The social stigma of gambling has fallen by the wayside. According to recent research, about 2.5 million adults in America are pathological gamblers and another 3 million of them should be considered problem gamblers, 15 million adults are at a risk for problem gambling. The study found that self-stigma increases with expectations that the public applies a range of negative stereotypes to people with gambling problems, holds demeaning and discriminatory attitudes toward them, and considers them to lead highly disrupted lives.
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In public gambling discourse there is a consensus that gambling problems are stigmatised and that stigma is a n important source of harm for those with gambling problems.In 2015 the US National Council on Problem Gambling stated in its strategic plan that ‘we will work to overcome the stigma and misconceptions associated with problem gambling by identifying public misconceptions about. In fact, problem gamblers have the highest rate of attempted suicide among all addictive disorders. Because of the stigma of problem gambling, those suffering under the weight of addiction and social pressure can be made to feel there is no other alternative. What can be done? There is significant stigma attached to problem gambling People with gambling problems experience stigma, however they were more likely to express this feeling as ‘shame', or with words such as ‘embarrassed', ‘guilt', ‘stupid', and ‘weak'. They rarely, if ever, used the actual.
Two recent reports funded through the foundation's Grants for Gambling Research Program highlight the role of stigma in problem gambling and how it may be reduced.
What Victorians think of serious gambling problems
In December 2015 Inside gambling featured the report The stigma of problem gambling: causes, characteristics and consequences. Led by Professor Nerilee Hing, this study highlights the conflicting nature of how Victorians view people with gambling problems and the role of stigma within this.
Around 96 per cent of Victorians believe problem gambling to be an addiction, just over half describe it as a diagnosable condition, and around a third consider it a mental health condition. However, many also consider people who experience problems from their gambling as impulsive, foolish, greedy or irrational.
Similarly, although many Victorians are willing to socialise with people with gambling problems in incidental ways, they are generally reluctant to form more ongoing relationships with them. This suggests many of us have unspoken social caveats on our involvement with people experiencing problems with their gambling. The April edition of Inside gambling represented some of these in graphic form in Would you marry Dan?
This suggests many of us have unspoken social caveats on our involvement with people experiencing problems with their gambling.
Compared to other conditions, Victorians feel problem gambling has more stigma attached to it than sub-clinical gambling or distress, but less than for alcohol misuse or schizophrenia. With the exception of alcohol misuse, they are more likely to attribute problem gambling to individual characteristics, such as having a bad character or upbringing.
So while Victorians might not attach as much stigma to problem gambling as to other conditions, the stigma associated with it is likely to be rooted in perceptions of personal responsibility.
In contrast, people who have experienced problem gambling attach much more stigma to their condition, believing it to be more publicly stigmatised than alcoholism, obesity, schizophrenia, depression, cancer, bankruptcy and recreational gambling. This highlights that stigma is created and maintained by the beliefs of both the broader community and people who have experienced problems from their gambling.
Given these complexities, how do we reduce the stigma of problem gambling? Recent research exploring initiatives aiming to reduce stigma can provide some answers.
How stigma has been tackled in other areas of health
The study Lessons for the development of initiatives to tackle the stigma associated with problem gambling examines the effectiveness of anti-stigma initiatives in the areas of mental health, HIV/AIDS and gambling.
Associate Professor Samantha Thomas and her team sought understand the different appeal strategies used, with a view to informing future anti-stigma initiatives for problem gambling.
While mental health campaigns typically used personal stories, gambling campaigns often featured more confronting approaches focused on individual responsibility. They tended to concentrate on raising awareness and encouraging people to seek help, emphasising individual actions, controls and responsibilities.
Bastide du jas de bouffan. Gambling campaigns often featured more confronting approaches focused on individual responsibility.
In comparison, mental health campaigns tended to highlight the causes of mental health conditions and the impact of stigma and discrimination, encouraging discussions about mental health.
Interviews with experts who have worked on anti-stigma initiatives confirmed the importance of drawing on successes in other areas, such as mental health, to reduce stigma.
What Victorians think of serious gambling problems
In December 2015 Inside gambling featured the report The stigma of problem gambling: causes, characteristics and consequences. Led by Professor Nerilee Hing, this study highlights the conflicting nature of how Victorians view people with gambling problems and the role of stigma within this.
Around 96 per cent of Victorians believe problem gambling to be an addiction, just over half describe it as a diagnosable condition, and around a third consider it a mental health condition. However, many also consider people who experience problems from their gambling as impulsive, foolish, greedy or irrational.
Similarly, although many Victorians are willing to socialise with people with gambling problems in incidental ways, they are generally reluctant to form more ongoing relationships with them. This suggests many of us have unspoken social caveats on our involvement with people experiencing problems with their gambling. The April edition of Inside gambling represented some of these in graphic form in Would you marry Dan?
This suggests many of us have unspoken social caveats on our involvement with people experiencing problems with their gambling.
Compared to other conditions, Victorians feel problem gambling has more stigma attached to it than sub-clinical gambling or distress, but less than for alcohol misuse or schizophrenia. With the exception of alcohol misuse, they are more likely to attribute problem gambling to individual characteristics, such as having a bad character or upbringing.
So while Victorians might not attach as much stigma to problem gambling as to other conditions, the stigma associated with it is likely to be rooted in perceptions of personal responsibility.
In contrast, people who have experienced problem gambling attach much more stigma to their condition, believing it to be more publicly stigmatised than alcoholism, obesity, schizophrenia, depression, cancer, bankruptcy and recreational gambling. This highlights that stigma is created and maintained by the beliefs of both the broader community and people who have experienced problems from their gambling.
Given these complexities, how do we reduce the stigma of problem gambling? Recent research exploring initiatives aiming to reduce stigma can provide some answers.
How stigma has been tackled in other areas of health
The study Lessons for the development of initiatives to tackle the stigma associated with problem gambling examines the effectiveness of anti-stigma initiatives in the areas of mental health, HIV/AIDS and gambling.
Associate Professor Samantha Thomas and her team sought understand the different appeal strategies used, with a view to informing future anti-stigma initiatives for problem gambling.
While mental health campaigns typically used personal stories, gambling campaigns often featured more confronting approaches focused on individual responsibility. They tended to concentrate on raising awareness and encouraging people to seek help, emphasising individual actions, controls and responsibilities.
Bastide du jas de bouffan. Gambling campaigns often featured more confronting approaches focused on individual responsibility.
In comparison, mental health campaigns tended to highlight the causes of mental health conditions and the impact of stigma and discrimination, encouraging discussions about mental health.
Interviews with experts who have worked on anti-stigma initiatives confirmed the importance of drawing on successes in other areas, such as mental health, to reduce stigma.
Interviewees recommended shifting the focus from ‘personal responsibility' to harm reduction. They suggested that, as well as promoting help-seeking, campaigns should raise awareness about the multiple factors that contribute to gambling harm. This would encourage a more compassionate approach to those who experience it.
I recently had the unique opportunity to have a conversation with one of the greatest humanitarians and champions of mental health – retired Lieutenant-General Romeo Dallaire.
General Dallaire has worked tirelessly to shape the dialogue within public discourse to create solutions on mental health issues. During our conversation, he provided great insight to what he perceives to be the challenges, gaps and opportunities in our efforts to prevent and reduce problem gambling.
It was touching to hear him speak so candidly and to hear the hope he retains for the future. He's a remarkable individual and I'm pleased that he's a keynote speaker at BCLC's New Horizons in Responsible Gambling Conference in March 2019.
It is my pleasure to share my interview with the Lieutenant-General Romeo Dallaire on stigma, mental health and problem gambling.
JW: In your book 'Waiting for First Light' you speak about the role and importance of understanding and empathy as it relates to stigma and mental health. What does that look like to you?
RD: A critical requirement of understanding and empathy is not to isolate the injured and those who are suffering, and to keep communicating.
Isolating a person who is injured by stress or suffering from any mental health problem should never be done. Yet isolation is often the outcome and an automatic response because people are never sure about what to say or are worried that they may make the situation worse.
Communication is more important than ever before. Show a human dimension of yourself. Show empathy that the person is injured, not diseased. They are injured and will welcome communication, even just the attempt to communicate. Without a sense of belonging, the injury only gets worse.
JW: I was struck by your focus on the power of language. You use the term 'operational stress injury' to promote the same sense of urgency in treatment for PTSD as those with physical injuries. How important are the words we use to describe a person's condition and how might we rethink and reframe the way we describe a gambling problem?
RD: The minute you label a condition, people will begin to show resistance. A lot of mental health injuries are related to the stress of extremes and are not physically visible, but exist deep in the brain.
The challenge is helping the injured understand this, accept that they are not malingering and that they are still respectable. They simply have an injury that has overwhelmed them. Positioning it as an injury in this way is crucial.
When it comes to problem gambling, choose your words wisely and stray from terms that may be perceived negatively by society, or imply something that people shouldn't do.
It's important to never frame it that way. These people have been injured in their minds, which has moved them to this extreme inability to control themselves.
Considerations to the power of language can help make a lot of in-roads to removing the stigma.
JW: You have said 'enough about the problems, let's talk about solutions.' How would this perspective apply to problem gambling, in your opinion?
RD: The industry, including physicians, outreach specialists, intermediaries and therapists, need to come together to develop a common lexicon and strategy that is reflective of human concern.
While people can recover from an injury, they still ultimately live with the lasting scars. Creating awareness campaigns to eradicate compulsive gambling does not get rid of the stigma. It just stigmatizes people even more. Therefore, it is most important to build your own lexicon based on words used by gamblers and those in the gambling industry to create effective communication.
Learn their culture and use their words in an attempt to resolve it.
Lastly, you need to build a peer-support system or a means by which a peer-support system can be created around the individual.
JW: What trends are you seeing around social norms and stigma around mental health? Do you see great improvements or are we concentrating on the wrong end goal? What are some of the best practices you support/champion?
RD: The gambling industry's objective should be to make it easier for the injured to express that they need urgent help. To achieve this, the industry needs to first become at ease with these ‘walking wounded' and ‘problem gamblers' who are in the midst of their injury.
The stigma is disappearing mostly because those who are injured are talking. It's not because of great campaigns by government or organizations. It's because of those who are injured are getting support and feeling more confident talking about seeking help. Much like how some people would talk about their cardiologist, people are now more comfortable talking about their psychiatrist.
JW: What message do you have for the gambling industry who are balancing their role as entertainment providers with their desire to assist those for whom gambling is an issue?
RD: How do you feel about being part of the industry that can trigger extremes as much as provide so much joy and entertainment for people who want to participate?
It seems to me that the industry has got to get this chip off its shoulder and feel that it has a responsibility to those who do ultimately fall victim to excess. I think sometimes the industry feels guilty that it's creating this problem. The more you engage in that thinking, the more it continues to stigmatize those who can't handle it.
Stigma Gambling Problems Involving
The industry must demonstrate a willingness to participate in the assistance of those who do fall victim. If you take a preventative position, I think you will go further and get away from this sense of culpability. Turn it into a positive aspect of your industry that gambling is simply offered for entertainment. For those who are injured, there is a whole parameter of supports that you are engaged in to help reduce the possibility of problems. This will help those who are caught up in it, and ultimately bring them back to health.
Stigma Gambling Problems Solving
The seventh annual New Horizons in Responsible Gambling Conference takes place March 12-14, 2019, at the JW Marriott at Parq Vancouver.
