Every town department, service provider or other professional has a different roll and responsibility as it relates to an individual with hoarding disorder. For more information, click on the the tabs below.
The Health Department is responsible for enforcing State and Local Public Health Regulations. When the Health Department receives a hoarding related complaint, or referral, they must first conduct an inspection. Generally the Health Department will contact the occupant to try to make an appointment for the visit, but may make an unannounced visit. The Health Agent will request permission to inspect the premises and will be looking for violations of Massachusetts General Laws relative to nuisance conditions and the State Housing Code, as well as any local bylaws that may apply. If violations are observed, an order will be issued to the owner/ occupant to correct the violations and a timeframe will be given to accomplish those corrections. How the actual process will occur depends on the individual situation. If the violations are serious, there is the possibility that an Order to condemn the property will be issued, and the owner/ occupant will not be allowed to inhabit the property until violations are corrected. If the violations are not serious enough for a condemnation order, but there are serious Health and Safety concerns, then the timeframe to correct the violations will be very short, but the owner/ occupant will be allowed to remain on the property. If the violations are not a serious threat to public health or safety, then the timeframes will be longer. Overall, if there is a continued, good faith effort made by the owner/ occupant to correct the violations, the Health Department can work with the individual, and allow for a longer timeframe to come into compliance with the any order that has been issued.
Animal Control-Hoarding Response
The law that protects animals in a hoarding situation is Chapter 272 Section 77. This is the Animal Cruelty Statute in Massachusetts, and it can make an owner or care taker of the animals accountable. It is a Felony which carries a penalty of imprisonment in a Commonwealth of Massachusetts state prison for not more than 5 years or imprisonment in the house of correction for not more than 2 1/2 years or by a fine of not more than $2,500, or by both such fine and imprisonment. This can only be enforced by either local Law Enforcement Agencies or through the two Animal Welfare organizations in the state; the MSPCA Cruelty Line 800-628-5808 or Animal Rescue League of Boston Cruelty Line 617-226-5610. The first step in an animal hoarding situation is to contact the local Animal Control Department that can be reached through the local Police Department. The Animal Welfare Agencies can be additional resources.
According to the 5th edition of the Diagnostic and Statistical Manual, hoarding disorder is a mental health condition characterized by one’s inability to discard possessions, regardless of their value, and the inability to use living spaces as intended because of the high volume of accumulated possessions. In addition, research shows that up to 50% of people struggling with hoarding disorder have at least one other mental health condition such as major depression, social anxiety, or generalized anxiety disorder. Thus, mental health professionals play an important role in helping manage a hoarding disorder case.
Research studies show that a specialized cognitive behavioral therapy (CBT) for hoarding is effective in many cases. This treatment consists of structured assessment; strategies to increase motivation; case formulation and goal setting; skills training (organizing, problem solving, decision making); challenging beliefs about possessions; and practicing sorting, discarding, and non-acquiring. Individual treatment may take a year or more and consists of office appointments, home visits, and practice non-acquiring in triggering situations (thrift shops, swap shops, stores). Group therapy based on this type of CBT has also shown promising results.
Fire Department response to a hoarding issue will depend on how the call comes in. If the situation is emergent the response will be immediate as with any other emergency. If the call comes in from a concerned party for a non-emergent situation the fire department has the authority, Under MGL 148, sec. 5, under strict guide lines, to enter upon the property, order a remedy, bill the responsible party for the clean-up, and if this doesn’t work to fine the responsible party up to $ 50.00 for each 48 hours of non-compliance. This would be probably be a last resort. A more likely response would be to meet with the property owner, in the company of other representatives, to point out and recommend ways to abate hazards and to arrange a follow–up inspection to insure compliance. The object in this situation is hazard removal in the least punitive manner.
The Building Department is charged with enforcing the Massachusetts State Building Code and local zoning. We are generally contacted by other town departments and individual citizens in response to concerns about perceived hoarding or general messiness. Our jurisdiction is limited, usually to deterioration of structures resulting in building code and/or life safety violations, and to unregistered automobiles and vehicle parts left outside on residential property. We occasionally receive calls relating to business use of residential property, which can involve substantial accumulation of inventory such as metal junk, etc. We partner with other town agencies, including Police, Fire, Health and Animal Control to conduct relevant Team Inspections. We are not a social service agency, but we will contact appropriate organizations if we feel they may be needed.