Government-operated gambling has grown over the past two decades,(1) with revenues reaching $6.6 billion in 2014-2015 in Ontario alone.(2) While these revenues support a range of health, education and other social services, it has also come at the price of emerging concerns about gambling-related harms.
While many individuals gamble without causing harm to themselves or others, about 2.5% of individuals exhibit evidence of problem gambling, with similar proportions among youth but a slightly higher proportion among older adults.(3) However, the proportion of those who seek treatment is small, with estimates suggesting that only 10% of problem gamblers seek support. There may be many other individuals who do not seek support who continue to experience social distress, debt or other symptoms associated with problem gambling. Gambling-related harms may result in a number of individual challenges, including: health-related harms (including substance-use problems); emotional or psychological distress; relationship disruption, conflict or breakdown; reduced performance at work; financial harm; and criminal activity. These gambling-related harms may also affect family members, broader communities and the population as a whole, for example by placing strain on relationships or by negatively influencing the financial situations of families.
The changes to both the gambling industry (including online gaming and venue expansion) and to the mental health and addictions sector provide a unique opportunity to consider what changes could be made to reduce gambling-related harms and better support those at risk of problem-gambling behaviours.(4; 5)
What the research tells us
There is a body of research evidence that could inform ways to improve the availability and accessibility of gambling services to reduce gambling-related harms, particularly through approaches that focus on entire communities and population (as opposed to focusing on individuals). This could mean pursuing any of the following:
Using tools to screen individuals for gambling problems
There is a wide variety of reliable tools available to screen individuals for gambling problems. However, there is some uncertainty about whether these can be relied on to identify problem-gambling behaviours in those who gamble online due to a limited number of studies and different characteristics of online gamblers such as poker players.(6; 7)
Using new technologies to deliver programs and services
Using internet and mobile technologies, such as cellphones and tablets, to deliver programs and services to help reduce gambling-related harms have shown promise, and have been found to be both time- and cost-effective.(8; 9)
Restricting access, changing prices and altering gambling environments to support healthy behaviours
Different forms of gambling are more and less responsive to changes to the cost of playing (for example, requiring an entrance fee, increasing the price of a lottery ticket or increasing the price per play). Research evidence shows that when the cost of lottery tickets and horse racing increases, less people participate in these activities. However, this was not found to be the case when the cost of casino-based gambling increased.(10)
Warning messages that pop-up over a player’s screen and require them to close the message can be used to reduce risky gambling behaviour.(11)
In addition, research evidence shows that each of the following approaches supported healthy behaviour changes among individuals who gamble:
- mandatory limit setting on the amount to be spent in one session;
- individual bet limits when set as a low dollar value, such as $1;
- mandatory shut-down at a certain hour or reducing casino operating hours; and
- on-screen clocks that display cash spent rather than credits.(12)
Know the signs
Gambling is not always just a game. The Centre for Addiction and Mental Health has identified key signs of problem gambling,(13) which include :
Behavioural signs: the person stops doing things he or she previously enjoyed; misses family events; changes patterns of sleep; ignores self-care or family tasks; or has conflicts with other people over money.
Emotional signs : the person withdraws from family and friends; seems anxious; or has mood swings and sudden outbursts of anger.
Financial signs : the person often borrows money; cashes in savings accounts, retirement savings, or insurance plans; alternates between being broke and flashing money; or has family members complaining that valuables are disappearing.
Health signs : the person complains of stress-related health problems (for example, headaches, stomach and bowel problems, difficulty sleeping, or overeating or loss of appetite).
If you recognize these signs, seek help. Contact your provincial or territorial helpline for information on available programs and services. The Centre for Addiction and Mental Health has also developed self-help tools which are available online.
The content of this blog post is based on a citizen brief prepared by the McMaster Health Forum on strengthening collaboration to optimize efforts addressing gambling-related harms in Ontario.