Montgomery County social worker Bonnie Klem usually has one or two "hoarders" in her caseload: people who fill their homes, sometimes from floor to ceiling, with paper, clothes and even garbage.
"We're finding there are larger and larger numbers of hoarders," she said, "perhaps because the community knows to report to us."
Once hoarders are reported, their cases pose challenges for government workers. Building inspectors show up to cite code violations, fire and safety officials need to ensure access in case of emergency, and health and welfare workers want to find a way to encourage hoarders to seek help.
The official attention can overwhelm someone who would rather be left alone. Hoarding is often a psychological malady, and hoarding behavior is frequently a symptom of different kinds of mental illness.
Inspired in part by a Fairfax County task force on hoarding that began in 1998, officials in Rockville and Gaithersburg are finding ways to discuss hoarding cases across bureaucratic boundaries. Their goal is to coordinate the response in order to develop the most compassionate approach possible. "You could put someone into trauma if you just start throwing out things that are precious to them," said Maureen Herndon of Gaithersburg's Human Services Division.
She and Robin Sparer of Rockville's human services department organized a seminar June 1 that drew more than 100 government workers and health care providers to discuss hoarding. John Yetman, chairman of the Fairfax task force, advised participants on how "to help the individual and return the home to a safe condition and a somewhat functional one."
"In most cases, a mental health issue is involved," Sparer said, in a statement announcing the seminar. "Most governments have the ability to identify the problem. They also have laws and regulations that allow them to intervene and mental health services to help hoarders. However, putting all of this together, and being careful of the legal rights of individuals, has been difficult at times." Some hoarders resist official intrusion and fight it in court.
Yetman said the Fairfax task force, which groups health, housing, public safety and welfare officials, addresses about five new cases a month. He, like other officials and experts, said the problem appears to be growing, at least in part because people are more likely to report hoarders to the authorities. "It's no longer that the recluse down the street . . . is ignored," he said.
Montgomery County takes on one or two new cases a month, said Mary Anderson, a county spokeswoman. The county maintains a $10,000 fund to pay for the cleanup of homes of hoarders who can't afford to pay for the work.
"There's a confluence of variables that are making this a problem of epidemic proportions that is just hitting the radar screen," said Charles Mansueto, director of the Behavior Therapy Center of Greater Washington in Silver Spring. Those variables include an aging population and a rising rate of homeownership. Hoarding is more prevalent among the elderly.
Klem and others stressed that hoarders do not see their collections in the way that others might. Hoarders "really can't understand what should be thrown away and what should not," she said.
The accumulation of materials becomes dangerous when it threatens a building's structural integrity, impedes access by emergency personnel or becomes unsanitary. Yetman recalled a case in which county officials filled 15 construction-size dumpsters with materials they had removed from a three-bedroom townhouse.