This story was first published in the Globe and Mail in October 2010.

His house was so full of junk that he slept in the bathtub.

Such was the finding of firefighters called this month to the three-storey walk-up of a Toronto man who had amassed so many possessions that he could not exit his home in an emergency.

They had walked into the domain of an urban hoarder.

While privacy and funding issues make the prevalence of hoarding difficult to assess, experts believe that the behaviour exists in every Canadian neighbourhood, across every socio-economic stratum.

And despite the efforts of myriad municipal agencies working to contain the threat hoarding poses to public safety, the little-understood behaviour continues to dog an untold number of citizens.

The Office of the Ontario Fire Marshal has examined four hoarding fires since January, including one that forced the removal of 1,200 residents from a midtown high-rise after a huge quantity of legal papers and computer equipment began to smoulder in a unit at 200 Wellesley St. E.

“There is a real balance between an individual’s right to have their home as their castle and the point at which that lifestyle and the accumulation of [stuff]actually poses a threat to others in the community and to the fire service,” spokesman Chris Williams said.

Damage to the 712-unit concrete-slab towers was so severe that renters living on the floors above and below the compromised units will not be able to return to their homes for several more months.

“Boy oh boy, when you see what happens in the context of a high-rise fire, it fundamentally changes your approach to considering an individual’s right to accumulate combustibles,” Mr. Williams said.

Firefighters rushing occupants out of the building last month found 19 units contained too much stuff – including a 15th-floor apartment housing a dozen cats and an eighth-floor unit containing 200 canaries.

“That fire isn’t even the beginning of the story,” Dean said. “This problem has been going on for years.”

As officials scramble to accommodate hundreds of residents who have yet to return to their homes, Mitzie Hunter, the chief administration officer with Toronto Community Housing, acknowledges that her agency is ill equipped to tackle hoarding on its own.

“What is critical is that people are able to access the supports when they need assistance,” Ms. Hunter said.

But treating a hoarder is done neither quickly nor easily and requires ongoing support from a range of agencies – even though the success of treatment is not guaranteed.

Some municipalities that have faced the consequences of hoarding, such as Simcoe County and Ottawa, have aligned mental-health professionals, emergency workers, property managers and cleaning companies in task forces designed to help hoarders. Toronto is not one such municipality.

“These are very complex cases and they require a multipronged approach and co-ordination to provide assistance to people who need that,” Ms. Hunter said.

“That’s the challenge for Toronto Community Housing in terms of our role as a landlord, providing housing for a high proportion of people who are vulnerable and may require greater assistance.

“We need to connect those tenants to the supports available and we need a community that is responsive and is involved in providing that assistance.”

Loitering outside The Montreal on Thanksgiving Monday, residents pointed easily to a dozen balconies rammed with junk – the disparate belongings of other problem tenants about whom they say property managers know but to whom little support is offered.

Even though Mr. Williams’s fire-prevention unit has diligently scoured the building and readied it for occupancy, detritus littered the balconies of multiple units, some draped in tarps or pigeon nets.

The renters said they have little faith that the standard of living in the high-rise will change.

They fear that once officials – and the leadership and foyer plants that arrived with them – leave, the building will return to its previous state of filth and clutter.

Many of them have with dubbed the fluorescent bracelets that grant them re-entry to their apartments “passports to hell.”