A recent wave of research and personal testimony is reframing hoarding not as mere clutter or eccentric collecting but as a complex mental-health condition often rooted in trauma, with serious safety and social consequences — and new treatments, including virtual reality, are showing promise. Reporting this week that brings together first-person accounts and clinical trials highlights how hoarding disorder (HD) was added to global diagnostic manuals only in the past decade, affects millions, commonly co-occurs with other health problems, and requires a compassionate, long-term approach that balances safety, legal rights and therapeutic care [CNN; WHO; US Senate report]. For Thai readers, the findings point to gaps in recognition and services here at home — but also to practical steps families and local services can take, from harm-reduction to peer-led programs and mental-health referral pathways [CNN; Department of Mental Health, Thailand].
Hoarding disorder is more than mess. People who develop the condition form strong emotional attachments to possessions, experience overwhelming distress at the prospect of discarding items, and may accumulate such volumes of belongings that rooms, kitchens and bathrooms become unusable or dangerous. The World Health Organization’s ICD-11 and the American Psychiatric Association’s DSM-5 formally recognize HD as a mental-health diagnosis in recent years, emphasizing that the behaviour causes clinically significant impairment or distress [WHO]. Personal accounts collected by journalists and researchers show that many people only seek help when their homes become unsafe or when eviction or social services intervention looms [CNN; US Senate report].
Why this matters in practical terms goes beyond household disorder. A 2024 report from the US Senate Special Committee on Aging described the scale and downstream consequences of hoarding — suggesting roughly tens of millions in the US are affected and pointing to higher prevalence among older adults, frequent co-occurring psychiatric and physical conditions, and risks including fire, falls, eviction and social isolation [US Senate report]. Although most detailed epidemiology comes from high-income countries, clinicians warn that the condition exists worldwide and is under-recognized in many low- and middle-income settings because of limited screening and stigma [PMC review on diagnostic status of hoarding; research on Buried in Treasures interventions].
The lived experience illuminates the “why” behind the behaviour. Researchers and people with lived experience describe hoarding as a coping strategy that often begins after one or more traumatic events — childhood neglect or abuse, relationship breakdowns, the death or illness of close relatives — and temporarily eases distress by providing a sense of safety, identity or future utility. “We call it the stuff under the stuff,” a participant in a recent feature told CNN, describing how traumatic life events accumulated until collecting became the primary way of dealing with pain and loss [CNN]. Academic researchers likewise emphasize trauma, chaotic early environments and comorbid psychiatric conditions — such as depression, anxiety, obsessive–compulsive symptoms and attention‑deficit traits — as common contributors [Northumbria University hoarding research; US Senate report].
What treatment looks like is changing. Traditional approaches include cognitive-behavioural therapy (CBT) adapted for hoarding, motivational interviewing, skills training around decision-making and discarding, and practical in‑home support for decluttering. Group-based, peer-facilitated programs such as the “Buried in Treasures” (BIT) workshop — developed by clinicians and researchers and run in many countries — combine skills teaching with social support and have demonstrated meaningful reductions in symptoms for many participants [Buried in Treasures research; randomized trials]. Newer interventions being tested include virtual reality (VR) augmentation and non-invasive brain stimulation. A small Stanford pilot augmented a 16-week BIT group program with eight weeks of VR practice in which participants used 360-degree recreations of their most cluttered rooms to rehearse discarding items in a psychologically safe environment; the research team reported VR’s potential to let people practice difficult discarding tasks when actual in-home work was unsafe or unfeasible [Stanford Medicine report; PubMed VR trial]. These approaches are early-stage but promising, especially for people who are too ashamed or physically blocked from letting therapists enter their homes.
Policy and community responses matter. Local authorities and landlords often resort to forced clearances or court orders when homes are judged unsafe; those actions can be legally permissible but may worsen trauma, secrecy and relapse if done without parallel therapeutic supports [CNN; UK intervention work in Birmingham]. The US Senate report called for a coordinated national response — increased therapist training, better first-responder awareness, and integration of hoarding care into aging and community services [US Senate report]. Models like the “Chaos to Order” intervention run in partnership with local councils in the UK show how combining housing, social work and therapeutic inputs can stabilise tenancies and improve outcomes; advocates say such models could be adapted and scaled in other cities [CNN; summary of UK project].
Expert voices underscore a humane framing. Clinicians and peer specialists interviewed in recent coverage emphasize avoiding stigmatizing labels and recognising that most people who hoard intend to be responsible and kind — many keep items because they hope they will be useful, gifted onward, or because those items anchor memory and identity. Peer-led programs, where participants learn alongside others with lived experience, create the social reinforcement and practical tips that are often missing from purely clinical interventions [CNN; Buried in Treasures literature]. As one peer facilitator put it, reframing “collector” language and building trust is often essential before any sorting or discarding can be attempted [CNN].
What this means for Thailand. There is limited published Thailand-specific prevalence data for hoarding disorder, a gap common across many lower‑resource settings; most national mental-health focus has rightly prioritised suicide prevention, depression and anxiety services [WHO Thailand profile; Department of Mental Health, Thailand]. But the condition’s public‑health implications are universal: the risk of falls and fire, loss of housing, caregiver burnout and the compounding of physical illnesses when kitchens or bathrooms are inaccessible are as relevant in Bangkok or Chiang Mai as they are in New York. Thai cultural patterns — a historic emphasis on thrift, reuse and avoiding waste, along with close extended-family networks and religious norms around giving and possession — can make hoarding harder to recognise. Behaviours that look like sensible saving or thrift may mask a disorder when they cause distress or functional impairment; likewise, family shame and face-saving can delay help-seeking [general cultural observation; local mental-health system context, WHO Thailand].
Practical steps for Thai families and services. For Thai readers worried about a loved one, public-health agencies and clinicians recommend a tiered response: reduce immediate risks, engage non-judgmentally, and link to specialised care when possible. If safety is a concern (smoke hazards, blocked exits, risk of falls), prioritize emergency interventions with local authorities but insist on parallel therapeutic and social-support plans that preserve the person’s dignity and tenancy where feasible [US Senate report; UK intervention model]. For psychological help, Thailand’s Department of Mental Health operates a 24/7 mental health hotline (1323) and national services can provide referrals to psychologists and psychiatrists; Samaritans of Thailand and other hotlines may also help with crisis counselling [Department of Mental Health, Thailand; Bangkok community resources]. Peer support and community groups — even Facebook communities and online BIT-style workshops — have been lifesaving for many who feel isolated; they can be an accessible first step while waiting for clinical services [CNN; Buried in Treasures program].
For front-line professionals and policymakers in Thailand, the evidence suggests several priorities: improve training for primary-care clinicians and social workers to recognise HD and its safety risks; develop pilot multidisciplinary interventions that combine housing, harm-reduction clean-ups and psychotherapy; create capacity for group-based peer programs modelled on Buried in Treasures; and consider ethical safeguards around forced clearances to avoid retraumatizing people who hoard [US Senate report; BIT research; UK models]. Technology such as VR offers promise for remote augmentation of therapy, which could be particularly useful in a country with urban–rural gaps in specialist services; collaborating with university research centres could help adapt and test such tools locally [Stanford VR pilot].
What the new research leaves open. Larger, rigorous trials are still needed to determine who benefits most from which treatment sequences (individual CBT, BIT groups, VR augmentation, brain stimulation), which components prevent relapse, and how best to integrate financial counselling, housing supports and family interventions. Epidemiological work in countries beyond North America and Europe would clarify prevalence and cultural expression of hoarding in Southeast Asia, including Thailand [PMC review; Buried in Treasures research]. There are also ethical questions about digital interventions: how to ensure privacy when patients upload photos of their homes and possessions, and how to adapt VR content to different cultural contexts.
How families can act today. If you suspect a friend or relative is struggling with hoarding, experts recommend these immediate, practical steps: prioritise safety (clear a fire exit, install a smoke detector, ensure basic hygiene and food access); open non-judgmental conversations that focus on concern and support rather than blame; offer concrete help such as accompanying them to a clinic appointment or a support group meeting; encourage small, manageable practice tasks (for example, sorting one box with them, using acceptance-based language and praise); and seek professional advice from a psychologist or social worker experienced with hoarding when possible [Buried in Treasures practice principles; CBT guidance]. For landlords and housing managers, pursuing solutions that combine safety remediation with referral to mental-health services — rather than unilateral eviction — tends to result in better long-term outcomes for tenants and the community [UK intervention insights; US Senate recommendations].
In short, the emerging coverage and clinical work underline that hoarding disorder is not a moral failing but an often-traumatic coping strategy with measurable harms and treatable components. Thailand’s health services and community organisations can draw on growing international evidence — peer-led group programs, CBT adaptations, harm-reduction models and technology-enhanced therapies — while adapting them to local cultural realities and resource constraints. Families confronted with a loved one’s hoarding should prioritise safety, reach out to mental-health hotlines and peer supports, and push for coordinated interventions that respect dignity and tenancy while addressing underlying trauma.
Sources used in this report include recent feature reporting and first-person interviews [CNN], WHO clinical descriptions for ICD-11 [WHO], US Senate Special Committee on Aging reporting on hoarding [US Senate report], peer‑reviewed and open‑access research on group treatments and augmentation strategies including Buried in Treasures [PMC: BIT studies], Stanford Medicine reporting and a pilot VR trial testing virtual reality to augment group treatment [Stanford Medicine; PubMed], and Thai public‑health resources including the Department of Mental Health hotline and WHO country material on Thailand’s mental‑health system [Department of Mental Health, Thailand; WHO Thailand]. Links: CNN coverage (https://www.cnn.com/2025/08/09/health/hoarding-disorder-wellness), WHO ICD-11 descriptions (https://iris.who.int/bitstream/handle/10665/375767/9789240077263-eng.pdf), US Senate report (https://www.aging.senate.gov/imo/media/doc/the_consequences_of_clutter.pdf), Buried in Treasures and group treatment literature (https://pmc.ncbi.nlm.nih.gov/articles/PMC7437985/), Stanford VR trial summary (https://med.stanford.edu/news/all-news/2023/10/vr-hoarding-disorder.html) and PubMed record for the VR augmentation study (https://pubmed.ncbi.nlm.nih.gov/37716272/), Thailand Department of Mental Health contacts (https://dmh.go.th/contact/), WHO Thailand profile (https://iris.who.int/bitstream/handle/10665/364903/9789290210238-eng.pdf?sequence=1).