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A holistic approach toward dealing with hoarders

Neighbors have filed complaints over the mounds of garbage bags outside this Osgood Street house in Andover.

yoon S. Byun/Globe Staff

Neighbors have filed complaints over the mounds of garbage bags outside this Osgood Street house in Andover.

Ted Teichert would like to drag his old boat to the curb, put a “Free” sign on it, and have someone take it away.

What has stopped him is the certainty that his boat will meet the same fate as his old bed frame and his old sit-down mower — it will end up across the street in his neighbor’s yard, among a number of portable sheds and other items covered with tarps.

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The Andover resident and former selectman believes his neighbor could be a compulsive hoarder, given the years-old and growing piles of items in his front yard, among which are things Teichert himself has put out for trash collection.

“One’s trash is one’s treasure, and I get that, but when it affects the value of your house — I’m not saying you need to have manicured green grass; he’s always had stuff there. But it’s gotten worse,” Teichert said. “For all cities and towns it’s a lot of frustration and you’re limited to what you can do, other than [rely on] health violations, permitting, or building violations.”

Compulsive hoarding is a disorder that causes people to acquire excessive amounts of items, ranging from valuables to garbage and even to animals, and become unable or unwilling to get rid of them without experiencing some sort of distress. Unless a family member or friend alerts health officials, the problem can go undetected for a significant period of time because frequently, the hoard is confined inside a home.

Most times, homes are cluttered to the point that they obstruct living spaces. When the hoard spills outside the home, it can upset the aesthetics of a neighborhood, and attract rodents and other wildlife that can lead to bad odors and other health hazards.

Code enforcement in these cases can be difficult for local health officials, who must respect the privacy rights of the resident, as well as determine whether their behavior poses a threat to their own or the public’s safety and health. To the frustration of neighbors of hoarders, most of the cases don’t meet that threshold, said Andover health director Thomas Carbone. Anti-blight bylaws proposed by residents to address “unsightly” properties failed at Town Meeting in 2008 and 2009.

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“We as health officials avoid aesthetic issues. It’s either a threat to the public or it isn’t,” Carbone said.

“We really try to balance the public’s safety with the individual’s [rights]. The hard part is getting access to the homes. They don’t have to let me in, and usually they don’t. . . . Each case is unique to itself. If you see rodents it would be a plus to the case — how we’d treat it differently and quicker.

“Ideally we don’t wait to see the rodents. Public health is prevention. Just because somebody’s grass is high and they have a lot of clutter, it doesn’t mean they’re harboring rodents.”

There are approximately 12 to 18 cases of suspected hoarding in Andover that officials are aware of, Carbone said. Recently grabbing local headlines is the case of a Manchester, N.H., woman whose stockpile of trash bags outside a home she owns on Osgood Street in Andover has upset some neighbors. The trash bags are said to contain items from an Andover condominium unit, also owned by her, that was condemned last year. After a new set of complaints from neighbors on the street, health officials determined that the state of the woman’s property poses a health hazard and ordered her to clean up her yard, Carbone said. If the cleanup order is ignored, the matter could end up in the state’s housing court, he said.

Ideally, community officials should exhaust all avenues before taking a hoarding case to court, said Laurie Grant, a licensed clinical social worker at the Greater Lynn Senior Services, and the coordinator for the Greater Lynn Hoarding Outreach Partnership Effort, serving Lynn, Lynnfield, Saugus, Swampscott, and Nahant.

“I think cities and towns should see hoarding from the big picture, so to see how they can intervene in moments when they can have an effect on changing the situation or helping to encourage mental health counseling for that individual,” Grant said. “It’s hard for cities and towns because their roles are so defined: The police have a role, the fire department has a role, the board of health has a role. The best we can do is to involve everybody with a little piece of it.”

“Each town deals with it differently,” said Kimberlie Flowers, a senior outreach clinician at Elder Services of the Merrimack Valley Inc. and head of its Merrimack Valley Hoarding Task Force, which helps seniors age 60 and older in 22 communities in that region. “I really focus on harm-reduction with people because you do have to develop that relationship with people that I’m not there to throw their stuff away. . . . I’ve had people that I’ve had to meet with outside of their home before they can say they trust me, that I won’t make a judgment about the way that they’re living.”

Massachusetts has the greatest number of hoarding task forces run by elder service organizations in the United States, including Lynn’s, Merrimack Valley’s, the Cape Ann Hoarding Task Force, and the North Shore Hoarding Task Force, said Christiana Bratiotis, director of the Hoarding Research Project at Boston University, and one of the authors of “The Hoarding Handbook.” For the most part, these task forces operate independent of local governments. But that is not the norm across the country, where the majority of hoarding task forces are made up of a variety of partnerships among private, governmental, and nongovernmental agencies, said Bratiotis, who has analyzed 85 task forces in the United States and Canada.

“The trend in the country and in Canada is community interdisciplinary groups, and they’re not government-run entities,” she said. “Oftentimes we think the government will have the teeth in this. You need the teeth, but we know that the resources the government brings to the table are not all the necessary resources. You need the mental health providers, voluntary organizations, private sector people, like professional organizers.”

With depleted municipal budgets, it is important that communities seek creative solutions when dealing with compulsive hoarders, such as applying for grants, creating a response team, engaging area experts and volunteers, and joining forces with neighboring communities looking to do the same, she said. Among the communities doing this successfully is Arlington, she said.

Last year, Arlington was awarded a $6,900 state Department of Mental Health grant, which it used to start a hoarding first-response team, including hiring a mental health clinician within the Police Department. The team is additionally made up of police officers, fire personnel, and town health officials, said Police Chief Frederick Ryan.

After the task force was announced, the number of active hoarding and/or squalor cases increased from 10 to 25, said Rebecca Wolfe, the hoarding task force clinician. Prior to creation of the task force, 75 percent of hoarding cases in town would end up in the court system and the properties were often declared condemned. Since then, that rate has decreased to 25 percent, or a total of five properties condemned, Wolfe said.

Before there was a response team, Ryan said, “The average police officer would respond to an incident unrelated to hoarding, come across these conditions, and simply leave a note with the Board of Health. Now they reach out to the task force in real time.

“We have access to resources that the average cop or firefighter may not have previously been aware of, and follow-up services provided by a mental health official, if that person can establish a relationship with the hoarder, engage the family of the hoarder to really do an intervention. But a well-planned and executed intervention.

“We are far better off as a community after the implementation of the program, with respect to compulsive hoarders, than we were before the implementation,” he said.

Bratiotis said more communities are starting to move away from an all-punitive approach, instead adopting a stick and carrot approach, where they help the person be compliant, while offering some sort of follow-up.

“This is not the person turning their head and looking away. It’s part of the illness, part of the pathology,” she said. “Taking someone to court is not going to increase that insight. Help the person be successful meeting the demands, and keeping up with the demand.”

Katheleen Conti can be reached at kconti@globe.com. Follow her on Twitter @GlobeKConti.

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