The excessive acquisition of objects, animals, or food is a characteristic of hoarding disorder. This is followed by the inability to discard these items. The result is excessively cluttered living spaces, often leading to unsanitary living conditions that can, in turn, become a public health problem.
Rodriguez and colleagues investigated this issue in their publication entitled, “Prevalence of hoarding disorder in Individuals at risk of eviction in New York City: A Pilot Study.”This examination was groundbreaking because previous studies had overlooked hoarders who were close to homelessness. Rodriguez and his colleagues filled this gap by quantifying its presence. The incidence of v in the general population ranges from 2 to 5 percent.
To examine homelessness among hoarders, the research group partnered with Eviction Intervention Services, a New York City nonprofit that offers support to individuals facing eviction. Their study included 115 adult participants who were seeking assistance from the intervention. The researchers used two assessment tools: a clinician-administered psychiatric evaluation to diagnose hoarding and self-report questionnaires to assess the severity of hoarding behaviors. The assessment focused on several key measurements, including the prevalence of hoarding as determined by both clinical interviews and self-reports. Whether the participants were currently facing eviction or had previously experienced eviction was verified. Additionally, there was documentation of whether those diagnosed with hoarding were receiving mental health services.
Conclusions from the Study
Clinician assessments found that 22 percent of participants met the diagnostic criteria for hoarding disorder, while 23 percent self-reported symptoms consistent with the disorder. Among those diagnosed with hoarding, housing instability was a primary concern. At the time of the study, 32 percent of the hoarders were actively facing eviction, 44 percent had previously been involved in eviction proceedings, and 20 percent had already experienced eviction at least once. These rates are five to 10 times greater than the estimated prevalence in the general population.
These figures highlight a clear correlation between hoarding behaviors and the risk of losing stable housing. Despite the seriousness of their situation, only 48 percent of these individuals were receiving any form of mental health treatment. These statistics suggest that hoarding disorder plays an underrecognized role in the cycle of housing insecurity and the risk of homelessness. On the positive side, if hoarding disorder is identified and treated early, it may be possible to forestall eviction and homelessness. Additionally, it is my understanding that legal frameworks now require courts to specify remediation for tenants with the disorder, allowing for reasonable accommodations under disability law.
The New York City 15/15 supportive housing initiative is part of this effort, which assists eligible families or individuals who are homeless or at risk of homelessness by providing affordable apartments and supportive services to help them toward the goal of long-term stability. NYC 15/15 assistance is provided through long-term contracts with private apartment owners, under which the New York City Housing Preservation and Development issues monthly rental assistance payments for apartments occupied by eligible households. Assisted households are responsible for paying approximately 30 percent of their adjusted income towards their rent.
A Broader Perspective of Hoarders
To fully understand the implications of this research, it’s essential to reach beyond the scope of this particular study. Clinically, individuals with this disorder often develop an intense emotional attachment to their possessions and feel unable to discard even items with little or no value. As stated earlier, their living spaces may become dangerously cluttered, unsanitary, and even uninhabitable, thus posing significant risks during emergencies when quick evacuation is needed.
Hoarding also presents a broader set of public health and legal challenges. It can lead to code violations, fire hazards, pest infestations, and increased strain on emergency response services. As these problems escalate, local government services (potentially including code enforcement, animal control, and mental health services) are required to address the most severe cases.
Conclusion
Hoarding disorder represents an overlooked intersection of mental health and housing policy. Rodriguez and colleagues remind us that when one in five individuals facing eviction meets the clinical criteria for hoarding disorder, our approach needs to be reconsidered. This disorder is not a private problem, but a public health issue associated with a significant risk of homelessness.