Understanding the barriers and facilitating factors to mental health help-seeking in adults with hoarding behaviours: a preliminary investigation

Objective. Hoarding behaviour (HB) is associated with significant psychological distress and risk to personal and public safety. Despite the need for support, individuals with HB commonly do not seek or engage with help/treatment. The current study explored the experiences of help-seeking in individuals with HB and aimed to establish barriers and facilitating factors to help-seeking in this population.
Method. Semi structured interviews were conducted with fourteen individuals who self-identified as engaging in significant hoarding behaviours. The data was analysed using a reflexive thematic analysis approach.
Results. The most prominent theme (control) referred to the importance that participants’ placed on being ‘in control’ of the help-seeking process, but this was also a fluid relationship as participants described feeling helpless/out of control and then needing complete control at different points. Preferences towards forms of help-seeking which facilitated high levels of personal control were expressed (i.e. in-house practical item management support, online information and support help-seeking and in-person support groups). Themes of poor literacy around mental health/hoarding disorder and stigma (perceived stigma from help, public and self-stigma around HB) were also identified.
Conclusions. This is the first study to identify how limited help-seeking in hoarding may be partially explained by specific perceptions of formal treatment (i.e. predicting a loss of control, likely stigma) with implications (e.g. pre-treatment education on the collaborative nature of CBT) for clinical pathways.