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Sandy Lupton, a self-described "compulsive hoarder" in her appartment in Surrey, B.C. on July 12th, 2011.Simon Hayter/The Globe and Mail

Les Sziklai is the first to admit the previous approach lacked finesse.

Dealing with hoarder houses – homes so cluttered with belongings that even moving around becomes a task – the Vancouver deputy fire chief didn't have much of a strategy but to eliminate any safety hazards.

"I remember, as an inspector, I went out to one of these and I was quite taken aback," he said. "I didn't really understand what they were doing. I thought, 'This person is packing a whole bunch of junk,' and I gave them an order. I said, 'You've got too much stuff; clean it up. It's dangerous,' and kind of walked away."

By contrast, the new approach is decidedly more cohesive: Now, when the city receives a complaint of a hoarder house, a small front-line group composed of a fire official, a property use inspector and two health-care workers is assigned.

The change grew from discussions between the city and Vancouver Coastal Health, which, over the past year, have been working toward a memorandum of understanding on more collaborative efforts for issues of common interest.

"It was through our discussions with Vancouver Coastal Health where we learned what the issue was," said Mary Clare Zak, the city's director of social policy. "One of the things that we learned, when we brought together our policing and our fire, in particular, is they do come across situations where people are hoarding and it's a life-safety risk for them as well as their neighbours."

Of 96 cases handled in 2011, the group found situations of hoarding throughout the city, in all housing types. About one-third involved seniors.

The old approach of merely telling compulsive hoarders to knock it off didn't work, of course. Landlords would sometimes use the warning as reason to evict their tenants; the hoarders would often go on to hoard elsewhere.

The city also learned hoarding is usually a mental-health issue, sometimes associated with depression and obsessive compulsive disorder. Previously, a city worker could refer a hoarder to mental-health services, "but there was no way to follow up, to see if anything happened," Ms. Zak said.

In the task force, the mental-health workers will work with the person to address the issue, drawing if need be on other supports such as family members, Ms. Zak said. Fire officials must remove imminent hazards – such as items covering stovetops or heating vents – but have also been instructed to show a level of respect and sensitivity that had been missing in past years, Mr. Sziklai said.

"What I told my staff is that you have to talk to the people – you respect their stuff – but it has to get down to a safe level," he said.

Hoarding is one of several topics that will be discussed on Friday at the Vancouver's inaugural Healthy People, Healthy City summit, highlighting joint initiatives between the city and VCH.

Others include efforts to improve Vancouver's methadone maintenance therapy program, which had garnered attention in recent years due to instances of fraud and abuse, and the city's "neighbourhood food networks."

André Picard, The Globe and Mail's public health reporter, will give a keynote speech.

The event runs from 8:30 a.m. to 12:45 p.m. at Simon Fraser University's Woodward's campus, in the Goldcorp Centre for the Arts. Tickets are $25.

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