Trauma (especially childhood disrespect for possessions) and other forms of trauma are extremely common. Underlying issues for hoarders can include ADHD, Dyspraxia, some people on the autistic spectrum, OCD, tiredness (e.g. due to ME), Brain Injury (whatever the cause of it, and associated organisational difficulties), personality disorder, and amongst people who have additional mental health issues, ranging from depression through to schizophrenia and bipolar disorder as well as post-traumatic stress disorder (simple or complex) . These often overlap. Hoarding is also more common with ageing and can be a feature of cognitive impairment and dementia.  Little of which is to be found in the spate of programmes about hoarding.

People with these conditions seem to have been excluded from the programmes, though we know that some expressed an interest.

People with additional conditions will tend to need more help and better tailored help.

They might also benefit from treatments to help underlying conditions, such as sensory integration therapy. As well as assistive technology, such as technologies used to help blind and partially sighted people find things. This includes IT.

A quieter environment and revising access standards would also help and the work of autistic activists, especially through the London Autistic Rights Movement (LARM) is pioneering in this respect on a global basis. This includes monitoring and submissions to the United Nations in this area. A member of the Hoarding Peer Support Group Executive Committee is also on the British Standards Institution (BSI) Accessibility Working Group and has widened access considerations to include issues other than disability and age, such as belief including religion, using the principles of Universal Design, as enshrined in the UNCPRD (see article 2). We want inclusion for all and the abolition of hierarchies of equality and diversity strands, including the hierarchy of impairments.

Failure to tackle underlying issues is unlikely to result in the best solution for people.

The Hammersmith and Fulham borough team covering hoarding reported at a conference in Hammersmith Town Hall on 23rd October 2013  that only 1 in 4 people who qualify for Hoarding Disorder diagnoses (based on the new Diagnostic and Statistical Manual (DSM) Version 5 diagnosis also qualify for a diagnosis of OCD (Obsessive Compulsive Disorder). Previously Hoarding was classified as a subset of OCD. 

It is not acceptable that the DSM V has "excluders" for a Hoarding Diagnosis. Especially as some people with these excluders were diagnosed as part of the research required to establish this new diagnosis. These "excluders" denying a diagnosis include brain injury, autistic spectrum, psychosis and schizophrenia, but do not exclude conditions such as depression. Nor is it acceptable that there was no involvement of hoarders organisations such as ourselves (contrary to domestic and international law, customary, case and statutory in all cases (such as the United Nations Convention on the Rights of Persons with Disabilities (UNCPRD) Article 4.3 which requires all policy affecting disabled people to be formulated with the involvement (at all stages) of both individual disabled people and their representative organisations. That means us. It is essential, rather that people receive diagnoses which include mention of underlying conditions, all of them. For example: "Hoarding Disorder with underlying dyspraxia, spatial memory difficulties, visual stress, obsessive compulsive personality disorder, complex post-traumatic stress disorder, central auditory processing disorder, autistic spectrum disorder, schizophrenia and bipolar disorder, attention deficit hyperactivity disorder, and severe pain caused by bowel lining damage, osteoporosis and plantar fasciitis, probably caused, directly and/or indirectly by a neonatal skull fracture and resultant traumatic brain injury (tbi) and reaction to additional childhood and adult bullying, neglect and abuse worsened by the denial of the caregiver who was responsible for the tbi and of the family, the public authorities, very late diagnoses, the cover up of information and negative public attitudes". We also want to see ways of building on strengths, and the provision of comprehensive support (including an adequate income (required by Article 28 of the UN Disability Convention).

This also applies to moves, to set up an ICD (International Classification of Diseases) diagnoses. 

Please email us to discuss further.

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