We've seen it on TV, following the "reality" show camera as it pans across a kitchen filled from tip to top with...stuff. The camera crew can't even excavate a path to the oven.
In 30 short minutes the apartment owner has gone from tears to relief and now sits in a newly refreshed space, talking of how he/she/they hope to continue on the new path of uncluttered existence.
If real life were only so easy!
The real reality
"It is a real mental health diagnosis," said Denise Egan Stack, of the newly renamed Cape Cod Hoarding Task Force. "When you watch these shows, you aren't getting a true picture of hoarding or how to manage it."
In the real-real world, hoarding creates complex and thorny issues. It triggers complaints from neighbors, creates friction among families, and puts individuals as risk.
The clutter, says Stack, is not the problem--it is merely a symptom of underlying issues.
Get it, keep it, never let it go
Stack, who is also president of OCD Massachusetts, an organization that serves individuals with Obsessive Compulsive Disorder and related issues, said the mental health profession defines hoarding as "the acquisition of and failure to discard objects of useless and limited value."
Gathering and keeping objects like newspapers or bottles--things with no practical use or value--takes over a hoarder's life, to the point where the disorder creates impairment in functioning. They can't make it to work any more, for example.
Space no longer fills its intended purpose. The oven becomes a storage bin. The refrigerator holds old magazines. The person starts sleeping on a space in the floor because the bed now holds hoarded goods.
"It is not a moral issue. It is not caused by laziness or lack of ability," Stack noted firmly.
Mental health issue
Hoarding is an OCD-spectrum disorder that affects 3-5 percent of the population. It is a childhood disorder, usually showing up around age 13.
Often, people don't look for treatment until they are in their 50s because for may take that long to reach critical mass, where the hoarded belongings tip the scales to literally impairing the person's ability to live or work.
The majority of hoarders--an estimated 92% --have more than one mental health issue. For example, a compulsive shopper who also has a hoarding disorder is not uncommon.
"I became involved in the Cape Cod Hoarding Task Force after watching health departments Cape wide struggle with the issues surrounding compulsive hoarding, often unsuccessfully," said Lee Mannillo.
Mannillo, Senior Environmental Specialist for the Barnstable County Department of Health and Environment, chairs the task force.
"I quickly realized that health departments alone are not equipped to deal with a mental health issue using the regulatory tools accessible to health agents."
In town after town, health departments, fire department, police departments, mental health services, elder services, and others came to realize that none of them alone could address the issue.
Often a town health agent would get called in based on complaints from neighbors. There might be building issues. And elder care issues. And mental health issues. And suddenly resolving the "pile of stuff that's an eyesore" complaint becomes a challenge that no one agency had the tools to tackle.
This realization triggered the initial creation of the task force--originally a more limited mid-Cape organization--in 2010.
The original group grew as more and more agencies realized the value of the approach. This September the group re-organized into a renamed Cape-wide effort.
Joint service brand
The group started by simply bringing together people who were seeing different facets of the hoarding issue. Talking, while good, was not enough. The outcome was to find a process to DO something, to find a way to solve the cases as they came up.
Today, the group has developed protocol for handling hoarding cases, relying on each others expertise and the power of a shared network. New education efforts have just launched and with its renaming, the group hopes to move to the next level.
"We are looking as this a 'joint service brand'," said Stack, "where community agencies work together."
As of earlier this month, the group will meet on the second Thursday of every month at 9:30 am at the Dennis Police Station, a meeting that is open to all. In addition, its new web presence launches shortly, with education and resources online.
It has also begun a series of public trainings. Next up? "Legal Issues in Hoarding", November 16, 9am-1pm.
All of this might not be a sexy as a 30-minute reality show solution, but for communities on the Cape, it's a heck of lot more satisfying.
For more info or to register for training visit the Cape Cod Hoarding Task Force here.