I attended a day-long seminar on a topic of significance to our housing clients called “Hoarding: New Approaches to Community Management” on October 20, 2016. The session, hosted by VHA Home HealthCare (VHA), was well attended by mental health agency staff, housing providers, and assorted others – like me – serving housing providers who encounter the problems resulting from tenants’ and members’ excessive clutter. The fifth of such events in Toronto, there is heightened awareness of problematic hoarding since the fire at 200 Wellesley Street, just over six years.

Dr. Peggy Richter kicked the day off with a session called Hoarding 101. Dr. Richter is the head of the Frederick W. Thompson Anxiety Disorder Centre at Sunnybrook Hospital. Dr. Richter gave us a good base-line understanding of hoarding as it relates to other disorders like OCD, and in particular, covered the kinds of interventions that work, like Cognitive Behavioural Therapy, as opposed to those that generally don’t, like the extreme clean approach. Richter also shared a couple of useful tools for housing providers to consider when working with members and tenants with excessive clutter. One, the Clutter Image Ratings from the OCD Foundation, is a tool that we have found useful for clients to use with tenants and members to help establish agreement on a unit’s condition and on a plan to improve the unit condition. The second, the HOMES tool, a Multi-disciplinary Hoarding Risk Assessment tool which was new to me. Both are available on a number of websites.

Next we heard from Jesse Edsell-Vetter who came to Toronto to share his experiences from the Metropolitan Boston Housing Partnership. Ten years ago, he enforced building standards at MBHP, with little sympathy for or understanding of the complexity of hoarding. Now he is instrumental in a very successful hoarding intervention program. Edsell-Vetter stressed the importance of having all staff – not just mental health professionals – trained to interview hoarders to best determine how to motivate them to get their unit condition to meet the community standard. The saving, the acquiring and the resulting clutter are just the tip of the iceberg – without some understanding of the underlying trauma, mental health disability, family history and so on, a housing provider can make little, if any, progress.

In the afternoon, I attended a session put on by the SPIDER program at the City of Toronto. SPIDER is short for Specialized Program for Interdivisional Enhanced Response to Vulnerability. It is a collaborative, risk driven approach to the management of problematic hoarding. Four panelists spoke about SPIDER each from a different perspective – Toronto Fire Services, Municipal Licensing and Standards, a paramedic, and one of the SPIDER co-ordinators. Although relatively new, SPIDER seems to have found a way to break down the silos that often occur at City Hall, allowing departments to bring their different perspectives and skills to assist clients to achieve a living environment that is safer for them and for their neighbours. I was very encouraged by this program and hope that our clients can find a way to tap into this resource.

Another great Toronto resource has recently emerged: a free peer support group for people living with hoarding tendencies. Put on by the Mood Disorders Association of Ontario, meetings are the 1st, 3rd & 4th Thursday of each month from 7 – 9 p.m. at 36 Eglinton Ave. W., Suite 602, Toronto. Contact 416-486-8046 if you have any questions. No registration is required. Housing providers may wish to make their members and tenants aware of this opportunity.

Missing from today’s presentations was any real discussion of housing providers’ obligations to accommodate mental health disability under Ontario’s Human Rights Code. (Our colleague, Lauren Blumas, published a paper on this in 2013 which you can find on our blog here.) Although certainly the undue hardship factor, heath and safety, is relevant, many have learned the hard way that working with a problematic hoarder to meet the Code obligations and help preserve housing can be a long road, with many bumps along the way. We remain committed to helping our clients in these efforts.

Filed in: Housing, Human Rights

Tags: Hoarding