Assessment of Critical Health and Safety Risks in Homes where Hoarding is Prevalent.

Hoarding behaviour sometimes requires intervention from community agencies to reduce risks to residents and the nearby community. Human services professionals from a wide range of disciplines are called upon to address hoarding concerns, often in collaboration with each other. No guidelines currently exist to guide staff from those community agencies in a shared understanding of common health and safety risks that occur with severe hoarding behaviour. Using a modified Delphi method, we aimed to generate consensus among a panel of 34 service-provider experts from a range of disciplines on essential risks in the home that would require intervention for health or safety reasons. This process identified 31 environmental risk factors that experts agreed are critical to assess in cases of hoarding. Panelist comments outlined the debates that commonly occur in the field, the complexity of hoarding, and the difficulty with conceptualizing risks in the home. The multi-disciplinary consensus achieved on these risks will facilitate better collaboration between agencies by providing a minimum standard of what to evaluate in hoarded homes to ensure health and safety standards are being met. This can improve communication between agencies, specify the core hazards that should be incorporated into training for professionals who work with hoarding, and facilitate more standardized assessment of health and safety risks in hoarded homes.