Using email to coordinate communication in hoarding cases

Hoarding Disorder is characterized by the persistent difficulty in discarding or parting with possessions, leading to an excessive accumulation of items and clutter. In extreme cases, local health departments may need to communicate with federal organizations if the issue is a threat to public health. 

Understanding the diagnosis 

Hoarding itself is characterized by the Mayo Clinic as, “...an ongoing difficulty throwing away or parting with possessions because you believe that you need to save them. You may experience distress at the thought of getting rid of the items.”

Hoarding results in an overwhelming accumulation of items that can clutter living spaces, making them difficult or even impossible to use for their intended purposes. Over time, these items can take over entire rooms, blocking doorways and hallways, and creating a chaotic and hazardous environment.

Hoarding can result in a dangerous environment that may be prone to pests, cause health additional health concerns, and more. 

When does public health become involved?

Public health officials in the U.S. become involved in hoarding cases when the situation poses health and safety risks that extend beyond the individual's home and affect the community. They may respond to complaints from neighbors, family members, or landlords about unsanitary conditions, fire hazards, or infestations of pests such as rodents and insects. 

Federal government organizations, like the Centers for Disease Control and Prevention (CDC), become involved in hoarding cases when there are broader public health implications. For instance, if the situation involves animal hoarding, it could lead to disease outbreaks. Another scenario is when hazardous materials, such as chemicals or biological waste, are involved in hoarding cases, posing a risk of contamination or disease. The CDC can offer guidance on how to handle and safely dispose of these materials to prevent health hazards.

See also: The role of HIPAA in disease reporting

The lines of communication in coordinated care

Initial reporting

• Often, neighbors or family members notice the hoarding and report it to local authorities.
• In rental properties, landlords or property managers may report hoarding due to property damage or tenant complaints.

Local health departments

• Local health officials visit the property to assess the situation and determine the health and safety risks.
• Health officials communicate directly with the individual, explaining the risks and necessary actions to mitigate them.

Fire departments

• Fire officials may inspect the property for fire hazards and provide safety recommendations.
• They communicate with the hoarder and health officials to develop emergency response plans.

Adult protective services (APS)

• APS communicates with health departments, mental health services, and family members to support vulnerable adults.
• If necessary, APS may coordinate legal actions to ensure the safety and well-being of the individual.

Mental health services

• Mental health professionals communicate with the hoarder to offer therapy and counseling.
• They work with local health officials to ensure comprehensive care and support.

Housing authorities

• Housing authorities communicate with health departments and property owners to enforce housing codes.
• They develop and communicate plans to clean and repair the property.

Non-profit organizations

• Non-profits communicate with health departments and mental health services to provide resources such as cleaning crews and organizers.
• They engage with the hoarder to offer support groups and community resources.

Animal control services

• If animals are involved, animal control communicates with health departments to address animal welfare issues.
• They may coordinate the removal and care of animals from the property.

Federal agencies (e.g., CDC)

• In cases with broader public health implications, the CDC provides guidance to local health departments.
• They coordinate with local and state health officials to manage public health crises related to hoarding.

Legal authorities

• In extreme cases, legal authorities may issue court orders to mandate cleanup or mental health treatment.
• Legal authorities communicate with health departments, APS, and family members to enforce legal actions.

How email coordinates communication in extreme hoarding cases 

1. Dedicated email threads for each hoarding case help keep all related communications organized and accessible. Organization is beneficial when managing complex and multifaceted hoarding cases.
2. Implementing conditional tags that automatically categorize incoming emails based on keywords or senders (e.g., "Urgent", "Legal", "Medical Update") assists team members in prioritizing their responses. 
3. Setting up custom automated email alerts that notify team members of critical changes, such as severe health risks identified or immediate interventions required, is crucial. 
4. Using automated emails as reminders for upcoming deadlines, scheduled interventions, and follow-up appointments helps maintain timely responses and accountability. 
5. Automatically generated and distributed email reports that summarize case statuses, resource utilization, and outcome metrics at regular intervals (weekly, monthly) are invaluable for supporting strategic planning and resource allocation. These reports provide a snapshot of ongoing progress and resource needs, allowing for timely adjustments to strategies and interventions.
6. Implementing shared email folders accessible to designated members of different organizations involved in the task force facilitates seamless sharing and retrieval of case-related documents and communications. 

See also: Top 12 HIPAA compliant email services

FAQs

What is the CDC?

The Centers for Disease Control and Prevention is a U.S. federal agency that conducts and supports health promotion, prevention, and preparedness activities in the United States to improve public health.

What is the tie between OCD and extreme hoarding cases?

Obsessive-Compulsive Disorder and extreme hoarding cases are linked because hoarding can be a symptom of OCD, where individuals compulsively hoard items as a way to alleviate anxiety caused by obsessive thoughts.

When should CC be used in reporting an extreme hoarding case?

Carbon copy should be used in reporting an extreme hoarding case when multiple members of a task force or different agencies need to be informed about the report or updates simultaneously to ensure coordinated responses and shared awareness.