Linda Harper is a woman on the brink of losing her home. But it's not a home in which anybody — including Harper — would choose to live. In fact, storage unit may be the more appropriate term for room 721 at the Columbia Hotel, which she has rented for the past four years.
The problem is that about two years ago, Harper filled up 721. Completely. She brought in furniture. Clothing. Papers. Antiques. Art. Books. Bags. Garbage. Food. She didn't bring in the rats or the spiders or the cockroaches. But when you fill a room with so much of everything else, critters tend to join the party.
It's the spiders she's most concerned about, as Harper guides her wheelchair into an old, rust-stained elevator and punches seven. "The penthouse," she jokes, then quickly adds, "Shithouse, actually."
Harper is a soulful, loquacious 58-year-old with a penchant for accumulating junk, and a past that makes it hard to blame her. Born in Dallas but raised all over America, she apparently had an old lady with a temper. "I grew up black and blue, in closets," she says. After receiving a beating, Harper remembers, she would get locked in the closet for hours. Eventually she started hiding snacks in there to make the next time a little more accommodating. Whenever Harper got a bad enough beating that somebody noticed, her mom would insist on moving away, she says. That meant Harper had to leave behind a whole lot of things she liked.
At 15, Harper ran away from home and took her boyfriend with her. They got married in Idaho, and before she hit 20, they had three children. Those children don't have anything to do with her now, she says.
At the seventh floor, Harper guides her wheelchair down the hall, studying the spotless white walls and the sea-foam-green trimming on the doors. She figures that's new, but the truth is she wouldn't know. She's been staying with a friend on the fourth floor for the past year and a half, and visits her own room only periodically, to deposit more items.
Harper parks at the end of the hall and fishes through two bulging bags slung around the back of the wheelchair. (They were mostly empty when she left the hotel this morning, but now visible at the top are several books, magazines, and free bread from St. Anthony Foundation.) She retrieves the key to 721, elevates herself out of the wheelchair, and slowly walks to the door.
"This is the war zone," she says, then laughs loudly. (When Harper faces a hard truth, she always laughs loudly.) With a twist of the key and a nudge, the door begins to open. Then it stops, blocked by an immense pile of crap that stretches wall to wall.
PG&E shut off the power long ago, rendering it difficult to tell what's going on inside 721. But the musty, hovering stink gives a few hints, and the crack in the door bathes a coffee table in outside light. Its surface is covered with unidentifiable, rotting food and Dr. Pepper bottles of various sizes. Some bottles, Harper admits, are filled with urine.
The Department of Public Health first inspected this room last June, and this is pretty much what it looked like then. The inspector told Harper she would have to clean it up. A month later, he told her again. Then again. Then again. Harper — who says she's been on disability since 1983 for health problems including a herniated disk and epilepsy — clearly needed some help with the cleaning, among other things. But instead of getting the help she needed, she bounced from one social service abbreviation to the next, never receiving the attention her affliction — compulsive hoarding and cluttering — requires.
She isn't the only one in San Francisco. Not even close.
The acquiring of and failure to discard seemingly useless possessions, causing significant clutter, distress, and impairment to basic living activities. That's the definition mental health researchers have basically agreed on for compulsive hoarding and cluttering. They also agree that hoarding behaviors cut across ethnicity, gender, and socioeconomic status, and although the elderly tend to hoard more than the young, they certainly don't have a monopoly. Hoarders can often be identified in suburban areas by the possessions spilling out of their homes, while in cities like San Francisco, they are often concentrated in smaller, concealed dwellings. According to a just-released citywide task force report on hoarding, there are an estimated 12,000 to 25,000 hoarders living in San Francisco.
Unaware they have mental issues or too embarrassed to seek help, many accumulate superfluous possessions until something catastrophic happens and reveals the problem. Too much clutter is a safety and fire hazard. It also tends to get people evicted.
Edward Singer, a San Francisco attorney who represents landlords, has come face to face with the problem, and although he tries to help hoarders and landlords work things out without an eviction, sometimes there's no alternative.
Two years ago, in an upscale Nob Hill building that provides executive housing, an elderly woman named Audrey McCamant destroyed not one, but two apartments. Over the course of four years, according to a lawsuit, she filled the first one with garbage, eventually attracting a rat infestation and failing to report a leak, which flooded her apartment and damaged the unit below. When the building manager moved her to an apartment next door, she trashed that one, too, and refused to answer the door.
As Singer tells it, police broke in and found McCamant naked on the couch, surrounded by piles of garbage and insects. It smelled so bad, they believed she was dead, but as they approached, she sat up and screamed, "What are you doing in my apartment?" The cop got spooked and knocked over a pregnant building manager, Singer recounts — luckily, she wasn't injured. McCamant, who declined to comment for this story, was evicted. The ordeal cost the landlord more than $56,000, Singer says.
Then there were Shoko Spurrier and her son, Charles. They loaded their apartment at 536 Leavenworth to the ceilings with clutter; fumes from rotting garbage eventually set off a smoke detector. Because the Spurriers had a second apartment, Singer opted for a fast eviction. After the Spurriers moved out, a cleaning crew discovered a dead cat behind the door.
These extreme situations certainly don't represent the majority of hoarders, who often quietly accumulate items, slowly rendering their homes unsafe and unlivable. Some are perfectionists and keep their collections in tidy piles, while others — paralyzed by decisions about what to do with their stuff — wind up living in squalor. Some hoarders have difficulty moving around their homes and are forced to create alternative (and perilous) routes. Those can involve tunnels through piled junk, or entrances and exits involving ladders and windows. Almost all have difficulty throwing things away, and they always have their reasons. Maybe somebody would need that yogurt container later. Maybe the junk mail was a really nice color.
Some of the saddest cases involve animal hoarding, or the accumulation of animals for which a hoarder cannot give proper care. Singer saw one of those last year. Her name was Carol Fyfe.
Fyfe, who, according to the phone book still lives at 100 Broderick, first rented apartment 206 in 1975. According to a lawsuit, she eventually brought in so many dogs that she could no longer clean up after them. The smell of feces wafted down the hallway, and late last year her landlord hired Singer, though the eviction was never completed.
After several knocks on Fyfe's door on a recent Thursday, it became clear she wasn't there, but apparently a neighbor — who was laughing manically inside an apartment across the hall — was. Perhaps he knew Fyfe?
Another knock brought Phillip House to his door. The 46-year-old with wild salt-and-pepper curls and a Cheshire cat smile welcomed company into his apartment, which happened to be brimming with videotapes, books, shoes, and clunky wooden shelving units.
Another hoarder. What were the odds?
House turned sideways and crept past an enormous shelf parked in the middle of his narrow entryway, then offered a seat in the kitchen, where a solitary chair was surrounded by stacks of videos, a shoe reigning over each stack. He said he'd never heard of hoarding. "This is very comfortable," he said of his apartment. "It's like a dream to have a place like this."
When asked whether he has a hard time finding things or getting around, House shook his head no, then turned the conversation to What's Up, his self-published book of poetry, short stories, and songs, and his unsuccessful runs for supervisor in 2004 and mayor in 2007. His slogan: "Let Mr. House put your financial house in order by allowing me to be mayor of San Francisco." He handed over a card that declares him president and CEO of World Financial Services, an unlisted real estate, tax, and poetry business.
Fyfe, it turns out, was the only person in the building who would talk to House, and though she never let him inside her apartment, he remembers her having a lot of animals. A whole lot. But something bad had happened to Fyfe, and House didn't want to talk about it. Some digging later revealed that on November 22 — a little more than a week before she would have turned 59 — a depressed Fyfe took her own life.
According to police documents, Fyfe had spoken with a friend on Nov. 20 about her worries, including large medical bills and the threat of eviction, which would mean she'd have to give up her dogs. "Investigation at the scene revealed the subject lying prone on the wooden floor of her unkempt studio apartment, which appeared consistent with her lifestyle," the medical examiner's report stated. "Evidence of a possible self-destructive act was found in the form of a four-page note reminiscing and expressing regret for past events, as well as saying goodbye to the addressee and expressing a lack of desire to live."
The report mentioned nothing about the fate of the hoarded dogs.
The Mental Health Association (MHA), a city agency most active in dealing with hoarders, has been acutely aware of San Francisco's hoarding problem since the mid-'90s, when mentally ill program participants told them about it.
Bill Hirsh, the agency's director at the time, had heard so many stories about people filling their homes with garbage and getting evicted that he decided in 1996 to start the first Hoarding and Cluttering Conference. The inaugural conference lasted just a few hours and attracted 100 people. An article about the conference in the San Francisco Chronicle got picked up by newspapers internationally, and soon Hirsh was getting calls from people affected by hoarding all over the world.
"The more we looked, the more pervasive we found the issue was," he said. "It was frustrating to see how little was being done. There still is markedly little being done."
The conference grew each year as more hoarders came out of the woodwork, and in 2007 current MHA director Belinda Lyons started San Francisco's Institute on Compulsive Hoarding and Cluttering. In addition to the annual conference, the institute funds a peer-run weekly support group, a treatment group, trainings for service providers, and consulting services for local governments and nonprofits. Along with the Department of Aging and Adult Services, the MHA cochaired the citywide task force on hoarding. The task force consisted of 28 city leaders, service providers, lawyers, mental health professionals, and hoarders, who have spent the past 19 months surveying for statistics and costs to figure out how to improve hoarders' lives.
That's more than any other city has done, according to Christiana Bratiotis, a doctoral student in social work at Boston University who is writing a dissertation on hoarding task forces. "San Francisco is really a gold standard," she said, comparing the city to 34 others that have formed hoarding task forces. Unlike in San Francisco, many of the cities have not gathered all the stakeholders, she said, and only San Francisco has attempted to estimate the costs of hoarding.
Although the task force surveyed only a small percentage of the city's landlords and service providers about their costs (including pest infestations, heavy cleanings, involvement of animal control, forgone rent, evictions, injuries, fires, and staff time), those who responded reported total costs of $1,166,105. When the task force extrapolated those numbers to represent the costs citywide, they came up with $6.43 million a year.
The two biggest financial burdens were unquestionably evictions and fires. One hoarding-related fire caused $500,000 in damage, according to the report. The task force found that an eviction typically costs a landlord more than $22,750, and that about 400 to 800 hoarders are evicted every year.
The report also emphasized "the incalculable human costs to the lives of individuals and families," referring to the fact that hoarders often feel ashamed of the way they live, isolate themselves, and have troubled relationships with family members. Plenty wind up on the streets.
Johnson Ojo, the lead inspector at the environmental health section of the Department of Public Health, says about 10 percent of hoarding-related complaints received by the department end in notices to vacate — which essentially means the property is condemned and its occupant must immediately move out.
That is the predicament Linda Harper now faces.
On Wednesday, March 11, Harper scoots into DPH Room 300 with her reading glasses perched on top of her head. Though she looks confident and ready to argue her case, she's up against some pretty damning evidence. It's been seven months since she was first ordered to clean up.
In this final hearing, DPH director Mitchell Katz may issue Harper a notice to vacate — or he may give her one last chance. He will certainly recognize that Harper is responsible for the landfill that room 721 has become, and stayed. But will he understand that she has her reasons?
"I haven't always been this way," Harper says. She has lived in the Columbia Hotel for more than seven years; it's the first place she can remember living in for more than six months without getting "itchy," a phenomenon she attributes to how often she moved as a child. But being in the same place for a long time meant that the things she brought home would accumulate.
Her first room in the hotel on the third floor eventually filled up, and then a pipe broke. To repair it, manager Scott Jordan-Michaels moved Harper to the seventh floor. Although she insists that she kept that room in good condition for a while, it eventually filled up, too. The problem intensified, she says, when the Columbia became a San Francisco Homeless Outreach Team (SF HOT) hotel, meaning the city paid for about 50 homeless people to move in while they searched for permanent homes.
Although nobody can back up her claims, Harper says the "sometime tenants" broke into her room, brought in drugs, and stole from her. Some people who became homeless again, including a man she identified as Worm, would sneak back into the hotel and sleep there, she says. She believes she was drugged and raped one night, and says the trauma exacerbated her agoraphobia. Harper locked herself in 721 for about six months, she remembers, too afraid to venture out.
Around New Year's Eve in 2007, she woke up to find someone standing in her room. She was so rattled that she moved in with a friend on the fourth floor, and hasn't lived in 721 since. Meanwhile, the friend's room has required a heavy cleaning from In-Home Supportive Services (IHSS), a statewide publicly funded program.
Although Harper has a fairly obvious hoarding problem, and a clean-up will be a Band-Aid on a bullet wound, it's the only thing that can prevent her from being booted from the Columbia. For the last seven months, Harper has been eligible for a heavy cleaning from IHSS, but the byzantine system of social service agencies combined with Harper's protectiveness over her belongings has meant it never happened.
Now, she fears, it may be too late. "They're going to put me out," Harper says, and starts to cry. When she notices how many people are walking into the hearing room, she gets the urge to flee. "I can't do it," she says. "I don't want to go through this. I need to leave."
Calming Harper down isn't easy, but eventually she decides to tough it out. She doesn't want to go back on the streets, where she spent a year and a half after she lost Social Security during a bout with breast cancer. The streets are no place for a woman with a herniated lower disk, spinal stenosis, epilepsy, and sarcoidosis, among other ailments.
"411 O'Farrell Street. Room 721," director Katz finally calls out.
Harper takes a deep breath.
If rat infestations and Dr. Pepper bottles filled with urine sound bad, ask any hoarder about the Collyers. Everybody knows this cautionary tale of two brothers whose hoarding actually killed them.
It begins in 1929, with the death of wealthy gynecologist Dr. Herman Collyer, whose sons, Homer and Langley, moved into his New York City brownstone. For two decades, the eccentric, unemployed brothers inexplicably locked themselves away, jobless and obsessively accumulating newspapers, books, furniture, musical instruments, and junk. In 1947, after a neighbor reported a stench, they were found inside, dead and barricaded in by 100 tons of debris. Homer had died of a heart attack. Langley, who had gotten caught in one of his own booby traps, was found weeks later, his corpse partly decomposed and eaten by rats. The sensational tale became a Broadway theater production, The Collyer Brothers at Home, and piqued plenty of public interest.
People are mystified by the lifestyle choices of hoarders, but mental-health researchers are convinced that hoarding isn't a choice at all. They say there is something different in the brains of hoarders.
The earliest studies linked hoarding behaviors — which have also been referred to as disposaphobia — to obsessive-compulsive disorder (OCD). Hoarding is categorized in the Diagnostic and Statistical Manual of Mental Disorders IV, essentially the diagnostic bible of mental health, as a characteristic of OCD, though plenty of researchers dispute that.
"Hoarding is distinct [from OCD] in many ways," says Randy Frost, a renowned hoarding researcher and professor of psychology at Smith College in Massachusetts. Frost and other researchers are investigating the possibility that people hoard not out of anxiety (which underlies OCD), but on impulse. There are also indications that hoarding, which Frost estimates occurs in roughly 2 to 4 percent of the population, may be twice as prevalent as OCD. In addition, hoarding tends to intersect with other mental disorders, including clinical depression, anxiety disorders, attention deficit disorder, and schizophrenia. These links have some researchers calling for a reclassification of hoarding in the next version of the DSM, due in 2012.
UC San Francisco researcher Carol Mathews works with the MHA and was part of the task force. She has found evidence that certain hoarding behaviors can be passed down through families, which could help researchers build a case that hoarding and cluttering deserves a DSM category of its own.
Sue Jean Halvorsen could have told you hoarding was genetic a long time ago. The San Francisco resident comes from a long line of people she has always referred to as pack rats, including her mom, aunts, uncles, grandfather, great-uncle, and great-grandfather. She says that although she grew up comfortable with hoarding and cluttering, for many years she believed she took after the neatnik side of her family.
"Only in my later years did I become overwhelmed with papers and possessions," says Halvorsen, who eventually accumulated more than 3,000 pounds of books. She needs them all, she says, because she wants them available for reading.
It's common for hoarders to believe that almost everything they come across should be saved for some later purpose, and often those with the financial means will wind up renting multiple storage units rather than discarding anything. Delta Burke, an actress on Designing Women and a self-acknowledged hoarder, admitted last year that she once rented 27 storage units.
One San Francisco hoarder and professor of physics has a home full of gadgets, which he says he began accumulating after slipping into a depression. When his landlord discovered the mess, the professor realized he had a problem, rented a couple of storage units, and joined the MHA's support group. It keeps him grounded, and it's very reassuring to talk with others afflicted with hoarding, he says.
Marlo Tellschow, a clutterer who has been working diligently to clean out her home for the past 10 years, moderates that support group. Her Nob Hill apartment once overflowed with newspapers, flyers, and various other leaflets. She used to feel compelled to save even empty junk-mail envelopes. "My brain would say, 'Well, maybe you missed something,'" says Tellschow, who has also been diagnosed with OCD.
She was one of the few hoarders interviewed for this story who had a home she didn't mind showing off (many hoarders say they are too ashamed to host visitors, much less a member of the press). Though most of her apartment was tidy and free of chaos and clutter, the guest room still contained a large plastic tub of newspaper clippings, calendars, and brochures from the '90s.
She'll get to it eventually.
Standing before Katz, the director of the Department of Public Health, in room 300, health and safety code inspector Mario Oblena is flanked by a nervous Harper on one side and property manager Jordan-Michaels on the other. "I just want to get the room clean," Jordan-Michaels tells Katz. "That's the bottom line."
Oblena explains to Katz that Harper failed a series of health and safety inspections, in the process becoming a human pinball and ricocheting from one service to the next, "with fingers pointing everywhere," he says.
Because Harper is disabled and on Social Security, she should have been eligible for an immediate heavy cleaning, but for some reason an Adult Protective Services worker asked her to obtain a primary-care physician first. Harper missed several appointments because she was hospitalized for kidney failure, and then bounced between Community Behavioral Health Services (CBHS) and SOMA MH, a mental health clinic. According to Oblena, both agencies recommended Harper try the Citywide Roving Team, a case management service that works with clients in 32 SRO hotels. The Columbia isn't one of them.
None of that should have happened, says Aregawie Yosef, a section manager at IHSS, the last-resort cleaning service for people who need it most. Yosef, a cochair of the hoarding and cluttering task force, says Harper's situation speaks to a chronic problem in the city — too much disconnected bureaucracy. "That's why people like her fall through the cracks," he said.
As part of its report, the hoarding and cluttering task force has made eight recommendations, including a streamlined response to hoarding issues, so that one phone call from a landlord or property manager can trigger a support system. It also recommended creating an assessment and crisis team, additional support groups, a physical services roadmap, more training, and a $200,000-a-year "hoarding czar" to oversee progress. All of this would cost the city more than $1 million. The point, MHA director Lyons says, "is to intervene before circumstances become dire and more expensive to the individual and the city."
But considering the Institute of Compulsive Hoarding and Cluttering just took a $20,000 budget cut (which was argued down from $75,000), it seems unlikely that those recommendations will come to fruition. In a recession, people like Harper often receive less help than ever. Often in denial that there's even a problem, hoarders are rarely able to help themselves.
But Harper knew what she had to say. "I'm ready to clean up," she insisted. "I got a storage unit. It's gonna take a few weeks." The director asked her how long it had been since she lived in the room, and she admitted it had been almost two years. A pregnant pause suggested skepticism from all sides, but with this being San Francisco, it shouldn't surprise anyone that Harper got one last shot.
Oblena recommended Harper receive one more week; Katz granted her two. Although it was better than she had expected, somehow she didn't look relieved. "There's no way I can do this," she whispered.
A week later, numerous calls to Harper had gone unreturned. But Harper did receive a visit from an Adult Protective Services worker, Jordan-Michaels said, and it looked like the room would soon get the deep cleaning it required. Presuming that Harper agrees to the cleaning, it will have taken eight months, four inspections, two caseworkers, an abatement conference, and a director's hearing to get it done.
Mental health researchers have long recognized that hoarding is one tough problem to treat. It's tougher than schizophrenia. Tougher than OCD. Tougher than depression. Cleanings never stick. Medications haven't worked. The only treatment that has seen limited success is cognitive-behavioral therapy, a time-consuming attempt to change a person's thinking patterns through what essentially amounts to cheerleading and hand-holding, while gently challenging a person's beliefs about his or her stuff. Sometimes that involves taking hoarders on trips in which they are not allowed to take home any items. Some are encouraged to take pictures of things rather than acquiring them.
At least some hoarders, like Gloria Feliciano, have received frequent support visits from various city agencies and nonprofits. That doesn't mean anything will change.
Although nobody could say how Feliciano died, at a recent estate sale in her former home, everybody got to see how the thin Puerto Rican woman, famous among her Glen Park neighbors as a nightgowned wanderer at twilight, lived. It wasn't pretty.
As shoppers entered 142 Hearst Ave., an outwardly dignified town home painted red with cream trimming, eyes popped and hands instinctively covered mouths. Crap was everywhere. Literally.
An unvarying stench of rat excrement and tobacco permeated the living room, which was congested with enough dust-covered furniture to comfortably outfit five rooms of the same size. The tables, couches, and miscellaneous wooden pieces were hopelessly buried under rusting tools, old appliances, cheap porcelain figurines, and Catholic memorabilia.
A small pathway cut through to the dining room and kitchen, where the household items, arbitrarily stacked and scattered, seemed to suggest the big one had already hit and concentrated its power on these quarters alone.
Why Feliciano owned five broken refrigerators was a mystery. Why she used them to store hammers and toilet paper was another. Next door in the bedroom, the wallpaper was peeled and yellowing, and the bed was no longer a bed, but a repository for clothes, purses, and woven blankets. It had taken the appraiser six days to comb through the mess, assign value, and make a reasonable cleaning effort before the sale.
A neighbor, Jim Roe, had no idea how bad the place had gotten. For more than a decade, he had witnessed a steady stream of visits from nonprofit employees and city workers, providing Feliciano with meals, clean-ups, and basic living assistance. No doubt about it, he says: That woman was well taken care of.
