Declaring the split-level home on Twinbrook Avenue in Salem unfit for human habitation is nothing new to veteran health inspector Brian Lockard, who has seen residences as bad or worse in both New Hampshire and Massachusetts.

“It’s hard to put a number on it. Over the past year or so I’ve been to several homes similar to this,” said Lockard, who has more than 20 years of experience in public health. “I’m sure like every community out there; there’s others out there. There’s many more out there. This is an issue for every community.”

Over the past few years, Lockard has investigated a number of homes and apartments in Salem found to have been left in squalid or unsanitary conditions. In one case, an individual walked around collecting discarded trash from the barrels neighbors brought out to the curb on garbage day. In another, Lockard found a woman who had been hoarding pets, even keeping the animals in her home after they had died.

Earlier this month, he declared the house at 31 Twinbrook Ave. unfit for human habitation after police discovered unsanitary conditions inside while returning the residents’ missing 2- year-old daughter. Human *** and dirty diapers were found on the carpeting throughout the house along with ants, flies and rotten food.

“It’s tough to rank. I think it was pretty unsanitary. Deplorable conditions, especially considering the five young children who lived there,” Lockard said. “It’s not the worse I’ve seen.”

The residents – Michael and Maureen Bell – turned themselves in to police after authorities charged them with five counts each of endangering the welfare of a child. The couple faces up to a year in jail or $1,200 in fines. Their arraignment is scheduled for Aug. 4.

Lockard became Salem’s health inspector six years ago after spending the previous 15 years handling the same job for the town of Burlington, Mass., where he found his share of squalid or unsanitary residences before crossing the state line.

“I investigated one situation with an elderly man in his 80s who was ill with cancer, who didn’t know it at the time,” Lockard said. “The plumbing wasn’t working, but he was still using the bathroom facilities. Horrendous conditions.”

Many of his cases involved hoarding – where individuals refuse to throw away any of their possessions or who collect clutter in their homes – a condition more common among the elderly.

“What we’re dealing with is a type of mental health issue. The research is a subset of obsessive-compulsive disorder. The tendencies are there,” said Rachel Lakin, program administrator for the New Hampshire Adult Protective Service. “We don’t see the individual until later when they start to experience some kind of difficulty. It happens, and when it’s not treated, it just kind of goes on. When we get to them, its been an issue for a long time.”

According to Lakin, over the past fiscal year, the number of cases involving “self-neglect” have risen by 141. The self-neglect Lakin usually finds can range from hoarding animals to collecting meals-on-wheels containers, creating health and public safety hazards.

“It’s an area that comes to our attention more and more, and our reports are up in the category of self-neglect over last year,” Lakin said. “Normally by the time they get to our attention they’re over the age of 60. We don’t have clearcut research on why that is, but what we think happens is people manage pretty well, and then they get some kind of illness or incapacity and are brought to our attention.”

Lakin’s program takes a multidisciplinary approach while working with those living in self-neglect in cooperation with mental health services. Just cleaning up the conditions doesn’t work, Lakin said, because a week or two later clutter begins cropping up again.

“What we try to do is work together with the mental health agencies and landlords in trying to see exactly what is going on. If the individual is in their own home and not impacting anyone else, we’ll work with them in small ways,” she said. “It takes a lot of people and a lot of resources and a lot of time to help.”

While Lakin deals most often with the elderly – 107 of the new cases over the last fiscal year involved individuals over the age of 60 – young people can also exhibit the OCD-like symptoms associated with hoarding.

Self-neglect commonly involves an individual living alone without much contact with relatives or friends, according to Lockard.

“Many times the person is working or has a job, but the living conditions can be very unsanitary or unhealthy,” he said. “It’s a situation where you try to correct the problems, but also steer the people in the direction where they need some assistance.”

“It’s not something that most people are aware of,” Lakin said. “We are, because we see it quite a bit and we see it throughout the state.”