless reasons and as many medical conditions which can influence a person’s decision to acquire or purchase items, as well as their ability (or otherwise) to reduce the number of possessions leaving their home.
Usually a combination of factors are involved, such as:
- life events (eg. bereavement)
- traumas (eg. Adverse Childhood Experiences – ACES)
- mental health issues (eg. Anxiety; Depression; PTSD; OCD; Dementia)
- neurological conditions (eg. ADHD; Autism; Dyslexia; Dyspraxia; Chronic Fatigue Syndrome/ME)
- conditions related to frontal lobe impairments (eg. Acquired Brain Injury – ABI)
- anything likely to affect a person’s Executive Functioning.
- Executive Dysfunction/Dysregulation can inhibit a person’s ability to plan; organise; prioritise; start/finish tasks; make decisions; be flexible with their thinking; remember things; control their impulses; self-monitor; and regulate their emotions.
- Examples of how Executive Dysfunction can manifest itself in the context of clutter, disorganisation and hoarding include difficulties with things like: opening and dealing with mail; bill paying; deciding where to store items (eg. documents, keys, etc) and remembering where they’ve been stored so they can be retrieved; deciding what to keep and what is surplus to requirements, etc.
Health issues that can be caused by having too much stuff
It’s not just the person who accumulates possessions whose health can be impacted – there are thousands of family members around the World who can testify to experiencing health and other problems as a result of a relative’s clutter, disorganisation or hoarding tendencies. For example:
- depression is common in those whose homes have become too troublesome for them to deal with
- debt can occur if compulsive shopping gets out of hand, which can lead to conditions such as anxiety or depression.
- mould can cause serious problems for people with breathing difficulties such as asthma, or skin conditions such as eczema.
- an inability to make decisions about what to get rid of and what to keep can lead to anxiety, depression and other mental health problems.
Sadly, many people perceive there is a stigma about having a cluttered, dirty or untidy home; it perpetuates the myth that “Cleanliness is next to Godliness”. The anxiety that people feel because of the fear of being judged and labelled “lazy, dirty or useless” is very real, and is one of the key reasons people feel too embarrassed to invite people into their homes, or to engage with agencies.
Especially if they have underlying conditions like Autism/Asperger’s (often undiagnosed), which can mean they struggle with things like meeting new people; making phone calls or travelling on public transport.
Thanks to hugely successful UK campaigns such as Time To Change (run by the mental health charities Mind and Rethink Mental Illness) and Heads Together (a mental health initiative spearheaded by The Royal Foundation of The Duke and Duchess of Cambridge and The Duke and Duchess of Sussex), the stigma of mental ill health in general is gradually diminishing as people become more comfortable about discussing their mental health and wellbeing, and Mentally Healthy schools are being introduced in the UK.
So, now that Hoarding Disorder has been officially recognised as a mental illness, and there is far more education available about this very emotive subject, we hope that stigmas and misunderstandings about hoarding will soon disappear too.
Help and support
In recent years it’s been proven that the most effective way to achieve long-term progress to overcome hoarding behaviours is for multiple agencies to collaborate and provide empathetic, person-centred, practical help and support.
Support groups offer a great way of meeting with others with similar experiences. For more information about locations of support groups around the UK, check out our Resources page.
Practical help and support
Professional Hoarding Practitioners work 1:1 with clients in their homes if practical support and assistance with decision-making is required.
For more information
If you would like to know more about how clutter, disorganisation, compulsive shopping/acquiring and hoarding are related to health: