School of Health Sciences, The University of East Anglia, Norwich, UK.
Health Soc Care Community. 2022 Nov;30(6):2292-2299. doi: 10.1111/hsc.13779. Epub 2022 Mar 20.
Hoarding behaviours are highly stigmatised and often hidden. People with problematic hoarding behaviours have a higher rate of mental health and other healthcare and social services utilisation. Hoarding is a community health problem, one factor being housing insecurity. Hoarding behaviours represent significant burden to housing providers, impact the community and dealing with it involves multiple community agencies. This study with a city council in England with a large housing stock (over 14,000 properties) in summer 2021 sought to understand the nature, circumstances and extent that hoarding presents. We developed a reporting system and conducted 11 interviews with housing officers in which they described a case to explain their involvement. Our report details the nature of 38 people who hoard: 47% had a known disability or vulnerability, 34% presented a fire and environmental risk, 87% lived alone and 60% were resident in flats. Our qualitative themes are: Working with others, Balancing an enforcement approach, Feeling conflicted, Complex needs of people who hoard and Staff needs. The cases described by the housing officers are combined into six case studies and illustrate the complex, multi-agency circumstances around decision making and risk stratification. Our findings point to housing officers as frontline professionals dealing with a public health and social care issue which is often the manifestation of complex life histories and mental health conditions. We suggest a greater focus on risk stratification and a more holistic approach to hoarding cases to effectively deal with this most complex of community health and social care issues.
囤积行为受到高度污名化，往往被隐藏起来。有囤积问题行为的人更倾向于寻求心理健康和其他医疗保健及社会服务。囤积是一个社区健康问题，其中一个因素是住房不安全。囤积行为给住房提供者带来了巨大的负担，对社区产生了影响，处理囤积问题需要多个社区机构的参与。本研究以英格兰的一个市议会为对象，该市议会拥有大量住房（超过 14000 套），于 2021 年夏季开展，旨在了解囤积行为的性质、情况和程度。我们开发了一个报告系统，并对 11 名住房官员进行了访谈，他们在访谈中描述了一个案例来说明他们的参与情况。我们的报告详细说明了 38 名囤积者的情况：47%的人有已知的残疾或脆弱性，34%的人存在火灾和环境风险，87%的人独居，60%的人居住在公寓里。我们的定性主题包括：与他人合作、平衡执法方法、感到矛盾、囤积者的复杂需求以及员工需求。住房官员描述的案例被组合成六个案例研究，说明了决策和风险分层方面复杂的多机构情况。我们的研究结果表明，住房官员是处理公共卫生和社会保健问题的一线专业人员，而这些问题往往是复杂的生活史和心理健康状况的表现。我们建议更注重风险分层，并对囤积案例采取更全面的方法，以有效地处理这一最复杂的社区健康和社会保健问题。
