Understand why people hoard and how to render help

The Sunday Times spoke to Dr Kelvin Ng, consultant, Institute of Mental Health (IMH), to understand hoarding behaviour.

A Most people have difficulty parting with valuable possessions, but one with hoarding behaviour will have difficulty parting with items that are not useful and experience emotional distress like anxiety attacks when asked to discard them.

However, a person with a cluttered house may not necessarily be showing hoarding behaviour. Instead, it could be due to an underlying mental or physical illness that impairs his ability to clean and upkeep the house.

A People hoard for various reasons and not all are caused by mental illness. But some mental illness can have hoarding as one of the presenting symptoms.

IMH and other agencies use the Clutter Image Rating Scale, an internationally verified tool, to rate the severity of the hoarding and determine what actions can be taken to help the person.

Sometimes, people without a mental illness may have a problem discarding items because of experiences with loss or stress in the past. These may create an emotional void that they try to "fill" by holding on to possessions. Some people may have gone through hardships in the past and though they are no longer in that situation, find it hard to throw away items they deem "still useful". People may attribute value to their hoard, as they feel it is a reflection of their past. Over time, such hoards become an extension of their self-image and self-esteem.

Underlying mental health issues may cause some people to hoard. For example, a person with severe depression may lose the ability to clean up after himself, and the eventual neglect of the home environment can look like hoarding. Treatment of the underlying mental illness can sometimes improve the hoarding behaviour.

A When hoarding starts to affect the person's functioning, and causes significant impairment in their relationships or social life, or if they are unable to maintain a safe environment for themselves or others.

A They should first seek help from a mental health professional to assess whether the person who hoards might have an underlying mental illness that is causing hoarding behaviour.

Family members are advised to seek mental health assessment for their loved ones and not stigmatise them. They should be gentle in their approach when raising the topic. A soft approach, built upon one's relationship with the person who hoards, to try to understand the intent and meaning behind the hoard, is more helpful and the person who hoards is usually more receptive and amenable to change, than a hard approach.

But if a continued soft approach goes nowhere, then a hard approach may be necessary, especially if hoarding has endangered themselves and others. Family may approach their grassroots leaders or community partners for help, and the relevant agencies such as the Housing Board and National Environment Agency will assist accordingly.