Hoarding 1

Paper 6: A Foot in the Door: A Guidance Document to Assist in the Management of Cases of Compulsive Hoarding and Domestic Squalor

Michaela Hobby and Andrew Brown, South Australian Department of Health, SA

Aims and objectives: Like Australia, and indeed the rest of the world, compulsive hoarding is prevalent in the South Australian community. Reports to the South Australian Department of Health indicate that compulsive hoarding has become an increasing problematic issue for government and non-government agencies. Public health legislation is often used in attempting to resolve cases, and while this pathway seems appropriate when there appears to be a risk to public health, it is not always successful because the many interwoven complexities associated with compulsive hoarding are not addressed. Therefore, the aim of the study was to develop a client central resource document to assist service providers achieve successful outcomes in cases of compulsive hoarding and domestic squalor in South Australia.

Methods: The research methods were largely qualitative. In combination with a literature review, surveys were developed for SA Local Government and other key stakeholders. Workshops involving both target groups were also held to further identify the key challenges and gain support for the guidance document.

Principal Findings: The survey results indicated that compulsive hoarding is prevalent throughout the SA community, and the associated social, financial and environmental costs for both clients and service providers are extensive. The key challenges identified included those related to the client (eg mental health and confidentiality requirements), and the need to regularly address the many complex issues which extend outside the realms of expertise of those called upon to intervene in cases of severe domestic squalor and compulsive hoarding.

Discussion: The significant discovery was the need for multidisciplinary partnerships, and a tool to determine which agencies should be involved on a case by case basis. To address these findings, a risk assessment tool and a framework for multidisciplinary partnerships have been developed for implementation at a local level.