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Arlington teams up to aid hoarders

By Erica Noonan
Globe Staff / August 11, 2011

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ARLINGTON - For many years, emergency responders arriving at a home that was overwhelmingly cluttered or filthy would do what was necessary to address the problem that brought them there, but unless a child, elder, or pet was in immediate jeopardy, very little else.

Three months ago, Arlington launched an unusual effort to train its police and fire personnel to recognize the characteristics of compulsive hoarding - a syndrome marked by the uncontrollable acquiring of objects, animals, and even garbage - and take steps to help the individual facing it.

Using $6,940 from a grant provided by the state Department of Mental Health to reduce unnecessary incarcerations, Arlington police and human services officials created a hoarding response team to provide a consistent approach for assisting residents.

The team, which includes police officers, the department’s mental health clinician, and the town‘s Health and Human Services Department, has trained most of Arlington’s police and fire personnel to use a checklist when they are called to a scene to determine whether hoarding might be an issue.

In most cases, police or fire officials arrive at a home after complaints from neighbors or family members that the property is unsightly or potentially unsafe; in other cases, they discover the situation while responding to an emergency call to 911, said Police Chief Frederick Ryan.

“It’s one more tool for our first responders to have,’’ he said. “We wanted to be proactive, not reactive.’’

It’s difficult to pinpoint how many people have hoarding or acquiring disorders, said Gail Steketee, dean of the Boston University School of Social Work and one of country’s leading researchers on hoarding.

Research suggests compulsive hoarding afflicts 2 to 5 percent of the US population, and a BU study found that complaints to public officials about hoarding in Massachusetts numbered about 26 per 100,000 residents, she said.

The Massachusetts Housing Finance Agency, which oversees the state’s affordable housing programs, coordinates a statewide steering committee on hoarding that involves a broad slate of researchers and public agencies. MassHousing has estimated that hoarding disorders in residents of public housing can cost municipalities up to $20,000 per household in cleaning fees and social services for people who lose their housing or develop health problems.

New research suggests hoarding and acquiring disorders are even more prevalent than Alzheimer’s disease, said Rebecca Wolfe, the Arlington Police Department’s mental health social worker and its liaison with residents receiving help through the town’s hoarding response team.

Since launching the initiative in late April, the town has been working with about 16 households, whose members meet with the clinical team on a voluntary basis.

Half of the people working with the team are back in compliance with health and zoning regulations, and participate in monthly check-ins, and the others are making progress, Ryan and Wolfe said.

Some Arlington residents have questioned spending money on the antihoarding training, and whether it is appropriate for the Police Department to tell residents how to maintain their homes and yards, Ryan said.

“We’ve had to do a good bit of public outreach and education on it,’’ the chief said. “The first question people had was, ‘Why would the police care about this?’ ’’

But the issue is very much in the public domain, he said, based on findings that compulsive hoarding increases the risk that a person will become homeless or suffer a medical emergency. Also, chronic hoarding, and living in squalor - a different, though closely related condition - often can lead to building code violations that decrease the quality of life for the hoarder’s entire neighborhood, Ryan said.

“That is an environment that reduces property values in a neighborhood, and lends itself to criminal activity,’’ he said.

After an initial alert from a police or fire worker, Wolfe - as well as town health or building officials - generally will visit the home and ask for a meeting. Most often the police do not need to return to the scene.

“It’s not just not being able to get a stretcher in during an emergency, but it also frees up police resources that would have otherwise been tied up for hours,’’ Ryan said of the response team’s role.

The typical hoarder in Arlington’s caseload, much like the national average, is male, living alone, and in his 50s, Wolfe said.

In one case the team is handling, a man had been evicted and was living in his vehicle. When Wolfe and a colleague met him for a monthly check-in, they noticed he was very ill from an infection, and persuaded him to go to the hospital.

“That could have been a very tragic situation if they had not been working with him,’’ Ryan said. “He would have died.’’

In another case, neighbors complained to police about the trash and smell of human waste coming from the apartment of a suspected hoarder. The clinicians connected him and his family to mental health services, and make monthly visits. Since then, the resident has been able to keep his home in compliance with health and building codes, she said.

“We aren’t out to get people,’’ said Wolfe. “We just want to help people sort out situations. The problem didn’t happen overnight and it won’t get solved overnight,’’ she said.

Only one of Arlington’s hoarding cases has involved a home where a child was present. The state Department of Children and Families, which protects minors from abuse and neglect, is now involved with that family, Wolfe said.

In recent years, as medical understanding of hoarding disorders has increased, and reality television shows about the problem have gained popularity, several other communities - including Newton and Cambridge - have established hoarding task forces or study groups.

But Arlington is the first to use state grant money to address the issue by training its emergency responders and linking them with mental health and human service workers, said Anna Chinappi, a spokeswoman for the Department of Mental Health.

The funds were drawn from a grant awarded through the state agency’s jail-diversion program, which has distributed $550,000 to a number of police departments statewide, including Framingham, Waltham, and Watertown as well as Arlington. The money allows police to have access to clinicians who can determine whether people with mental illness would be better served by treatment rather than incarceration.

“They are really responding to a need in their community, so it’s a very creative and appropriate use of the funds,’’ Chinappi said of the Arlington effort against hoarding. “We applaud what they are doing.’’

Steketee also said Arlington’s approach on hoarding disorders shows promise.

The BU dean, who along with Smith College researcher Randy Frost published “Stuff: Compulsive Hoarding and the Meaning of Things’’ last year, said combining law enforcement and mental health counseling may help where traditional measures, such as medication, therapy, and family intervention, have not been effective.

“The question in my mind,’’ Steketee said, “is how to get programs like that to go national.’’

Erica Noonan can be reached at enoonan@globe.com.


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