What is hoarding disorder?

Here of late, I have began watching Hoarders on Arts and Entertainment channel (Channel 38 on Comcast here in Atlanta) and was under the misconception that it was something of a new phenomenon. Turns out I was wrong -- I had been hearing about it for years, but knew it by another name -- Collyer's Mansion Conditions. It was originally coined by the Fire Department of New York (FDNY) to describe a residential dwelling (either a single-family dwelling or an apartment building) that is cluttered either by a collector or a "pack rat". I also learned the original name for such a situation was Collyer's Mansion Syndrome.

New York Police officers investigate conditions inside of the
Collyer mansion

What causes Hoarding Disorder? The exact cause is unknown, however, researchers have identified a number of risk factors including having a family member who also suffers from a problem with hoarding. Genetic research has recently shown that there are certain gene variants that might convey the risk of becoming a hoarder. There is also a confirmed correlation between brain injuries and acquired or secondary hoarding symptoms in some patients.

The symptoms of hoarding disorder - such as difficulty in discarding items - is usually first seen during the teen years. If these symptoms are not treated, the hoarding disorder tends to become chronic often becoming more severe over the decades. Interestingly, the Collyer brothers were an exception to this rule as both were in their early to mid-twenties when they began hoarding.

Is hoarding disorder treatable? The answer is yes. According to the American Psychiatric Association it can be treated using either medication or cognitive behavior therapy (CBT). Patients treated with CBT gradually learn to discard the unecessary items while, at the same time, experiencing less stress and diminishing their exaggerated perceived need (or desire) to save these possessions. They also learn to improve their organizational, decision-making, and relaxation skills.

To find help with hoarding disorder in the Atlanta area, contact.The Anxiety and Stress Management Institute

GBI Director has the right idea!

Georgia Bureau of Investigation director Vernon Keenan isn’t known for being soft on crime, but he is working to keep one class of “criminals” out of jail.

 

Keenan (pictured at left), like sheriffs statewide, contends law enforcement turns jails into asylums at huge human and financial costs. Now, a study in which the Georgia Bureau of Investigation (GBI) is partnering with the Georgia chapter of the National Alliance of Mentally ill (NAMI), shows how to keep people with schizophrenia, bipolar and other mental diseases out of jail, Keenan said.

“The project is designed to prevent the acutely mentally ill from routinely being incarcerated,” he said. “It is a humane program, but one that also has significant taxpayer savings. The participants have been arrested dozens of times and been in and out of jail, usually for minor crimes.”

NAMI got a $2 million grant from the nonprofit Bristol-Myers Squibb Foundation and another $2.3 million from other donors recruited 100 mental patients from Georgia Regional Hospital in Savannah and assigned each patient to caseworkers who monitored medications and lifestyle. The two-year program ends next year.

The GBI flagged all the names in the law enforcement database so when an officer checks the database for any warrants, a message instructs the officer to call the caseworker before taking the patient to jail, usually for crimes such as criminal trespass, shoplifting, disturbing the peace or minor assaults, Keenan said.

The caseworker also gets an email about the arrest and contacts the officer at the scene. If the officer decides there is no public safety reason to take the person to jail, the offender will be handed over to the caseworker who will decide the most appropriate next move.

The project has had a few bumps, she said, especially when officers didn’t check the Georgia Crime Information Center. “Our patient No. 17 was totally psychotic several months ago and he went into a convenience store and started drinking a Coca-Cola and walked out of the store,” said Nora Haynes, who is overseeing the project. “That Coca-Cola ended up costing the taxpayers $1,160 because instead of checking the GCIC system, the officer just took him to the jail. It took us 21 days to get him out.”

Currently the project is only funded in 34 sparsely populated counties in southeast Georgia, but sheriffs across the state are paying close attention to its results. Last year, an investigation by The Atlanta Journal-Constitution reported state jails house mentally ill inmates for months — even years — for minor crimes because they’re incompetent for trial.

“We’re doing absolutely the wrong thing by incarcerating people with mental illness,” said Oconee County Sheriff Scott Berry, president of the Georgia Sheriffs’ Association. “There has to be some community-based-response system that is set up not just in a few counties in Georgia but all of Georgia.

“It is not right to shackle a mentally ill person and throw them in the back of a patrol car. It is not humane.”

The costs also get extreme for both local tax dollars, which fund the jails, and state tax dollars, which fund psychiatric hospitals. Last year, metro Atlanta jails reported the mentally ill accounted for at least 20 percent to 30 percent of the inmates. Fulton County spent about $4 million on jailed mentally ill. Cobb County spent more than $1 million a year and DeKalb County officials said they spent $2.2 million in 2010.

State costs are even more dramatic. The 35 patients who have been in the study for at least six months have cost state taxpayers $2.5 million because of repeated stays — 458 in all — at Georgia Regional Hospital, 83 of the visits coming within six months before enrolling in the project, according to NAMI numbers.

Since joining the project, the 35 patients have only had 26 stays — with three patients being responsible for half that number.

Fulton County Commission Chairman John Eaves said the project sounded worth emulating. Local law enforcement has to move past jailing the mentally ill people, he said.

“There has to be a more effective and efficient means of dealing with this population,” he said. “If they are not a threat to society and their actions result from their mental illness, there should be a way of hooking them up with mental-health services.”

Haynes said legislators were impressed with the early results — at least enough to award $500,000 in state funding. Former first lady Rosalynn Carter, a longtime advocate for the mentally ill, also endorsed the program. Mental health advocates are putting strong hopes on Gov. Nathan Deal, who voiced support for drug courts and mental health courts as mechanisms to reduce the prison population.

Marietta police Chief Dan Flynn questioned whether the state would ever fund enough mental health treatment alternatives to make the program viable statewide. Critics contend the Legislature doesn’t fund mental health programs in part because local law enforcement dollars end up directed at providing some level of treatment in the jails.

“Common sense tells you that these people aren’t going to do any better in a jail locked up with criminals,” he said. “My only skepticism is what is the end game here? Are we going to have new places to send them for treatment?”

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As someone who works with those with mental disorders, I can only say why didn't someone do this sooner?

-- Walter