Gambling and Mental Illness Study
Gambling is a popular pastime for many individuals, but it remains a significant public health issue in Australia, with negative impacts on psychological, social, familial and/or occupational functioning for many people. While a recent survey suggested that only 0.8% of people in Victoria are problem gamblers, little is known about the rates of gambling problems among people in treatment for mental health problems.
First, we surveyed 311 clinicians working in 14 different mental health services (public, private, and community outreach) and found that whilst most were confident asking about gambling behaviours, few (<20%) ‘often’ or ‘always’ did this and less than 2% used a formal problem gambling screening tool. Confidence in managing a gambling problem was low. Qualitative interviews with 30 clinicians identified key barriers to responding to gambling problems (lack of time, competing priorities) and facilitators to responding, which included previous training in problem gambling and knowledge of screening tools and referral options.
Next, in the same mental health services, we surveyed 837 patients to assess rates of gambling problems using the Problem Gambling Screening Index (PGSI). Whilst gambling was less common than among the general Victorian population, the rate of problem gambling was 8 times higher among patients. Among those who had gambled in the past year, over half experienced at least some gambling-related harm. People with a diagnosis of a psychotic disorder, drug use disorder, bipolar disorder, or borderline personality disorder, were particularly at risk of experiencing gambling problems.
Despite these elevated rates of gambling problems, the majority of clients had not been screened or asked about gambling problems at the mental health service they were attending. This suggests that clinicians may be missing opportunities to address gambling problems that may be contributing to poor mental health outcomes. Increased use of routine screening in these services may improve this situation. The findings identified the effectiveness of brief problem gambling screening tools, and point to significant opportunities for prevention, early identification and intervention for this group as well as the need for improved cross-sector partnerships and referral pathways to ensure patients with mental health and gambling issues receive timely and appropriate treatment.
Turning Point team
Associate Professor Nicki Dowling (Deakin University), Dr Simone Rodda (Auckland University), Dr Stuart Lee (Monash Alfred Psychiatry Research Centre), Dr Stephanie Merkouris (Deakin University), and Dr Rachel Volberg (University of Massachusetts).
Learn more about this project
Papers and reports:
- The full report on this research can be found at:
Lubman, D, Manning, V, Dowling, N, Rodda, S, Lee, S, Garde, E, Merkouris, S & Volberg, R 2017, Problem gambling in people seeking treatment for mental illness. Victorian Responsible Gambling Foundation, Melbourne.
- Manning., V., Dowling, N. A., Lee, S, Rodda, S., Garfield, J. B. B., Volberg, R., Kulkarni, J., & Lubman, D. I. (2017). Problem gambling and substance use in patients attending community mental health services. Journal of Behavioral Addictions, 6(4), 678-688.
- Dowling, N.A., Merkouris, S. S., Dias, S., Rodda, S. N., Manning, V., Youssef, G. J., Lubman, D. I., & Volberg, R. A. (2019). The diagnostic accuracy of brief screening instruments for problem gambling: A systematic review and meta-analysis. Clinical Psychology Review, 74, 101784.
- Dowling, N. A., Merkouris, S. S., Manning, V., Volberg, R., Lee, S. J., Rodda, S. N., & Lubman, D. I. (2017). Screening for problem gambling within mental health services: a comparison of the classification accuracy of brief instruments. Addiction, 113(6), 1088-1104.
- 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. (2018). Journal of Gambling Studies, 34(1), 307-320.
Gambling Research Exchange Ontario (GREO) Research snapshots:
- Problem gambling and substance use in patients [PDF 217KB]
- Barriers and facilitators responding to problem gambling [PDF 216 KB]