Gambling in Suburban Australia

Research Report – March 2019

7. Harms to health

This chapter describes the impact gambling had on the overall physical wellbeing and mental health of study participants and their families. Stress, anxiety and fatigue from gambling were reported to contribute to reduced work performance and productivity; at times, this threatened employment, which, in turn, contributed to increased stress and anxiety. There are links between the harms discussed in this chapter and those discussed in the preceding chapter.

Participant codes

Quotes from participants reported in the results section are coded to provide anonymous context with reference to the site (1 and/or 2), study categorisation (person who gambled [G], significant other [SO], local resident [LR], Vietnamese local resident [LRV] or professional [P]) and gender [M] or [F].

7.1 Physical health problems

Participants who gambled commonly reported a variety of physical health problems caused by prolonged EGM use. Complaints included skin disorders (rashes), insomnia, exhaustion, coughs, eye strain, sore back and neck and headaches:

Sometimes I don't eat for eight hours, I don't even go toilet, yep. You can sit - I have sore back in my sitting because I sit like this [it's] very painful and my eyes is strained as well. My neck and my head [are sore after] doing this for hours. (1GF)

I got psoriasis ever since I started to, you know, like gamble … So probably caused the depression and things like that from gambling, so … Psoriasis is a major cause from stress. (1GM)

Fatigue was also a factor causing injuries; one person who gambled reportedly had two major car crashes as a result of driving home tired after gambling:

He crashed, he - there were two cars crashed in, totally damaged ... At the moment he is just going to work, you know, just by the public transport so he don't drive anymore at the moment. So yeah, because his driving licence has been suspended twice [following car accidents]. (2SOF)

Other participants who gambled in both sites reported that high levels of frustration led to destructive and sometimes violent outbursts resulting in injuries:

And you know how many times I have walked out, gone to the side street and I have smashed a brick wall ... And then I missed one day and then I had eight stitches there when I smashed a glass. Gambling is the worst thing in life. (2GM)

No machine pay and then I sweat and then sometime I cry on the machine, 'What you doing?' and sometimes I hit myself on the face. I get the bottle, I smack on my head. (1GM)

Like sometimes I honestly feel like putting a lasso around them and taking it with the car, I'm not going to lie, you know, but I never would but that's how angry they make me. You know, I've been in pubs where I've been kicked out because I've punched screens and stuff like that. Cause it's taken me money. (1GM)

Men in both sites often described alcohol consumption and, in some cases, illicit drugs as contributing to their excessive gambling:

When you drink two or three, then you start, you know, you don't even know what happens at times. You start playing more. (1GM)

You don't think about the consequences when you're drunk and you go there and gamble. You'd just drink more and gamble and gamble more ... Yeah, they go hand in hand. Like gambling goes in hand with drinking. One hundred per cent. (2GM)

7.2 Mental health issues

Almost all people who gambled and significant others in both sites reported decreased mental health as an effect of gambling in their lives. Conditions ranged in severity from those that may have been symptomatic of gambling harms, such as stress, anxiety and depression, to other mental illnesses that were likely to have preceded gambling such as bipolar and obsessive-compulsive disorders. Regardless of the sequence in which mental illness developed, all people who gambled in the study reported instances of stress, guilt and anxiety following gambling sessions where they had lost control and spent more than they intended:

I feel, you know, depression … I hate myself, I say, 'What you doing …?' Oh my God. (1GM)

Stress, can't concentrate on work. Too much of pressure you feel because you're blowing so much of money at the end of the day then you have to repay your credit cards bills, yeah ... It affects my sleep, I feel anxiety, and then you know, I can't concentrate on my work. (1GF)

Professionals also noted that mental illness was a common experience for people who gamble:

I think 60% of problem gamblers … are dealing with depression and anxiety, I think, roughly from my education presentations … Then there's schizophrenia and other more serious, you know, bipolar, borderline personality disorders. (1LR)

One participant reported that her doctor loaned her money to cover mortgage arrears, allowing her to avoid homelessness, and addressing one immediate and major stressor leading to her suicidal ideation:

I gambled $5,000 and I couldn't pay my mortgage and I was lying in bed very depressed for, I think it was 29 days. And then I decided to call the CATT [crisis assessment and treatment] team and then I got a letter from the bank saying they were going to foreclose my house unless I paid the $5,000. So … they admitted me to [acute psychiatric ward]. And I was prepared to let the house go … I came out and … I went to see my GP and she said, 'Where have you been?' I told her and … she paid my arrears for me. (1GF)

Some participants described how their mental illness related to their gambling. For instance, the following person who gambled was diagnosed with obsessive-compulsive disorder as an adolescent and described how this condition made gambling particularly problematic for him:

So, let's just say I'll have like four coins. I need to bet evenly, so I'll get all four of them, not just one or two ... I have very strange beliefs so I always have to abide by them. But If I see a gold card machine … my brain will tell me, you have a go [and use the machine] or else something bad will happen. (1GM)

A number of significant others reported their partner's stress and exhaustion affected their ability to participate in everyday activities at home:

Even when he was present, he really wasn't present because he'd be exhausted ... To get him to do anything … was like a little chore for him. (2SOF)

Many partners of people who gambled also recounted that they, their children and often the wider family experienced high levels of stress as a result of gambling. This participant described how her husband's gambling problems had affected their family:

He had depression and then he was put on antidepressants for a while ... I sort of hit rock bottom and then couldn't sleep … I had a couple of weeks off work and then sort of slowly got back up on my feet and brushed myself off and - this all took time … I was very scared ... And then he started turning into an angry drunk. Not a violent drunk, just a snappy - and if the kids did one thing wrong, he'd blow up over nothing and it was all that ... It was terrible. My parents were disgusted, his mum was upset. (2SOF)

Overall, significant others reported experiencing gambling harms such as high levels of stress and anxiety as a result of their partner's gambling. This participant described how mutual support was compromised when both partners were suffering from extremely high levels of stress:

I've been exceptionally stressed. We used to take it in turns to be what we called, 'up our tree' and the other one would … coax the other down and at one point we were both up our trees and no one was getting us down. (1SOF)

7.3 Suicidal ideation and suicide

A small number of professionals and people who gambled in both sites reported suicide and suicide attempts related to gambling. A single father who recently served several years of jail time for gambling-related crimes described suicidal ideation in the context of homelessness, family violence and depression:

At the same time [as gambling] I raised six children at one stage and then the other daughter came because her mother turned into a drug addict and I had to raise her up too … But the gambling never leaves you. And it just hurt so much … We had nowhere to live … And every time I had a dollar, it has to go there [gambling] … Probably twice I was going to commit suicide because of - I couldn't stop. (2GM)

One person who gambled at the same time as living with bipolar disorder described her suicide attempt when her house was about to be foreclosed:

There was a time where I was very depressed when I gambled and I wanted to kill myself ... I was on the second rail on the West Gate [bridge] and I turned around and the police were there and they capsicum-sprayed me and put me in the van and took me to hospital and then … I went into the psychiatrist's hospital. (1GF)

Professionals in both sites also reported regularly working with people who gamble where suicide was a concern:

The worst one if you work in a venue, and it doesn't happen very often anymore, but you find someone in the toilets who's attempted suicide. (2P)

However, experiences differed among professionals on the regularity of reported suicide at venues:

It's not less common. It's less heard of. (2P)

7.4 Summary

Participants reported that the threats to health from gambling harm were significant and long lasting, and affected the whole family. Understanding these threats and how they affect people who gamble and their significant others is critically important for community health and wellbeing.

Participants reported a variety of physical health problems such as coughs, stress injuries and exhaustion. Fatigue was reported as an underlying factor contributing to potentially serious and long-term consequences, including traffic injuries and withdrawal from activities that compounded isolation from family and friends. Emotional and mental stress ranged in severity; however, generalised stress and guilt and anxiety were reported by nearly all participants who gambled. Gambling was also identified by participants as a factor involved in other mental illnesses such as bipolar and obsessive-compulsive disorders. In a small number of severe cases, participants reported suicidal ideation and suicide attempts.

People with mental illness may be particularly susceptible to developing gambling-related harms. It may be that people with such health issues use gambling, especially EGMs, as a form of 'self-medication'. However, our findings suggest that gambling will not assist management or recovery from such illnesses and may, in fact, exacerbate poor health and contribute to other gambling-related harms such as financial and relationship harms.

The threats to health reported by participants were not trivial. Understanding these threats and how they affect people who gamble and their significant others is critically important for community health and wellbeing. Browne and colleagues (2016) have produced evidence of the burden of harm attributable to gambling, which should better inform public debate about the appropriate balance between the acceptable level of gambling exposure, associated harms and the protection of vulnerable populations.