Understanding gambling harm and ways to identify those at risk
Cailem Murray Boyle, Anagha Joshi, Rebecca Jenkinson
Australians spend more on gambling per capita each year than any other country, around $1,300 per adult.1 Over a third of Australian adults (35% or 6.5 million people) gambled in a typical month in 2018.2 Gambling can result in the loss of time, money or both. Gambling losses can lead to a range of negative consequences, or gambling harms. These harms can range from financial, relationship or psychological issues to serious legal or health issues.3
Despite Australians’ exposure to gambling products, gambling harms are often under-reported and/or unidentified. Studies have shown many Australians would like support for their gambling problems but may be reluctant to seek help. Fears of stigma or misunderstanding, as well as not knowing where or how to seek help, are among the main barriers identified.4,5
Recent estimates suggest that 7.2% of Australian adults (or 1.3 million people) are at some risk of, or are already experiencing, gambling problems or harm.2 Allied health workers, social workers, and family and relationship counsellors may be the first point of contact for people experiencing gambling harm (see Why is it relevant to me?). Gambling harm can be experienced alongside other complex challenges for individuals and families.
A common barrier for practitioners is knowing what questions to ask to explore potential gambling harm.6 This short article describes the types of gambling harm that people can experience and how they can be identified. Links to tools and resources have been provided to help practitioners identify and support affected individuals and their families.
What is gambling harm?
Gambling harm is any negative consequence experienced by an individual or members of their social network because of participation in gambling. This can be experienced on a spectrum, ranging from minor negative experiences to crises, and is not always proportionate to the amount of gambling participation. 7Gambling harms can include: 8
- relationship harm (e.g. conflict within relationships, neglect of responsibilities)
- health harm (e.g. stress, depression, reduced sleep)
- emotional/psychological harm (e.g. feelings of regret, worthlessness, failure)
- financial harm (e.g. credit card debt, reduced spending on essentials)
- work/study harm (e.g. reduced performance due to tiredness, absenteeism).
Harms relating to relationships, health and emotional/psychological wellbeing are the most-reported gambling harms (Figure 1). Family members, such as partners, children and parents of those who gamble, can also experience gambling harms.9
Figure 1: A breakdown of the types of gambling harms and an estimate of their prevalence in Australia
Source: Browne et al., 2016, p. 134, Figure 19
How to identify if someone is experiencing gambling harm
If harms such as those described above are disclosed in practice, this may be an opportunity for practitioners to determine if they are gambling related. Similarly, if gambling participation is disclosed, practitioners may be able to determine if any harms are occurring – or have occurred as a result. Screening for gambling harm is considered a feasible and acceptable strategy for health and community practitioners.10
Screening questions and scales (sets of questions) can help to identify if someone is currently experiencing, or is at risk of experiencing, gambling harm.11,12 The Victorian Responsible Gambling Foundation recommends the following questions to help practitioners start the conversation on gambling:
- Do you or a family member gamble on the pokies or online, at the casino or the track?
- Is this a problem for you?
- Would you like to go to a specialist service?
To investigate further, the Problem Gambling Severity Index (Box 1) can be used in practice to categorise the level of risky gambling behaviour.
Box 1: Problem Gambling Severity Index
The Problem Gambling Severity Index (PGSI) is an evidence-based scale for measuring the risk of gambling problems and which can be used by practitioners.12
The PGSI includes nine questions that measure different risky gambling behaviours and associated harms during the previous 12 months. Scores are summed and respondents are categorised into one of four categories:
- non-problem gambling (0)
- low-risk gambling (1-2)
- moderate-risk gambling (3-7)
- problem gambling (8+).
The limitation to the PGSI is that it may not identify all gambling harms, particularly among individuals with less risky gambling behaviour.14,15,16 For this reason, although the PGSI is useful, it is important to keep in mind that low levels of gambling can also result in harm, and further support and referrals may be warranted.
What to do if you believe an individual or family is experiencing gambling harm?
There are many free resources available to guide practitioners on supporting individuals and families experiencing gambling harm, and referral services for specialised gambling support.
Most Australian states and territories have their own gambling help resources available online.
|Jurisdiction||Gambling support website||Description of information/services|
|Australian Capital Territory||Gambling Help: ACT Gambling and Racing Commission||Practitioners can refer individuals or family members experiencing gambling harm to the ACT Gambling Support Service. It provides telephone and face-to-face counselling, peer support and outreach programs.|
|New South Wales||Gamble Aware: NSW Office of Responsible Gambling||The health and community workers section of this website provides resources for practitioners to support individuals and families experiencing gambling harm.|
|Northern Territory||Gambling Hotline: Amity Community Services, City of Darwin||This is a 24-hour free helpline for people affected by gambling, which practitioners can refer their clients to.|
|Queensland||Counselling, Support and Advice for Problem Gambling: Queensland Government||This website provides advice and resources for those experiencing gambling harm. Practitioners can refer their clients to the services described on this page.|
|South Australia||Gambling Support: SA Office for Problem Gambling||This website provides advice for those participating in gambling and for family and friends experiencing gambling harm. Practitioners can direct their clients to this page.|
|Tasmania||Getting Help: Tas. Department of Communities||This website provides a list of gambling help services, which practitioners can refer clients to if they suspect gambling harm.|
|Victoria||Health and Community Professionals: Victorian Responsible Gambling Foundation||The ‘Health and Community Professionals’ section of this website provides step-by-step guidance on how practitioners can help detect and support individuals and families experiencing gambling harm.|
|Western Australia||Problem Gambling: WA Department of Local Government, Sport and Cultural Industries||This website provides a list of gambling help services, which practitioners can refer clients to if they suspect gambling harm.|
There are a range of direct services to refer individuals or families experiencing gambling harm.
|Gambling Help Online||This a confidential 24-hour online counselling and support service for anyone in Australia affected by gambling. Each state and territory has a dedicated Gambling Help service.|
|Gambler’s Help||This service provides online, telephone and face-to-face counselling, advice and information for individuals and families in Victoria who may be experiencing gambling related harm.|
|Under 25s Youthline||This is a confidential 24-hour telephone service for young people under 25 who are concerned about their own or someone else’s gambling. Young people can call 1800 262 376 for advice and support.|
|Gambling Help Services||This resource by Relationships Australia, South Australia, provides practical advice for making a Gambling Safety Plan.|
|Uniting Gambling and Financial Help||Uniting provides counselling services for those experiencing gambling-related harm.|
|Self-help addiction resource centre (SHARC)||The Family Drug and Gambling help service at SHARC provides counselling services, support groups, educational programs and a 24-hour helpline for families experiencing gambling-related harm.|
Gambling harm can be experienced by people who gamble, as well as their families and social networks. Harms may present as relationship difficulties, financial problems or changes to mental or physical health. However, it is often unclear whether gambling is causing harm to an individual or family member. Asking questions to determine whether any harm from gambling can be identified is important, so that appropriate intervention, referrals and support can be provided.
Further reading and related resources
- Guide to Supporting Culturally and Linguistically Diverse Communities
This resource from the NSW Office of Responsible Gambling provides a step-by-step guide for supporting clients from culturally or linguistically diverse backgrounds.
- Victorian Responsible Gambling Foundation
The ‘For Professionals’ tab provides practical advice to practitioners on how to support individuals and families experiencing gambling harm, including signs to look for and links to specialist support services. Other links on the Foundation’s website include tips on ‘Identifying a Problem’, as well as a free online version of the ‘Problem Gambling Severity Index (PGSI).
- Families and gambling
This webinar by CFCA and Emerging Minds explores how practitioners can support parents experiencing gambling harm.
- Types of harm from gambling
This resource, produced by the Victorian Responsible Gambling Foundation, explores the findings of a study to identify the types of harm from gambling.
- Gambling in Australia during COVID-19
This research report by the Australian Gambling Research Centre examines what impact the COVID-19 pandemic and related government restrictions had on people's gambling participation, alcohol consumption and health and wellbeing.
- Child maltreatment and problem gambling
This CFCA short article explores the link between experiences of child abuse and development of gambling behaviours later in life.
- Addressing gambling in Indigenous communities: Embracing community, diversity and wellbeing
This CFCA webinar explores the effects of gambling in Indigenous communities and discusses a health promotion framework to inform policy and practice.
1 Queensland Government Statistician's Office (QGSO). (2021). Queensland Treasury, Australian Gambling Statistics, 36th edition, 1993–94 to 2018–19. Brisbane: QGSO.
2 Australian Gambling Research Centre. (2021). Gambling in Australia Snapshot. Prepared for: Australian Institute of Health and Welfare. Canberra: AIHW.
3 Browne, M., Langham, E., Rawat, V., Greer, N., Li, E., Rose, J. et al. (2016). Assessing gambling-related harm in Victoria: A public health perspective. Melbourne: Victorian Responsible Gambling Foundation (Online).
4 Australian Gambling Research Centre (unpublished). National Gambling Reporting System (NGRS) report. Prepared for: Department of Social Services, Canberra.
5 Victorian Responsible Gambling Foundation. (2014). Seeking help for gambling problems. Discussion paper. Melbourne: Victorian Responsible Gambling Foundation.
6 Rodda, S. N., Manning, V., Dowling, N. A., Lee, S. J., & Lubman, D. I. (2018). Barriers and Facilitators of Responding to Problem Gambling: Perspectives from Australian Mental Health Services. Journal of Gambling Studies, 34(1), 307–320. doi:10.1007/s10899-017-9713-3
7 Langham, E., Thorne, H., Browne, M., Donaldson, P., Rose, J., & Rockloff, M. (2015). Understanding gambling related harm: A proposed definition, conceptual framework, and taxonomy of harms. BMC Public Health, 16(1). doi:10.1186/s12889-016-2747-0
8 Victorian Responsible Gambling Foundation. (2016). Assessing gambling-related harm in Victoria: The seven dimensions of gambling harm. Melbourne: Victorian Responsible Gambling Foundation.
9 Riley, B. J., Harvey, P., Crisp, B. R., Battersby, M., & Lawn, S. (2018). Gambling-related harm as reported by concerned significant others: A systematic review and meta-synthesis of empirical studies. Journal of Family Studies, 27(1):112–130 doi:10.1080/13229400.2018.1513856
10 Blank, L., Baxter, S., Woods, H. B., & Goyder, E. (2021). Should screening for risk of gambling-related harm be undertaken in health, care and support settings? A systematic review of the international evidence. Addiction Science and Clinical Practice, 16(1), 35–35. doi:10.1186/s13722-021-00243-9
11 Manthorpe, J., Norrie, C., & Bramley, S. (2018). Gambling-related harms and social work practice: Findings from a scoping review. Practice, 30(3), 187–202.
12 Suurvali, H., Hodgins, D. C., & Cunningham, J. A. (2010). Motivators for resolving or seeking help for gambling problems: A review of the empirical literature. Journal of Gambling Studies, 26(1), 1–33. doi:10.1007/s10899-009-9151-y
13 Ferris, J. A., & Wynne, H. J. (2001). The Canadian problem gambling index. Ottawa, ON: Canadian Centre on Substance Abuse.
14 Browne, M., & Rockloff, M. J. (2018). Prevalence of gambling-related harm provides evidence for the prevention paradox. Journal of Behavioral Addictions, 7(2), 410–422.
15 McMahon, N., Thomson, K., Kaner, E., & Bambra, C. (2019). Effects of prevention and harm reduction interventions on gambling behaviours and gambling related harm: An umbrella review. Addictive Behaviors, 90, 380–388. doi:10.1016/j.addbeh.2018.11.048
16 Rawat, V., Browne, M., Bellringer, M., Greer, N., Kolandai-Matchett, K., Rockloff, M. et al. (2018). A tale of two countries: Comparing disability weights for gambling problems in New Zealand and Australia. Quality of Life Research, 27(9), 2361-2371. doi:10.1007/s11136-018-1882-8