AMA(SA) joins with SA Office for Problem Gambling to help counter gambling harms
12 December 2013
The AMA(SA) is joining with the Office for Problem Gambling to raise awareness among GPs of problem gambling and what they can do to help patients who may be facing issues due to problem gambling.
The AMA(SA) is encouraging general practitioners to consider screening for gambling as part of their systematic lifestyle risk assessment when taking a medical history and during mental health care planning.
The campaign includes a website based resource to assist with identifying, assessing, screening, treating and referring people affected by gambling problems. Information and continuing education sessions, forums and distribution of resource materials for general practitioners will continue throughout 2014.
Problem gambling is now recognised as an addiction in the Diagnostic Statistical Manual V, released in May this year, and is more common than stroke and coronary heart disease: its prevalence is comparable with the estimated prevalence of type 2 diabetes in Australia. For each person with a gambling problem, it is estimated that a further 5-7 family members and others are negatively impacted.
Gambling can be a hidden cause of many of the symptoms and problems encountered regularly in general practice. Many problem gamblers are unaware that health problems such as headaches, anxiety, depression or poor sleep may be related to out-of-control gambling. Consequently, they are unlikely to seek help until their gambling has created a crisis.
General practitioners may be one of the few groups whom those with a gambling problem trust or are willing to visit. Evidence is mounting that problem gambling is a crippling and significant public health issue in Australia, affecting not only gamblers but their families, particularly children, friends and communities.
GPs ideally placed to help identify and support people facing gambling issues Vulnerable groups include:
- People with a ‘severe mental disorder’ as defi ned by scores in the Kessler K10
- People from culturally and linguistically diverse communities
- Aboriginal and Torres Strait Islander People
- Employees of gaming and gambling venues
- Women experiencing loneliness, grief or trauma with co-existing anxiety and depression
- Younger males who report significant stress, anxiety and financial problems without any obvious indicators of substance abuse
- Middle-aged males with difficulties with substance abuse.
“Problem gambling can ruin a person’s life socially, emotionally and financially. It may lead to the loss of relationships, home, health and career. It may cause stress, anxiety and depression. There are few people today who are not affected in some way by the impact of problem gambling on society.” - beyondblue
Losses from gambling can result in the person, their partner and their families having their livelihoods and health completely destroyed. Early diagnosis and treatment can help to eliminate these extreme outcomes and general practice is best placed to detect problem gambling and initiate treatment.
The AMA recommends that medical practitioners consider including gambling as part of their systematic lifestyle risk assessment when taking a medical history. Where a gambling problem is suspected, a psychosocial assessment should be undertaken.
Where relevant, a shared-care approach to the case management of people with gambling problems and their families may be developed. The general practitioner can be assisted by community agencies such as gambling intervention and counselling services, community mental health, relationship counselling, alcohol and drug services, financial advisory services and legal services.
A simple screening process can help identify problem gambling. When consulting with ‘at risk’ patients ask a simple screening question: “Have you ever had an issue with your gambling?” or “Has anyone in your family ever had an issue with gambling?” If the patient answers yes to the screening question, consider performing an assessment or referring the patient for a more thorough assessment by a Gambling Help Service. It may be helpful to explain to the patient the links between their presenting symptoms, stress and the gambling behaviour. Some simple advice about how to control their gambling may be helpful as well. Some brief motivational interviewing could assist the patient to acknowledge that they need to seek further help to reduce their gambling. For more information and resources visit www.problemgambling.sa.gov.au/gps.
A 24/7, free and confi dential Gambling Helpline, with interpreter services available, can be contacted on 1800 858 858. Gambling Help Services operate in a range of SA Metropolitan and Country locations, providing free and confidential personal, financial and family counselling and support for people affected by gambling.
The above is included as an article in the December 2013 issue of medicSA, the AMA(SA) magazine