Hoarding and self-neglect the focus of new guidance in Orkney

A new guidance document around hoarding and self-neglect is being launched in Orkney on Monday (13 May) - the start of National Hoarding Awareness Week - in a bid to raise awareness of the lesser-known mental health conditions. 

Partnership working between the Council, Scottish Fire and Rescue, Police Scotland and third sector agencies has led to the creation of a new protocol for practitioners and professionals in the county. 

The Council’s Service Manager (Adult and Learning Disability Social Work) and Mental Health Officer, Cathy Martin, led on the piece of work, which has the backing of the Orkney Public Protection Committee. 

She said: “Quite often people think of hoarding and self-neglect as ‘lifestyle choices’ rather than a mental health difficulty – this, I feel, is reflected in the very low number of referrals that our Social Work teams receive. The reality is that these conditions are as a result of mental ill health and/or physical health problems. 

“Through discussions with the partners mentioned, it became clear that a set of protocols and practical guidance would be welcomed to enable a clear pathway to share information and concerns about an individual or family, and the practical tools required to provide support to those people experiencing self-neglect and/or hoarding. 

“The end result of this is the Orkney Practitioner Guidance being launched today (13 May) which is the first day of National Hoarding Awareness Week.” 

Out of all referrals to the Social Work team in Orkney, less than 5% relate to self-neglect and less than 10% hoarding. 

Team Manager, Social Worker and Mental Health Officer, Lynn Nicolson, said: “Our social workers and support workers have worked really hard to ensure we are protecting the most vulnerable adults in Orkney by reaching out to the community and partner agencies to alert us to any concerns or worries they may have about an adult they know or care for. 

“As a result, we have seen the number of adult support and protection referrals increase year on year which indicates both an increased awareness of the need for safeguarding of adults and, an increase in confidence in Social Work to respond appropriately and, proportionately to concerns. 

“With such a small proportion of these referrals relating to hoarding or self-neglect, we are interested to know the reasons behind that – maybe folk don't regard it as a concern that needs to be flagged up or maybe people don't see it as a mental health or physical problem. But if there are people out there suffering, then we want to be able to collectively support them.” 

Adult Services have an established permanent team of social workers and support workers who have been supported to enhance their skills in building trusting relationships with folk through patience and compassion. 

Lynn said: “We need to be interested in people’s life stories, what they have experienced and how this has impacted them. We need to go at their pace to allow them to retain control over their own life. 

“This takes time particularly when this is a longstanding issue for the person, who more often than not will be feeling ashamed, embarrassed, and sometimes worthless. At the same time we need to be acutely mindful of any immediate risk to the person’s health, safety or welfare and of any other risks to the public or wider community.” 

The guidance will set out who is best placed to deal with a referral – there may already be a trusted practitioner in the person’s life who can be supported to achieve the best outcome for the adult. 

Hoarding Awareness Week is in its 10th year and there’s much more understanding around the condition. 

Lynn continued: "We have moved on from the thought that simply clearing out a person’s perceived ‘rubbish,’ will resolve the problem and have become better at recognising that identifying and understanding the root cause has the best outcome.  

“There is no simple quick fix here - people are complex, trauma is complex, its impact is complex, and recovery therefore is a long and sometimes repetitive process.” 

The aim of the guidance, protocol and toolkit is to support practitioners and professionals to identify when there may be a need to contact the Social Work team for a chat about anyone they may be worried about – from home carers to GPs and, tradespeople to Elected Members - effectively anyone who may be seeing someone in their own home and has a concern for the welfare or living conditions. 

The guidance will be distributed throughout the Council, NHS Orkney, support services and third sector agencies. 

If you are concerned about someone you can call the Council on 01856 873535, Monday – Friday 9-5 or, by email at asw@orkney.gov.uk . If you feel that someone may be at immediate risk of harm either an adult or a child, and the Council is closed, please contact the Balfour on 888000 and ask for the duty social worker.