We all have that closet or attic that’s packed with old junk we can’t bear to part with. Most of us tend to hang onto possessions a little too long, but few of us would be diagnosed as actual “hoarders.” Hoarding is more than just a tendency to collect junk. It’s a mental health condition and can be a serious risk to health and safety.

Hoarding – actually piling up possessions, food, and garbage — is far more than simple eccentricity. It has now been determined to be a verifiable psychiatric condition, described as “hoarding disorder” in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association.

Approximately 3-5% of Americans would be classified as “hoarders.” These are people who have been conditioned to find pleasure in acquiring possessions, and who suffer great anxiety at the thought of relinquishing possessions. As reported by the National Institute of Health, hoarding is a very difficult mental disorder to effectively treat.

Eliminating the hoarding situation is not as simple as it may appear. Simply cleaning up the mess doesn’t solve the underlying problem. When hoarders do not get proper treatment, some of their hoarded possessions may be discarded, but they will quickly revert to the hoarding behavior that is familiar, and add more junk to the piles. Professional therapists should be called in. Buddy Hays, a homeowner in Atlanta who rented out a three-bedroom house to an acquaintance for 14 years, found when the renter had moved out that she had been hoarding. It took six dumpsters and six days to remove the piles of garbage.

Today, hoarding has become a serious public health hazard. Hoarding can cause house fires, vermin infestations, and spread disease. Sometimes hoarders are trapped in burning houses or affected by diseases related to hoarding and actually die. Let’s look at some of the consequences of severe hoarding.

Disease and vermin

Most hoarders hoard far more than new purchases or even thrift store finds. Piles of garbage or rotting food often attract rodents and insects, and vermin carry disease. Rats and mice will nest in papers or upholstery. Where there are mice, snakes may follow. Even fresh food can attract vermin. Sweeping up spilled food is not merely for cosmetic purposes, it’s necessary for health.

Oftentimes, hoarders cannot keep up with bills, and utilities like water or electricity are turned off. Hoarders end up urinating or defecating and do not clean up the waste, which attracts flies. Flies carry disease. Mold in hoarder houses often goes undetected [or simply is never cleaned] and can cause respiratory illness. Pests and vermin attracted to hoarding situations may also become more prevalent in homes occupied by the neighbors, so hoarding becomes hazardous to the health of more than just the hoarders themselves.

Companies like Address Our Mess specialize in cleaning out homes of hoarders. Their website explains that “…the unsanitary nature of a hoarded home can attract many insects, rodents, and unwanted animals to the property. These critters are harbingers for various diseases and will take the pathogens and allergens anywhere they go.” Additionally, according to the website, “Insects and rodents can also ruin the structural integrity of a home by leaving behind feces and urine. Animals and insects will also eat away at building materials such as wood, drywall, insulation, etc. to build nests or for nourishment.”

Fire hazard

According to some estimates, more than 25% of all home fires may be the result of hoarding. Fires are often the result of candles burning because the homeowner’s electricity has been cut off. The flames feed on the stored garbage and junk.

Firefighters are very familiar with hoarding as a cause of fires. According to Fire Rescue Magazine, once a fire location is determined to be a hoarder house, a second alarm is always called in, and special precautions must be taken. “The stacks of stuff can make a container inside a room, thereby providing the perfect environment for backdraft/flashover. Advancing firefighters MUST continuously evaluate the conditions and maintain situational awareness when opening up the structure and even during the overhaul process.”

Child and animal endangerment

Imagine a child having to climb over piles of garbage to get to its clothing or food. Many times hoarders are turned in by neighbors concerned for the safety of children living in hoarder houses. Often parents are given a deadline and must clean up their homes or face having their children removed by Child Protective Services. Animals, too, are sometimes hoarded. Hoarders may lack the money to buy proper food or get appropriate medical treatment for their dogs or cats.

What can be done about hoarding? Across America, communities are finally waking up to the dangers of hoarding and more than 80 communities have established task forces to deal with hoarding. In each case where hoarding is reported, the investigation always walks a fine line between public health and each hoarder’s basic right to privacy.

Hoarders who live in apartments are easier to handle because landlords usually retain the right to inspect their property. Private homeowners are more difficult because inspections cannot occur without an invitation or a warrant. Treating hoarding can be very difficult. According to the Mayo Clinic, most hoarders respond to cognitive behavioral therapy, although medications for anxiety and depression may also be prescribed. Talk therapy treatment usually focuses on a number of areas, including identifying patterns of thought, resisting the urge for more possessions, becoming more social, and learning to organize and categorize things.