Boxed in

Extreme hoarding is more than just 'too much stuff'. It can be a distressing and dangerous condition that requires careful, targeted help

- Samira Shackle

At a recent "hoarding panel" meeting in east London, Daniel Pearson, commander for Shadwell and Whitechapel fire stations, played attenders a recording of a 999 call in which a panicked resident reported a fire at their home. A team of firefighters was dispatched immediately, but couldn't access the property. Pearson displayed photographs from the scene, taken after the event: the doorways and corridors were blocked by heaps of possessions, now charred and unrecognisable. The person who made the call died. Pearson told me this kind of case is seen regularly. Last year, the London fire brigade attended 1,036 hoarding-related fires, which led to 186 injuries and 10 deaths. It now logs the properties of identified hoarders on a database, so fire stations know to send out extra firefighters if a fire is reported in one of them.

The hoarding panel, which meets monthly, brings together senior firefighters, mental health workers, landlords of social housing properties, and housing and environmental health council officers. At most meetings, they debate interventions for specific cases: should firefighters visit and offer smoke alarms and flame-retardant bedding? Could the person be referred to a specialist support programme? Or should the landlord consider forcible cleaning or eviction? Underlying these questions is a larger one: what can we do about hoarding? The panel's very existence is a sign of a shift in the understanding of hoarding: not as a simple matter of too much stuff, but as a complex condition that requires targeted social policies and careful, long-term management.