hoardingFIRE’s US Correspondent Catherine Levin reports on the growing problem of hoarding fires and what is being done to tackle the issue on both sides of the pond:

There is a small park on the corner of 128th Street and 5th Avenue in Harlem, New York. It is on a fairly quiet residential street but not far from the hustle and bustle of 125th St, a major transport hub in northern Manhattan. The park marks the footprint of the house that until 1947 was the home to the Collyer brothers and bears their name. The park is dark, dank and unloved; and often under threat of being renamed. This is not a surprise considering what happened to Langley and Homer Collyer, who were found dead in their home amongst 130 tonnes of junk including, famously, 14 grand pianos and a model T Ford car.

Fast forward 66 years to the present day and you will still find firefighters in the US and in the UK entering homes stacked to the rafters and inhabited by those suffering from hoarding disorder. Back in 1947 it would not have been categorised as such and indeed it was only earlier this year that hoarding was defined as a mental health disorder by the American Psychiatric Association.

It is possible that the only reason anyone is interested in hoarding right now is because of the power of television. In the UK and in the US, reality TV shows about hoarders are popular and have given a wide audience to this hitherto hidden phenomenon. London Fire Brigade has worked with the TV presenter Jasmine Harman. It was her programme, ‘My Hoarder Mum and Me’, which brought the problems of hoarding to a wider audience on the BBC back in 2011. As a result London Fire Brigade has developed its own training and awareness package for operational staff. 

The extent to which hoarding is a fire problem is hard to pin down. The US Fire Administration does not include hoarding as a data field in its National Fire Incident Reporting System, so there is no federal record of how many fires there have been in homes of hoarders. The same goes for the recording of fire statistics in the UK with its Incident Recording System. But of course, all these statistics would tell you are when the Fire and Rescue Service responded to a fire at the home of a hoarder.

It will not tell you about any proactive work, discovery through home fire safety visits or any partnership work that goes on at a local level. The response statistics would only form part of the picture. In terms of hoarding, the end goal for fire and rescue services is twofold: first to reduce the likelihood of fire through good fire safety advice and attempts to change risky behaviour; and second to know about high fire load and go into fires when the first goal fails, knowing what you are up against.

“There’s a lot of shame wrapped up in hoarding” says Jennifer Sampson, President at the Washington State based Hoarding Project. Fire department staff often have the edge over their counterparts in the police in terms of the trust people have in them, and yet, according to Sampson, “any official in uniform is treated with suspicion; they just don’t know what their jurisdiction is”. She goes on to explain that those suffering from hoarding disorder “are concerned about having their things taken away from them”.

Hoarding in the USA
This is reinforced by Ryan Pennington, who works for the Charleston Fire Department in South Carolina and is a contributing editor to Firehouse magazine. He has trained hundreds of firefighters about how to safely respond to fires in homes where people hoard. He cautions against using the term ‘hoarding’ and prefers ‘heavy content environment’. And he says this is about shame, because no one wants to be called a hoarder.

The Hoarding Project is involved with research about the influence of family relationships on the mental health of hoarders. “The influence of good family relationships can go a long way in positive outcomes for treatment,” says Sampson. Hoarding affects those relationships and Sampson agreed that family members could often be a conduit to services like fire, where they recognised the dangers faced by their loved ones.

Going back to the Collyer case, it is not clear what powers the FDNY had to force access to the Collyer brothers’ home in the 1940s. In the US it is very much about building codes. Pam Wilderman is the Code Enforcement Officer for the City of Marlborough in Massachusetts. She is a passionate advocate for helping hoarders be safe in their homes and is the perfect link to the fire department, having spent ten years previously working for the Massachusetts State Fire Academy.

Wilderman described how fire departments in the US today can gain access where they believe there is a public safety issue related to hoarding. She said that the State Building Code, with its fire protection clauses, gives her powers to gain access to homes using an Administration Order. She jokingly said she plays her ‘little old lady’ card to gain voluntary access to homes where men in uniform had previously failed.

In a slightly different approach, David Michaels, Acting Chief of the City of York Fire Department in south central Pennsylvania, said that his fire department is responsible for the tenant occupied licence and inspection programme. To rent a property the owner needs to get a licence and to get a licence you need the fire department to inspect your property. Using a property maintenance code, based on the international one (IPMC), any violations can be enforced, ultimately by the courts.

Getting in to people’s homes and identifying issues and being able to pass this information on to other community services is a key role for the fire department – enforcing fire codes provides one way of dealing with public safety issues that come with hoarding behaviours. However, it does seem that the powers are much greater when the home is leased or is public housing. Private housing is much harder to reach.

Hoarding in the UK
In the UK, one case in recent years provides an insight into the way in which powers of entry could be improved. In January 2011 a 59-year-old woman died after fire broke out in her home in Long Eaton, Derbyshire. It took firefighters and police three days to find her body after the fire had been extinguished as waste filled every room in her house “from floor to ceiling” as the Derby Telegraph reported after the inquest held a year later.

The Derby and South Derby Deputy Assistant Coroner, Paul McCandless, noted the lack of powers that local authorities had to enter private houses where they believed there was a health risk. He used a rule 43 letter (under powers provided by the Coroners Rules 1984) to write to the Secretary of State for Communities and Local Government (Bob Neill MP at the time). McCandless requested in his letter dated April 27, 2012 that DCLG ‘should give serious consideration to introducing legislation which would provide a specific power of intervention due to ‘hoarding’ and the attendant fire risk’.

The Secretary of State’s response refers to the Housing Health and Safety Rating System (HHSRS) under the Housing Act 2004. Drawing on the HHSRS operating guidance used by local authorities he replied: ‘the hazard in relation to fire states that there should be adequate, appropriate and safe means of escape in case of fire from all parts of the dwelling’. Local authorities can enter dwellings after giving 24 hours’ notice where they believe a hazard exists and have enforcement powers to take remedial action. As a result of this, Derbyshire Fire and Rescue Service is now in discussion with housing providers to try to improve public safety outcomes with hoarders in their area.

It is also worth mentioning the Fire and Rescue Services Act 2004 which includes a section (s.45) on powers of entry. However, this section only relates to firefighting, road traffic accidents and emergencies (read terrorism etc). When the lawyers at DCLG were drafting this Bill in 2003 they did not include the power of entry for the purposes of fire safety, as set out in section 6 of the Act. Perhaps they should have.

Hoarding Task Forces
Taking a very different and possibly unique approach, the State of Massachusetts is considering a draft Bill which will change the State’s General Laws to categorise hoarding as elder abuse. At its heart the sponsors of this Bill have a desire to protect older people and make organisations which are responsible for the care of older people in the community focused on finding and helping those with hoarding disorder.

The definition of abuse in this draft legislation is telling, it states that it is ‘an act or omission which results in serious physical or emotional injury to an elderly’. It is the ‘omission’ that is crucial here – not knowing that someone in a community is living this way, not providing help for them; perhaps this change will focus the energies of those who should care.

The use of the carrot approach of collaboration between agencies, rather than the stick of approach of enforcement and legislation exists both in the UK and in the US. The first hoarding task force in the US was established in Fairfax County, Virginia in 1998. Since then, around 90 task forces have been established across the US.

Bringing agencies together to work for a common goal is nothing new and certainly in the UK, the now defunct Local Strategic Partnerships were intended to do just this across a broad spectrum of issues. Adult Safeguarding Boards are prime candidates to deal with hoarding and maybe health and wellbeing boards will pick this one up too, but there is little evidence of this so far.

The reality of how influential a hoarding task force can be was brought home clearly by Janet Yeats, the Chairman of the Minnesota Hoarding Task Force. She is an impressive driver of change in the state of Minnesota. Co-founder of the Hoarding Project, Yeats’ background is in marriage and family therapy, but she has witnessed the damage hoarding can do to family relationships. She took this interest and brought agencies, including the fire department, from across Minnesota together to form a hoarding task force, bringing together mental health concerns with public safety. She says “the only way we are going to be effective is by collaboration”.

The combination of managing someone’s mental health whilst protecting their own safety and that of the people around them in their community that lies at the heart of Yeats’s work. “Public policy change is my next step” she explained, determined to get legislators in Minnesota to take hoarding seriously. The planning is in its infancy, but Yeats is committed to change and is going in the right direction.

In the UK, the Chief Fire Officers Association (CFOA) is seeking to make public policy change through its recently created hoarding working group chaired by Ian Bitcon, Area Manager at West Yorkshire Fire and Rescue Service. Bitcon says that hoarding is “a common problem experienced by fire brigades, but has a varied response”. It was a hoarding fire related rule 43 letter from the Durham and Darlington coroner that led to CFOA creating this group. The level of interest is high, with 26 fire and rescue services attending its inaugural meeting back in July. It is early days for CFOA’s work in this area, but Bitcon sees this group having a long term role and encourages all fire and rescue services to get involved. He can be contacted direct at ian.bitcon@westyorksfire.gov.uk.

Influencing public policy change in the UK through organisations like CFOA could lead to better outcomes for hoarders, where fire risk and public safety issues are identified and managed long before a fire response is required. Deciding what that public policy change should be and how to get there will be crucial to successful outcomes for this group.

Collyer Brothers Park will never be in the tourist guides to New York, but it is a salient reminder of how mental health disorders, like hoarding, can have tragic consequences. Fire and rescue services in the UK and US have a central role to play, whichever route they choose to take. They can help keep those who cannot change the way they live be safer in their homes and reduce the possibility that they too will be just one more fire statistic.