The British Association of Social Workers
PROFESSIONAL SOCIAL WORK MAGAZINE | FEBRUARY 2021
HOW TO HELP A HOARDER
Many social workers will have come across people who hoard but they often don’t know how best to support them, Heather Matuozzo of hoarding social enterprise Clouds End tells Shahid Naqvi.
You would have struggled to see the floor in David’s house a few months ago. Or even his furniture for that matter, so buried were they beneath piles of old newspapers. Copies of the Daily Mirror to be exact. And
Barbie dolls by the hundreds, if not thousands, stacked throughout his two-bedroomed house.
“I have been working with him slowly over time, digging his living room out,” says Heather Matuozzo, of West Midlands hoarding social enterprise, Clouds End.
“He fell through the gaps in services and was referred to me by a social worker.
“I said to him ‘You have to let go of some of these newspapers otherwise you won’t be able to get your new furniture in – you have a Mirror mountain over there’.”
Some may have been tempted to simply order a skip and clear out the house. But with her understanding of hoarding, Heather knew a different approach was needed.
“I found out he kept the newspapers because of the Garth cartoon the Mirror used to have which he was collecting.
So I looked on eBay for Garth cartoon albums but couldn’t find any. Then I asked a journalist friend who gave me the name of someone in the Mirror Group.
“They said they could scan all the cartoons for him but he would have to let them go. I said I will get photos done and show you the progress. David was thrilled to bits and we are now able to throw them out.”
For Heather, this is an example of the kind of creative and person-centred solution needed when working with people who hoard.
The condition was recognised in the Diagnostic and Statistical Manual of Mental Disorders in 2013. The World Health Organisation acknowledged it in 2018. It is estimated to affect between two and five per cent of the population – that’s potentially more than 1.2 million people in the UK alone. Growing awareness has seen it the subject of several television documentaries, most recently Hoarders screened on Channel 5 last year.
Many social workers will have come across people exhibiting symptoms but like many professionals they
don’t always know what to do about it, says Heather. She believes this is because they often feel “overwhelmed” when confronted with a hoarding home.
“There is a lot of overwhelming that goes on. A lot of people don’t even realise they are overwhelmed. They will say ‘so and so’ didn’t engage so they close the case. Or agencies just dump on each other because nobody understands whose job it is.
“There is no one who takes responsibility, they get passed around. Then there is a massive fire. And people say why did this happen?”
Parking biases, prejudices and judgement at the door is a key part of working with people who hoard, says Heather. And because of their unique skillset and training, social workers are the best placed professionals to lead on providing support.
“You need someone who is able to stand back and take a deep breath and understand this isn’t their choice. What you may want to do instinctively might stop you from hearing what they need. For example, you may say, ‘You just need a skip, let’s get this place cleared up’. While they are saying, ‘This is my mum’s stuff, I got that from her house, she only died three months ago’.
“So it’s maybe, have they had any bereavement counselling? That is where you need the tools to not have a kneejerk reaction.
“If you understand it better you don’t panic and you can talk to someone nicely rather than thinking ‘How can you live in this s**t, it’s disgusting’. Because it so isn’t their choice.”
Birmingham City Council has commissioned Clouds End to work with 100 hoarders.
The two-year project, funded by the city’s adults services, also involves mentoring students and delivering multi- agency training to professionals.
One of the big challenges of working with people who hoard is that they often don’t see themselves as having a problem. Others may be highly secretive through shame or fear of someone making them throw out belongings they have become emotionally attached to.
According to Hoarding UK, as few as five per cent of hoarders come to the attention of services as a result.
The causes of hoarding are complex and wide-ranging. They are linked to mental health issues, such as depression and obsessive compulsive disorder, or it can be triggered through loss of a loved one. For some it’s as simple as never having had anyone teach them how to organise their stuff.
“I call that organisational dyslexia,” says Heather. “If you don’t know how to put things in your house you are never going to know until you know how to do it.
“There are children being taken off parents because of this. It is classified as neglect but actually it’s that they don’t know how to do it. They haven’t been taught it.
“If you treat it as neglect they never get the help and it continues through families and families get split up.”
Hoarding is often a response to trauma. This can be from childhood, first manifesting itself during teenage years, and becoming a significant problem to people in their 30s, according to Hoarding UK.
Heather says: “With hoarding that is attached to a traumatic incident, the brain says, ‘I don’t like this, let’s buy things’. That is deflecting from this horrible thing that happened to you.”
She has also come across people wrongly labelled as hoarders when the cause of their home being over-run is none of the above.
“It may just be their housing association won’t let the cleaner take their bag of rubbish and so they keep it because maybe they have a physical disability that prevents them going to the bins. Anyone keeping their rubbish for eight months is going to look like a hoarder.”
A popular misconception with hoarding is that it mainly affects people living in deprivation.
“It is nothing to do with money or education,” says Heather. “It can happen to anybody. I worked with someone famous who was married to a footballer who said they had lived in their house four years and not slept in the bedroom because it was full of stuff.
“They would pack a case when going away and dump it in the hallway when they returned and buy another case and pack this with clothes and dump that in the hallway.
“Another very well-off person I worked with filled up his big farmhouse, his grandmother’s house and his dad’s business premises. He collected horse and cart carriages and had about 17 of them, plus eight to nine classic cars, four containers, five caravans and a mobile home. You stand back and look at one person’s ability to collect and think ‘Wow’.”
Helping professionals spot the difference between the different types of hoarding and understanding the motivation behind it is part of the training provided by Clouds End. Sessions aim to include a range of professionals, not just social workers.
“These sessions are multi-agency because I wanted housing to start talking to social workers and the fire service and mental health professionals and vice-versa,” says Heather. “It needs all of them working together.”
See www.cloudsend.org.uk and www.nhs-uk/conditions/hoarding-disorder; hoardinguk. org/abouthoarding
Photos by Steve Carse: www.infinityphoto.co.uk
Article courtesy of The British Association of Social Workers’ Professional Social Work Magazine.