Elsevier

Public Health

Volume 148, July 2017, Pages 137-139
Public Health

Short Communication
The economic costs of hoarding behaviours in local authority/housing association tenants and private home owners in the north-east of England

https://doi.org/10.1016/j.puhe.2017.04.010Get rights and content

Highlights

  • We assessed the incidence of hoarding behaviours in private and Housing Association tenants in the North-East of England.

  • We assessed the economic costs to Local Authorities and Emergency Services.

  • While hoarders comprise a small proportion of the population, the economic and social costs of dealing with their behaviours are high.

Introduction

Everybody accumulates possessions over their lifetime, and many of these items are given sentimental value. Humans show a strong tendency to collect possessions; this may be adaptive by ensuring survival when resources become scarce.1 However, in a minority of individuals, the normal hoarding tendency becomes pathological, and the person hoards uncontrollably. Hoarding behaviours are characterized by the excessive acquisition of, and unwillingness to discard, large quantities of seemingly ‘useless’ items.2 Such items typically comprise clothing, newspapers and books, empty food cartons and even animals. Over time, these acquisitive behaviours render living spaces uninhabitable, normal activities become difficult to maintain and there is an increase in the risk of personal injury due to fire/toppling hazards and poor sanitation.3 The inability to use one's home as intended, and embarrassment about the clutter, restricts social access, and hoarders are typically socially isolated.4 Hoarders are much more likely to have sought treatment for psychological problems, and to be affected by a range of physical health complaints and be claiming state benefits as a result of these issues.4

Estimates of the prevalence of hoarding typically come from volunteers from self-help groups, or individuals referred to clinics for other psychiatric problems such as obsessive-compulsive or personality disorders. Such studies reveal prevalence in those groups of between 1% and 6% for hoarding behaviours.5 Currently, there is little information about hoarders from normative community samples, as such individuals rarely come to the attention of research teams. In one such study in the UK, volunteers recruited for a large-scale community health study were screened for hoarding, and prevalence was around 1.5%.4 What causes someone to become a hoarder is difficult to assess, though traumatic life events in childhood (e.g. physical, sexual and emotional abuse) are associated with hoarding in adulthood,6 with the number of traumatic events correlating with hoarding severity.7

In the UK, the ‘Care Act’ (2014) set out the basis on which social care is expected to develop in forthcoming years. A key aspect is the principle of ‘individual well-being’, comprising personal dignity, physical and psychological health, protection from abuse and neglect and social/economic well-being. The authorities and other organizations now have a statutory safeguarding responsibility overseen by a ‘Safeguarding Adult Board’. Part of the Act references ‘self-neglect’ as a potential form of abuse or neglect to be considered within the arrangements for safeguarding adults. The document describes self-neglect as ‘a wide range of behaviour neglecting to care for one's personal hygiene, health or surroundings and includes behaviour such as hoarding’. Staff managing hoarding cases need to take into consideration the new safeguarding guidance brought in through the Act.

As hoarding behaviours are associated with psychological and health problems, and hoarders are more likely to be single, poorly educated and receiving benefits,4, 8 it is possible that such individuals may well form a significant group of Council/Housing Association tenants. Due to the nature of their hoarding behaviours, their rented accommodation is likely to be cluttered, unhygienic, and potentially dangerous for themselves, their families, and visiting housing officers/emergency services. They are thus likely to be the focus of ‘Adult Safeguarding Reviews’ and due to the complexity of their behaviours require the involvement of other services/specialist teams. Such individuals may thus pose considerable economic challenges to Local Authorities/Housing Associations.

The aim of this preliminary study was to undertake an initial assessment of the scale of the problem facing housing providers and emergency services, and to estimate the annual economic cost to these organizations of dealing with hoarding.

Section snippets

The scoping study

The north-east is one of nine English regions classified at the first level of NUTS for statistical purposes. It comprises four major administrative areas: Northumberland, Tyne & Wear, County Durham and Tees Valley; the largest being the metropolitan county of Tyne & Wear with a resident population of over 1.1 million, ranked 16/48 of the English counties in terms of total population. Housing provision is regulated via these Local Authorities through 13 housing providers (one covering

Ethical approval

None sought.

Funding

None declared.

Competing interests

None declared.

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