Raising the Stakes: Assessing Human Service Response Capacity to the Social Impact of Casino Gambling

Background and Purpose: When casino gambling is introduced to a community, there is an increase in the proportion of the community with problem or pathological gambling disorders (Room, Turner, & Ialomiteaunu, 1999). Compounding this problem is a high co-occurrence with other addictive and mental health disorders. In addition, there is an increase in the social and economic consequences on individuals and families. Therefore, there is a greater need for prevention and treatment interventions to address problem gambling and associated problems. This study seeks to assess the capacity of human service providers to engage in prevention and treatment efforts for gambling addiction and gambling-related problems in a county surrounding a large urban center in Southwest Pennsylvania that has been selected as a site for a slot machine casino set to open in early 2009. While existing research focuses on gambling prevalence rates and community attitudes and expectations, there are virtually no studies that assess human service provider capacity prior to the opening of a casino.

Methods: Using a cross-sectional survey design, questionnaires were mailed to executive directors of all mental health, family counseling, drug and alcohol, and faith-based, addiction-related organizations in the county. Organizations were included in the sample if they provided direct services to adults (age 18 and older) in non-residential settings in the county. Of the 248 human service providers contacted, 137 (55%) responded to the survey. The survey consisted of four domains: agency demographics, training, screening and treatment, and public awareness/education. Descriptive statistics and bivariate analyses were used to summarize the findings.

Results: The analyses revealed a lack of human service response to the social impact of casino gambling. More than three-quarters of respondents had not sent staff for training in screening or treating gambling disorders, did not screen for problem gambling, did not treat problem gambling, and did not refer clients to other agencies for treatment of gambling-related problems. Less than a third of the respondents indicated that their agency was familiar with a public awareness or educational campaign about problem gambling and less than 10% were educating clients about problem gambling. The most common reason offered for not engaging in prevention and treatment activities was that problem gambling is not considered an issue for the agency.

Conclusions and Implications: Since problem gambling is often accompanied by other mental health, substance abuse, and family issues, there are likely to be different pathways to treatment. Yet, the findings of this study suggest that these agencies are not prepared to identify and treat problem gambling. A comprehensive educational campaign is necessary not only for the community, but one targeted directly to human service providers regarding the nature of problem gambling, efficient methods of screening, and evidence-based treatment. As it is likely that most agencies will refer clients, rather than treat clients, a centralized data bank identifying providers offering treatment should be developed.