Gambling is the act of wagering something of value on an event whose outcome is uncertain, where there is a potential reward. This can take many forms, such as a horse race or lottery ticket. In some forms of gambling, such as in casinos or sports betting, there is a clear advantage to one or more participants who bet against other people.
Harm minimisation and harm reduction are key public health priorities relating to gambling. However, current approaches lack a coherent and appropriate definition of harm and often fail to address the full range of harms experienced by those who gamble.
Despite these problems, it is also widely accepted that gambling has a negative impact on physical and mental wellbeing. Moreover, there is a strong connection between gambling and suicidal ideation and attempts, which further adds to the complexity of these issues.
A clearer understanding of the breadth and experience of harms related to gambling was essential in order to develop effective strategies for prevention, intervention and support. To this end, we conducted qualitative research involving semi-structured interviews (n = 25) with individuals who had identified they had experienced harm from either their own and/or someone else’s gambling.
The study utilised a mixed method approach with a focus on the use of focus groups to gain a better sense of how participants conceptualised their experiences of gambling related harm. A total of eleven focus groups were conducted, each containing between ten and twenty participants. Interviews were carried out by telephone and averaged around sixty minutes in length.
Results showed that a range of different types of harm were consistently reported by the participants, at varying levels of severity and intensity. These included emotional and psychological distress, biological manifestations of harm such as high blood pressure or loss of sleep, a range of comorbidities such as depression and anxiety, relationship breakdowns, financial harm and other legacy harms.
Emotional and psychological distress was the most consistent type of harm reported across all categories and was reported at any level of engagement with gambling. This category was classified into three sub-themes: shame and stigma; lack of self worth; and feelings of lack of control over one’s gambling.
These sub-themes were associated with a wide range of emotional and psychological symptoms, including anxiety, depressive mood, psychosis, self blame, low motivation and feelings of being overwhelmed or trapped. They were often exacerbated by other harms and were particularly linked to suicidal ideation and attempts.
Another common type of harm was financial harm, which was primarily seen as a loss of surplus, or items that are purchased with extra money derived from other sources. These harms were associated with a crisis point where the individual’s ability to buy luxury goods or activities had become compromised due to their ongoing gambling activity.
Financial harms are a key threshold for seeking help or treatment and can be caused by a range of factors, such as a change in income or debt. It is important that these are addressed as early as possible, and if possible, with free and confidential debt advice from StepChange.