I am grateful for the opportunity to lead this debate on a subject that, to the best of my knowledge, has never been discussed on the Floor of the House before.
I often speak of my 25 years as an NHS nurse because that experience has fundamentally shaped my understanding of the hidden struggles within our communities, and it is from that perspective that I raise the urgent and often misunderstood issue of hoarding disorder. Many years ago, as a district nurse serving the Kingstanding community—the same community that I am now proud to represent in Parliament—I entered homes where extreme clutter was not an anomaly but a visible sign of a deep, unaddressed need. Today, we have a name for it. In 2018, hoarding disorder was formally recognised in Britain as a distinct mental health condition. It is defined by persistent difficulty in discarding or parting with possessions, regardless of value, leading to cluttered living spaces and significant distress or impairment in daily life.
My hon. Friend speaks very effectively about hoarding disorder. As she has explained, it is a mental health condition in its own right, although it is often confused with obsessive-compulsive disorder. One of my constituents spoke to me about her husband, who has completely filled the living room with items that he just cannot discard. Does my hon. Friend agree that whether it is related to OCD or to another condition, hoarding not only disrupts the lives of the individual who goes through the anxiety and trauma of the condition, but affects others around that individual?
During Prime Minister’s questions this morning, we heard that one in four of us will suffer from a mental health condition. Does my hon. Friend agree that we need to increase mental health support to make it easily accessible and enable it to provide effective treatment, and that such earlier intervention can avoid the deterioration of the condition?
I congratulate the hon. Lady for bringing forward this issue. She is a dear friend of mine, and I always look forward to her contributions to this Chamber and Westminster Hall. I often think of a TV programme on this subject. Perhaps I did not always understand the obsessive behaviour of hoarding, but that TV programme opened our eyes to it, and helped us understand it. The makers of the programme not only showed the problem, but how to bring about a solution. That is what I always loved about the programme: it started off with a problem, but ended up with a solution.
The hon. Member is right, but this is not just about a solution. A number of people in our society are living with a mental health condition, and it needs to be treated. At the moment, there are no strategies in place, but I will answer his question as I go on. I thank him for his contribution.
I am really grateful to my hon. Friend for securing tonight’s debate. I have met York’s Community Bees, who have developed strategies for supporting people in the community. They dearly need money, because they are not only addressing mental health needs but de-risking a situation. Hoarding risks infection, infestations, fire and structural damage to homes, so they play a really crucial role.
Again, my hon. Friend raises a valuable point. The issue of financing is vital, but I will discuss that more as I go on.
Hoarding disorder is a widespread condition affecting between 2% and 5% of the population, which equates to approximately 1.2 million to 3 million people in Britain. Let me be absolutely clear: hoarding is not a lifestyle choice, or a matter of laziness. It is a complex mental health condition, deeply rooted in emotional distress and underlying trauma, often stemming from adverse childhood experiences. For hoarders, it can result in unsafe living conditions, social isolation and a diminished ability to manage day-to-day responsibilities. If left untreated, it has a huge cost for families, the NHS, housing providers and emergency services.
On top of that, hoarding is a long-term condition with few effective treatment options, meaning that behaviours are often left unresolved. My professional experience showed me the heartbreaking reality of individuals drowning in clutter, their mental health deteriorating and their relationships broken. Dealing with hoarding can be very time-consuming and expensive. Providing support falls disproportionately to ill-equipped local authorities and overstretched third-sector organisations, such as Birmingham’s Clouds End CIC, led by the inspirational Heather Matuozzo.
The challenges can be broken down into four key areas. The first area is public health and safety. Hoarding does not just hurt individuals, but has knock-on effects on the entire community. The hazardous living conditions that it creates, from severe fire risks and blocked escape routes to unsanitary and unsafe housing, pose a direct danger not only to the individual, but to their neighbours and the brave professionals, firefighters, social workers and others who are called in to intervene.
The second challenge has to do with public awareness and education. We cannot combat what we do not understand. We urgently need to educate our communities, and our frontline professionals working in social care, housing, health and the emergency services, to recognise hoarding as a mental health issue, so that we can reduce stigma and promote more compassionate and effective intervention.
My hon. Friend is being incredibly generous with her time. Community Bees in York has helped 600 people over the past seven years. It has a lot of expertise, not just in how to sensitively support people in decluttering, but in upcycling; it makes a positive contribution by selling things on. It has sold 7,000 books, and collected 5,323 items from landfill and passed them on. That not only helps people who have hoarded, but contributes to the future. Does she agree that that should be part of the holistic model?
My hon. Friend makes an absolutely brilliant point. Yes, that should be part of the holistic model, but there is no model in place at the moment. It is like the wild, wild west—everybody is just doing as they see fit. That is why I secured this debate.
I urge the Government to prioritise the development of national guidelines, in order to equip all frontline workers with the tools to identify and address hoarding compassionately and effectively; to ensure a truly integrated, multi-agency approach that brings together mental health services, social care, housing and emergency responders; and to invest in research and data collection, so we can properly understand the scale, causes and economic impact of hoarding in the UK, and ensure that our policies are evidence-based and our resources are allocated wisely. In my nursing career, we were taught that prevention is always better than cure. That holds true for hoarding. Early intervention is more humane and more cost-effective than crisis response.
This issue has remained in the shadows for too long. We have a duty to bring it into the light, to replace judgment with understanding, and to offer a hand up to the millions of our citizens who live with this devastating condition. I look forward to hearing in the Minister’s response how the Government intend to lead this vital change.
I sincerely thank my hon. Friend the Member for Birmingham Erdington (Paulette Hamilton), who is vice-chair of the Health and Social Care Committee, for securing this debate. I pay tribute to her for her work on that Committee, on which she has consistently championed the voices of the unheard, and for her 30 years’ service in the NHS as a district nurse. As she was speaking, I recalled that, as a medical student at the University of Glasgow, I had the pleasure of spending a lot of time shadowing district nurses. I always found them to have the perfect mixture of clinical acumen and a sixth sense of something being not quite right. She displays those attributes in abundance.
My hon. Friend has been true to form in raising the issue of hoarding. This disorder is, by definition, kept from public view. Although it is often overlooked, it has a profound impact on the lives of the affected, their families and their carers, and, of course, on local services. Too many suffer in silence. I thank Hoarding UK, Clouds End and Clutterers Anonymous, to name just a few of the charities that do so much to support people up and down the country.
For too long, hoarding has been seen as something quirky, or perhaps even comical, but the disorder is neither a joke nor a rarity; it is a complex and often misunderstood condition that can have devastating consequences for people’s mental and physical health. Often, it is a portent to investigating further mental wellbeing and illness.
Estimates vary, but research suggests that between 2% and 3% of the UK population, as my hon. Friend adumbrated, may be affected by hoarding behaviours. These are often associated with traumatic life experiences such as bereavement, divorce or eviction. People who hoard can experience deep emotional distress, guilt and anxiety. The clutter in their homes often represents emotional pain, memories or attempts to regain control.
7:00 pm
Motion lapsed (Standing Order No. 9(3)).
Motion made, and Question proposed, That this House do now adjourn.—(Mark Ferguson.)
The impact of hoarding can be severe. The clutter can compromise hygiene, strain relationships and pose safety risks, so let me be clear: these people deserve compassion and support from this Government and from every corner of society.
My hon. Friend asks whether the Government will introduce a national hoarding strategy. There are no plans for a specific strategy, but we absolutely recognise that people who hoard must have access to the right support. At the moment, that requires more co-ordination than is currently in place. As she knows better than anyone as a district nurse and an independent lay manager, mental health services have been decimated over the last 14 years. This Government are doing the hard yards of rebuilding those services while transforming our mental health system, so people can access the right support at the right time and indeed the right place. Through our 10-year health plan, we have set long-term reforms to make mental health a core priority of the NHS and to move from crisis care to prevention and early intervention.
This transformation will include: investing up to £120 million to expand the number of mental health emergency departments to 85 across England; a modern service framework for severe mental illness to support consistent high-quality and high-value care; and, as my hon. Friend mentioned, recruiting 8,500 new mental health workers across the NHS to increase capacity and make sure help is available where and when needed.
We are already piloting six 24/7 neighbourhood mental health centres, which will bring together a range of professionals and imbibe that holistic concept—professionals such as psychologists, peer support workers, housing specialists and employment advisers. The pilots are testing out mechanisms that will enable that whole-team approach to capture people who otherwise remain hidden, including collaborative planning of care and treatment, communication and engagement, single patient records and shared outcome measures. This joined-up approach presents an opportunity for people, including those with hoarding disorder, to be identified and to get holistic support and treatment, and then to better join up between social services and mental health support.
I am grateful to the Minister for giving way. From listening to, meeting and engaging with those from York Community Bees, I know that their big cry is for funding. These people are specialists in the work that they do to support my residents, but they need funding. Will the Minister send a message to commissioners to ensure that they commission these support services?
My hon. Friend brings a great deal of experience in these matters to this House. I can certainly give her an assurance that as part of this Government’s 10-year health agenda, we encourage all commissioners to commission strategically on the basis of what will prevent ill health in the long term. I believe this issue is an exemplar of where we could think about commissioning mental health services differently to try to pick up the signs earlier.
For too long, people with mental health conditions, including those who hoard, have not received the understanding or support that they deserve. I want to end, however, on a note of optimism. With love from families, patience from friends and the ongoing support of charities and third sector organisations, countless people with hoarding disorder have managed to live safe, healthy and fulfilling lives. We will continue to work closely with these partners, local authorities and charities to ensure that this Government are also playing our full part.
Question put and agreed to.
20 of 23 shown
The third challenge has to do with mental health and support gaps. Mental health services and treatments that address hoarding specifically remain scarce and underfunded. Many people affected feel reluctant to seek help because of stigma, lack of awareness, or fear of eviction or other legal consequences. Closing this support gap is not optional; it is essential.
The final challenge concerns the legal and housing implications. Housing providers can be faced with challenging legal situations in which tenants’ hoarding behaviours lead to breaches of tenancy agreements or safety policies. Unfortunately, these cases are too often handled through eviction or legal action, rather than support being provided, so that the root causes of the problem can be addressed. We need policies that balance legal responsibilities with compassionate mental health support. As a society, we have a responsibility to support those living with hoarding disorder. In Birmingham, the number of people needing support has risen exponentially since the covid pandemic, and the story is the same across the country, as Members have highlighted. The seriousness and scale of this issue demands a co-ordinated national response, led by Government. We need a national strategy to bring consistency, reduce risk and improve lives.
The current legal framework is simply not fit for purpose. The Care Act 2014 recognises that people who hoard may be considered vulnerable or entitled to advocacy. However, there are no national guidelines for the agencies that encounter hoarding in their work. Without guidance, responses to hoarding will remain inconsistent and ineffective. In the absence of national guidelines, agencies are forced to rely on outdated legislation, such as the Public Health Act 1936, which refers to “filthy or verminous premises”. Under these powers, a person can be forced to clear their property, even if they own it. If they cannot afford clearance, it is undertaken on their behalf and charged to the property. This approach is deeply flawed. It treats hoarding purely as a practical or environmental issue, rather than recognising that these are vulnerable human beings in need of help. Failing to recognise hoarding as a mental health condition risks traumatising individuals, worsening hoarding behaviours and, in the most extreme cases, contributing to suicidal thoughts. The human impact should not be understated. Lack of proper support and compassion leads to further trauma, distress and a greater risk of re-accumulation.
National guidelines would provide clarity on what constitutes appropriate and effective practice, a consistent framework for agencies across the UK, a balance between addressing practical risks and meeting underlying mental health needs, and clear routes for advice, support and specialist referral.
That brings me to my central ask of Ministers. We need a co-ordinated national strategy for hoarding disorder. Although the Care Act 2014 provides a foundation by recognising vulnerability, the absence of specific national guidelines leads to a postcode lottery of care, and to inconsistent and often ineffective intervention. A national framework would provide clarity, consistency and compassion by balancing risk management with mental health support and establishing clear pathways for specialist help.
I was proud that the Labour manifesto committed to recruiting 8,500 extra mental health staff, and to delivering a transformative 10-year plan for mental health. It is essential that those welcome initiatives explicitly include and address hoarding disorder.
We know, too, that there are people in contact with social care right now who have a suspected hoarding disorder. Digital social care records, which have been implemented by 80% of Care Quality Commission providers, are already improving that quality and safety, and that personalisation of care. We are also investing in the development of a national infrastructure for social care, which will lay the foundations for ensuring greater interoperability and integration between care and health services, so that, again, fewer people slip through the net, as is often the case with hoarding disorders.
People who hoard may be isolated, may not recognise their behaviour as a problem and may be reluctant to engage with services. That is why safeguarding plays such an important role. The Care Act 2014 and its statutory guidance make clear that self-neglect, which explicitly includes hoarding, is a safeguarding concern. Where a local authority has cause to suspect that an adult appears to be at risk of self-neglect and is unable to protect themselves as a result, that authority must carry out a safeguarding inquiry. The purpose of that inquiry is to establish what action is required and by whom, and to keep that person safe and ultimately get them the support they need. The guidance also advises that each case of self-neglect should be assessed on an individualised case-by-case basis. Professionals, whether social workers, carers, housing officers, emergency services or clinicians, have a responsibility to spot the signs, raise concerns, and support people and direct them towards help.
One of the most effective treatments of hoarding disorder is cognitive behavioural therapy, otherwise known as CBT. CBT is a form of talking therapy that helps individuals to understand the thoughts and feelings that influence their behaviour and supports them gradually to make practical changes to their living environment. Through NHS talking therapies, people with a hoarding disorder can access evidence-based psychological interventions such as CBT.
This Government are expanding access to talking therapies this year and have committed to continuing this expansion over the coming years. We aim to increase the number of people completing a course of talking therapy by 384,000 by the end of this Parliament and to increase the number of sessions someone can access, meaning that more people will be able to access timely and high-quality mental health support in their local area, and that these services can be accessed not only through their GP, but through self-referral.
We know, however, that accessing these services can be difficult for those who feel isolated or who feel shame about their condition. As advised by national charities, therefore, during National Hoarding Awareness Week, we encourage friends and family members of people suspected of having a hoarding disorder to gently encourage them to speak to their GP, who can help to assess their needs and refer them to the appropriate mental health and community support. No one should face this condition alone.
Of course, hoarding can also be associated with serious mental illnesses, including severe depression and obsessive compulsive disorder, which can require more specialist or intensive forms of support. That is why the Government are transforming services for people living with severe mental illnesses by investing in new models of integrated community care, expanding priceless support and increasing access to physical health checks and tailored interventions.
At its heart, this debate is about dignity and compassion. We are talking about members of our own communities who deserve the same compassion, care and support as anyone else with any other illness. The Vice-Chair of the Health and Social Care Committee, my hon. Friend the Member for Birmingham Erdington, deserves real credit for her work on this issue. We will continue to work with her, mental health professionals, voluntary organisations and people with lived experience to smash the stigma while improving access to care.