Mental Health and Hoarding

Paulette Hamilton Excerpts

Wednesday 22nd October 2025 Commons Chamber

[Paulette Hamilton (Birmingham Erdington) (Lab)]

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.

[Warinder Juss (Wolverhampton West) (Lab)]

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?

[Paulette Hamilton]

My hon. Friend raises a valuable point. I will come on to that later in my speech, but I absolutely agree that hoarding disrupts people’s lives.

[Jim Shannon (Strangford) (DUP)]

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.

[Paulette Hamilton]

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.

[Rachael Maskell (York Central) (Ind)]

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.

[Paulette Hamilton]

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.

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.

[Rachael Maskell]

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?

[Paulette Hamilton]

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.