The Harms that People Suffer
There is no one profile of a ‘typical’ person who suffers gambling harms. Not everybody reaches ‘rock bottom’ for instance, and problems that arise for some gamblers may be relatively easy to address. The right support, especially from family, friends and employers is invaluable.
Nevertheless, for the many who fall deeper into gambling addiction, the harms can be immense and difficult to unravel.
Martin in his brave interview highlights such harms. There can be little doubt after watching it that gambling addiction is itself a serious mental and emotional agony. His inner experiences which he shares for us are unquestionably signs of a severe illness.
Below, we outline the surrounding complexities which surround the illness.
For the gambler:
- shame and guilt
- suicidal thoughts
- compleing suicide
- intense mental and emotional pain
- severe depression and anxiety
For Family and Loved Ones:
- depression and anxiety
- family breakdown
- physical and emotional abuse
- harm to children’s wellbeing
- health services
- social care services
Gambling with Lives was set up by bereaved parents whose children completed suicide because of gambling. The organisation states;
Gambling with Lives was set up by the families and friends of young people who have taken their own lives as a direct result of gambling. These were all very normal, bright, popular and happy young folk who had great futures ahead of them … gambling was their only problem. We’re starting to get evidence from neuroscience that gambling on electronic machines affects mental health and even creates suicidal thoughts. Our children had all struggled with their gambling addiction for years, often being clear for many months at a time … but always dragged back in by an industry offering “free bets” and other give-aways. They all felt that they could never break free.
Their site contains excelllently researched papers. It is possible that as many as 600 people a year complete suicide each year because of gambling, many more attempt to, and most consider doing so. This briefing paper focuses on the research.
There are many good reasons to attend to the voices of ‘experts by experience’ in improving mental health care. Often we are entranced, ‘in the zone’ of, familiar and safe with, figures, numbers, data, models, impressive power point presentations. These things are important. Yet as GP Roger Jones reminds us (British Journal of General Practice)
One of the targets of Charles Dickens’ Hard Times is the 19th century equivalent of the bloodless, box-ticking bureaucracy that many people feel is now strangling the NHS. Mr Gradgrind demands facts, facts unadorned by sensitivities, emotions, or other human foibles. And facts we have — league tables, performance indicators, Care Quality Commission inspection scores, 2-week waiting time performance — facts coming out of our ears. Measuring the cost of everything and the value of practically nothing.
There is a need to employ quantitive thinking where, as so frequently, it’s appropriate. But quality, value can get lost. Addiction, the extreme negativity of gambling harms, is a pervasive mental illness than can be considered beyong the context of gambling. It’s a conceptual quagmire. The person with an addiction cannot articulate what’s going on, how or why they feel forced to do things they know are bad for them and others. So much harder then for others to understand. Perhaps the best we can do is acknowledge without a shred of doubt that we are dealing with a genuine illness, baffling as it is. As a society we are uneasy talking or thinking about this pervasive illness that may affect directly perhaps ten per cent of the population plus the knock-on distress of between 60 and 100 per cent of affected others. Perhaps society is not only stigmatising addiction but actively repressing it as at some level it represents a symptom of a deep distress spread throughout the population.
Therefore it is vital to hear cleary the voices of those most obviously affected for they have the qualititative insights into the illness. This is, of course, true of all health conditions. Listening to individuals talk about depression, for instance, convinces us tha there is no neat ‘box’ that defines it: it is different for everybody, varies widely in its manifestations, the severity of its impact, its centrl role at the heart of a person’s self-identity. Voices suggest too ways of recovery, journeys from darkness to light. So too with gambling related mental health issues. Apart from the extreme of addiction, these will often be seen as depression and anxiety, suicidal ideation, deteriorating physical health. These need addressing as they would be for anybody. Harmful gambling behaviour too is often preceded by mental and emotional distress such as depression and anxiety. Certain conditions such as ‘bipolar disorder’ make people far more likely to practise risky behaviours.
Add to this the negative factors of high debt, family breakdown, possibly crime, unemployment and the complexity of supporting and treating the more severe cases of individual mental and emotional distress becomes evident. Further, there are social and economic factors which no doctor, therapist or ‘method’ can ‘cure’. An NHS Scotland report (health-inequalities-what-are-they-how-do-we-reduce-them-mar16) states:
Health inequalities are the unfair and avoidable differences in people’s health across social groups and between different population groups.They represent thousands of unnecessary premature deaths every year in Scotland, and for men in the most deprived areas nearly 24 fewer years spent in ‘good health’
Life expectancy between the most deprived and wealthiest communities in Glasgow varies by more than twenty years. (It is in those deprived areas – or ‘data zones’ as the new terminology has it – that there is a clustering of gambling outlets (and retailers of fast food and alcohol). Hence, whatever treatment and support is given to people with mental and emotional distress in deprived areas, for many individuals it will remain insufficient. Addressing inequality, poverty and injustice requires a public health approach backed by political will. Nevertheless, many people overcome great obstacles to achieve wellbeing; many initiatives really do help people away from health problems; the value of peer support can never be underestimated: those who have been through and survived a problem are in the best position to help others. We need to avoid stigmatising a whole community as ‘deprived’. Only those familar, by residence or work, with the communities most battered by inequality and injustice can appreciate the enormous reservoir of mutual care and support and strong commitment to life-enhancing actions. In these communities there is no deprevitation of the best of humanity despite there being higher levels of ill health than in the leafy suburbs.
The ‘ripple effect’ imagines the waves that spread outwards from an initial disturbance. A stone dropped into water will produce regular waves. Real life is messier. Waves affect other waves, get tangled in unpredictable ways. No wonder that feeling bewildered, lost and confused are among the feeling dimensions of all who are negativey affected by gambling.
In mental health generally there continues to be a need for support available to carers and those affected by someone’s illness. There has been great progress in this but more needs to be done.
With gambling harms, it is estimated that between six and ten people close to a person in deep trouble with gambling will be seriously impacted. Taking current statistics, that means up to five million people are suffering directly from gambling damage, a figure which includes children.
The Beacon Counselling Trust which operates in the North West of England recognises the urgent need to bring support to those affected by somebody’s gambling.
The financial hardship families will suffer as a result of harmful gambling is a common theme within this arena, but little attention has been given to the much greater, wider, and often catastrophic impact these harms often have on the day-to-day function of family life. Even less attention is given to the regular, immediate, and necessary support these “Affected others “may need.
The voice of many ‘affected others’ demonstrates a clear evidenced requirement to increase support in areas such as: education and awareness raising, bereavement, debt and financial management, legal advice, and family practical support, in a co-ordinated and structured way, which needs be initiated without delay, with its primary aim to minimise the collateral damage from GRH and to protect in some cases, what remains of the family unit.
The many voices of Lived Experience feel that recognition of the need to provide support to ‘affected others’ should be equal to those who are recognised as harmful gamblers, and in this regard their voices should be heard.
Gambling’s Contribution to Society
It’s frequently pointed out by the gambling industry that it satisfies customer demand for a fun and harmless leisure activity. It acknowledges that there is work to be done to reduce harms to people who run into difficulty with gambling, and points out its record of funding education and treatment.
It also says rightly that it provides employment to tousands of people, and makes significant tax payments in the billions of pounds.
For some, gambling business is an example of others like the fast food industry. While some people may gamble irresponsibly or feed their children junk food, this should not be a concern of the state. What is generally meant by a ‘libertarian’ position includes emphasis upon personal autonomy and responsibility for choices. It is argued that it is unfair to the vast majority who enjoy products without detrimental effects should be penalised by heavy-handed laws and regulations that restrict personal choice.
Such points have merits when taken separately, and can be discussed one by one. Taken together they tend to establish a ‘dominant narrative’ whereby relatively very few people suffer from gambling. Phrases used beyond industry such as ‘pathological gambler’ also reinforce the narrative of individuals suffering from a rare illness or disease. This emphasis upon a small group of ‘pathological’ individuals serves to shift attention from industry’s practices and social responsibility with the latter addressed by the small amount of profits voluntarily donated towards research, education and treatment.
Some issues here, of course, are not restricted to gambling. The balance between public health ephasis, business and personal freedoms and responsibilities, is evident in many other cases. A current debate for instance is about the legalisation and regulation of (some or all) recreational drugs. Tobacco was involved in decades-long arguments, claims and counter-claims before the ‘balance’ swung towards severe restrictions such as the banning of advertising, public health campaigns and universally available free NHS treatment for cessation, hiding of products from view, draconian annual increases in duty.
Any attempt to examine the costs and benefits of gambling need to avoid ideology (such as a central belief in personl freedom and responsibility) and then to engage in democratic arguments with all stakeholders.
Anticipating reforms arising from the current Gambling Act Review,The Social Market Foundation concludes in a March 2021 report, Double or nothing? acknowledging a total contribution of £8 billion from gambling, ‘it seems very unlikely that this economic contribution is truly additional to what would have taken place if gambling did not exist. Indeed, with most other parts of the economy having more extensive supply chains, and thus higher economic multipliers, reductions in gambling expenditure would almost certainly be a net economic benefit as households instead spendmoney elsewhere.’ The report states stridently, ‘Far from being acase for timidity, the economics of gambling – presented in this report – are in fact a case for bold, robust and significant regulatory reform. Done right, there is scope to both reduce the societal costs of problem gambling, and realise economic gains.’ This represents one line of thinking among the many we’ll witness as the Gambling Act review unfolds.