CINCINNATI -- Charles O'Bryan hoards tools, electronics and a jumble of other items that end up piled inside and outside his house -- and he doesn't see anything really wrong with that.

O'Bryan, 52, who was placed on probation for hoarding-related health code violations, collects things, often fixing them to give away or sell at flea markets.

"Who's to say when something is too much," he said. "A lot of people collect stuff."

Authorities say huge piles of hoarded items like those at O'Bryan's home create health and fire hazards.

Mental health experts say compulsive hoarding -- where people acquire and fail to discard a large number of items with no apparent use and limited value -- is not new, but only in recent years have communities begun recognizing it as a mental disorder.

A few communities have formed cleanup task forces, but a Cincinnati judge is trying to get to the root of the problem by requiring mental health treatment for severe hoarders as a condition of probation.

"The last thing I want to do in these cases is send someone to jail, but I have found that the threat of jail is what makes them get help," said Hamilton County Municipal Court Judge Russell Mock, who oversees the city's housing cases.

Mock set up a program with Centerpoint Health, a nonprofit behavioral health care agency that provides counseling and treatment.

"These are criminal cases where you often have to lock people up or remove them from the situation because of health or safety issues, and six months later, it's all back again," Mock said.

Hoarding is a big concern for fire officials, Capt. William Long of the Cincinnati Fire Department said.

"We've had people die because buildings have been so packed with things that they couldn't get out, and it puts firefighters and neighbors in danger," Long said.

While mental health experts say compulsive hoarding has been commonly viewed as a subtype of obsessive-compulsive disorder, some researchers are studying it as a possible mental health disorder on its own. And they're trying to determine the cause.

Hoarders typically get attached to useless items and often don't want others entering their homes, said Jeff Szymanski, executive director of the Boston-based Obsessive Compulsive Foundation.

They squirrel away newspapers, books, containers, animals, even garbage.

"Hoarders don't mind clutter and usually aren't happy with treatment because they don't think they have a problem," Szymanski said.

Many hoarders don't come to anyone's attention until someone reports them. They often keep the outside of their homes clean and clear even though the inside may have items piled to the ceiling, with only narrow pathways through the massive clutter.

Researchers have estimated that the disorder might affect 1 or 2 percent of the population, although one study suggests it might be as high as 5 percent, said Randy Frost, a psychology professor at Smith College in Northampton, Mass.

More courts and communities are dealing with the problem.

Fairfax County, Va., formed a hoarding task force several years ago after four homeless people died in a fire in an abandoned house crammed with papers and other items.

Franklin County Environmental Court Judge Harland Hale in Columbus said he looks at each case and sometimes orders counseling as a condition of probation.

Specialists at the Housing Court Department of the Massachusetts Court System are trained to deal with the issue and make hoarders aware of mental health services, said Paul Burke, the agency's director of court operations.

O'Bryan, who has attended some Cincinnati counseling sessions, was recently indicted on one count of aggravated arson and three counts of arson when firefighters had to put out a small fire next to his house. He pleaded not guilty Dec. 19 and was released on $10,000 bond with electronic monitoring. His attorney, Bruce Attenborough, has said that O'Bryan denies any involvement.

Prior to his arrest, O'Bryan said he had no complaints about the counseling.

"I don't mind it, if it can help me organize things," he said.

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