Factors Affecting the Referral Rate of the Hoarding Disorder at Primary Mental Health Care in Quebec

Abstract

Hoarding disorder (HD) places an important burden on people with HD, on their family members and society. In this paper we evaluate help-seeking in HD at primary mental health, measured in referral rate, together with its individual, environmental and structural correlates. We conducted an aggregate study by combining existing official data with our own survey data at the catchment area level. We found a mean annual referral rate of 1.58 (SD = 1.79) cases of HD in primary mental health facilities per 10,000 of adult population. The referrals rate correlated with socio-demographic characteristics of the catchment area, the availability of tools for clinical management of HD, and affiliation to a University Medical school. We also found that: (1) family members, neighbours, municipal workers and health professionals are the primary source of complaints for HD; (2) 72% of primary mental health facilities worked with HD in crisis situations, 52% expressed difficulties in obtaining the consent of people with HD for an intervention (3) health/social services professionals lack HD clinical management tools, training and formal collaboration with municipal (housing, building security, fire prevention) specialists. Improvement of the readiness of the health-system to deal with HD will improve help-seeking for formal medical counselling on the part of people with HD. We can improve this readiness by providing primary mental-health facilities with training, clinical management tools and by helping them to establish formal collaboration with municipalities and community organisations. University medical schools can take a leadership role and become centers catalysing the change in HD clinical management.

Compulsive Hoarding Symptoms and the Role of Mindfulness Skills During Social Distancing for the COVID-19 Pandemic: An Exploratory Survey

“…This finding suggests that perhaps people have more intense hoarding behaviors during quarantine and social distancing, and this behavioral pattern should be more carefully monitored during the pandemic. As already reported (18), CHS are generally under-recognized by practitioners and underreported by the individuals themselves. Such an increase of CHS during the quarantine might be attributed to a variety of factors including stocking of masks, soaps, sanitizers, disinfectants that can lead to CHS, increased stress subsequent to quarantine and nation-wide lockdown in response to the COVID-19, a lower chance for interpersonal contacts that increases people's attachment to objects, and a higher chance for compulsive online shopping as a way to cope with quarantine-related distress and loneliness (27).…”

“…Like other obsessive-compulsive spectrum disorders, HD is often an under-recognized and untreated pathological condition ( 17 ). According to some studies [e.g., ( 18 )], people suffering from HD may wait for a long time before attending a mental health facility or seeking professional help. In addition, most of them may be not enough aware of their symptoms due to social stigma and poor mental health literacy ( 19 ).…”

An exploratory study on the lived experiences of hoarding in Singapore

“…Saxena, Brody, Maidment, and Baxter () similarly found that those individuals with hoarding behaviour deny their illness, are indifferent to the consequences of their hoarding behaviours, have inflexible beliefs in relations to their possessions and show defensive reactions against change (Saxena et al, ). Bodryzlova and O'Connor () also identified the lack of insight as a significant barrier to help‐seeking and engagement in treatment. This study also found that participants experienced significant distress associated with decluttering, even when initiated by themselves.…”

Community Partnership in Response to Hoarding Disorder in Montreal

“…Some people with hoarding disorder are oblivious to the clutter and unsanitary conditions of their houses and therefore do not consider their hoarding behavior to be unusual or abnormal. Initial complaints may come from neighbors, landlords, family members, health professionals who are treating these people for other health conditions, and municipal service employees (e.g., housing, building security, fire prevention, police) (5).…”

“…Even when seeking help, a person can rarely receive tailored care. Interventions-namely, assisted decluttering, psychoeducation, and cognitive-behavioral therapy-are rarely available in the public health care system because of a lack of specialized training among health care professionals (5).…”