walkitout (walkitout) wrote,

Public Policy by Body Count: Hoarding Edition

Once upon a time, most adults/adult men smoked. And they smoked everywhere: in homes, offices, cars, movie theatres, restaurants, public transportation, while playing with their babies, in bed, etc. It wasn't that long ago. We took steps. "Second hand smoke" turned the tables on smokers' "right" to smoke into a more general right to not-filled-with-cigarette-smoke air. "Voluntary" decisions not to advertise and/or include favorable depictions of smoking on air and in movies helped delay/prevent _in_voluntary restrictions. We put warnings on cigarette packages and in print advertisements for cigarettes. Smoking in restaurants was corralled first into smoking sections, then into bars and finally, increasingly, banned in all public places. Auto insurance cost more for smokers, because fiddling with fire in the car increased the risk of accident. Home insurance cost more for smokers, natch.

But _before_ we did all that, _before_ we had "second hand smoke" as a tool to clarify right to smoke vs. right to not-smoke-filled air, we did a bunch of stuff designed to reduce the fire risk from smokers and their lit cigarettes, matches, lighters, etc. We had laws about kids pjs and laws about what you could make furniture from.

Fast forward to today: we're living in a world with a lot fewer house fires, in part because even people who still smoke often don't do it indoors, because the stigma of having a home filled with smoke has gotten pretty severe. So what's the next big risk factor for dying in a house fire?


Hoarding. And now that DSM-V is out and hoarding is officially an illness, we can make the observation that people die in fires when their hoard makes it difficult or impossible for them to keep the utilities on (lost bills, no money) and resort instead to burning things for light, heat and cooking. Also, kinda hard to extract people from their hoard, even, or especially, when it is on fire. We can take those observations and use them to motivate the creation of a task force to prevent the deaths.

I am overjoyed to live in a world where more serious problems -- like falling asleep in bed with your small child and a still-smoldering cigarette kills you both -- have been addressed sufficiently to move onto less, but still very serious problems, like being unable to keep a clear path to the exit in case of fire.

The next time you see an article saying DSM-V blah blah Allen Frances Does Not Like It Because It Pathologizes Normal/Eccentric/WTF blah blah bleeping blah, remember this:

"A pilot study last year led by Carolyn Rodriguez, an assistant professor of psychiatry at Columbia University, found that of 115 clients who sought help from a New York City nonprofit organization to avoid eviction, 22 percent had clinically diagnosed hoarding disorder."

This is not cute. It is not eccentric. It is not "normal". These are people who need help, but we've been too busy doing other things. Now, we have the time and resources and bandwidth -- and compassion and leadership. About freaking time.

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