Equity, a new priority in the fight against compulsive gambling

Social problems

A new health strategy turns to the stigma and social inequalities caused – and exacerbated – by problem gambling

The Department of Health has launched a new strategy to put equity at the center of its response to preventing problem gambling harms, backed by state-funded research from the University of Auckland.

The revamped approach to gambling-related harms will focus on addressing current gaps in the range of support services, reducing stigma and preventing problem gambling among affected population groups, such as as Maori, Pasifika, Asians and young people. .

The Department’s 2020 Health and Lifestyle Survey found that Maori were more than three times more likely to be moderate-risk or problem gamblers than non-Maori and non-Pacific, while the Pasifika were about two and a half times more likely.

Meanwhile, a survey analysis over a number of years found that the Asian population’s gambling risk factor was 9.5 times higher than that of Europeans/other New Zealanders.

To equalize these opportunities, the ministry will establish new public health and clinical response services, which will include kaupapa Māori and other services based on Pacific and Asian worldviews.

This, along with a number of other new tactics, is expected to cost just over $76 million over the next three years. This represents an increase of nearly $16 million over the three-year period previously measured, with more spending on health and support services and departmental operating costs, and nearly $1 million less for research and evaluation.

The changes come as ministry-funded research is published examining the effectiveness of different counseling treatments for problem gamblers.

Professor Maria Bellringer, director of the AUT Center for Gambling and Addictions Researchconducted a two-year randomized controlled trial to see if cognitive behavioral therapy or motivational interviewing would have a greater impact on people with gambling problems.

She was surprised to find that the two treatments had broadly similar positive results across the 227 study participants, even two years after starting treatment.

“We were quite surprised because we thought CBT with exposure therapy would have better outcomes in that the people who participated in this treatment would have better outcomes, just because it was a more longer and more intensive,” Bellringer said. “But both treatments were effective to a similar level.”

She said this research supports the fact that if there is a good relationship between therapist and client, there is a good chance of positive outcomes, regardless of the type of treatment.

The study was conducted among people who had accessed gambling treatment services offered by the Salvation Army Oasis across New Zealand, which Bellringer says should help limit the effects of gambling bias. self-selection on the results.

People who contacted the Salvation Army Oasis for help were asked if they wanted to participate in the trial. The 227 recruited participants were then assessed on four occasions: before receiving their randomized treatment, at the end of treatment, after one year and after two years.

The relatively long study duration was another selling point for Bellringer’s research, with most randomized controlled trials only running for about a year.

In keeping with promises from the Department of Health to devote more time and money to reaching minority communities harder hit than others by gambling harms, Bellringer resists labeling a single gambling treatment as the best and move forward with this one.

“One size doesn’t fit all,” she said. “All individuals are different and people have different problems with gambling activities.”

Apart from demographic differences, gambling in New Zealand is divided into several forms, such as slot machines, lotto, online poker, sports betting and casinos.

Slot machines do the most harm with a fairly wide margin.

Bellringer said the latest data showed that 60% of people seeking help for problem gambling were slot machine players – 50% from slot machines in bars and clubs and 10% from slot machines. in casinos.

However, while 70% of adults gamble, only 10% regularly use slot machines. This means that a disproportionate amount of damage comes from the insidiously engineered machines in the back of the local pub with their flashing lights and promising jingles.

According to data from the Problem Gambling Foundation, New Zealanders lost $987 million on slots outside of casinos in the 2020/2021 financial year – almost exactly the same cost as the mental health program and drug addiction unveiled by Health Minister Andrew Little in May.

There are just under 18,000 slot machines in New Zealand, many of which are placed in poorer communities.

“Pubs and clubs with slot machines are disproportionately located in poorer areas,” Bellringer said. “And of course the poorest are the ones who can least afford to lose their money.”

She noted that there is a strong correspondence between problem gambling and substance abuse, which means treatments targeting more than one problem at a time could be the way forward.

“Holistic treatments addressing substance use in conjunction with gambling problems could be important because substance use is strongly associated with gambling problems,” she said.

Along with this, there is a need to reduce the stigma surrounding problem gambling, which often acts as a barrier to people’s access to treatment.

“People have told us that admitting to having a gambling problem is more shameful than admitting to having a drug problem,” she said. “The general public considers it a behavioral addiction, so they think you can just quit. But behavioral addictions cause the same changes in the brain as a drug addiction.

The ministry’s strategy speaks to the need to tackle stigma, which it intends to do through a $3 million initiative focused on priority populations encouraging people to access help.

This $3 million will cover market research to ask affected communities what might be the best way to deliver the message, before developing, testing and delivering an age and culturally appropriate approach:

“This will be designed to challenge negative perceptions and stereotypes, to convey positive images of people with gambling problems and to encourage people to seek help from available services.”

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