GambleAware

Background A number of studies have noted a significant association between suicidality and pathological gambling (PG), but the exact relationship has not been extensively characterized. It is unclear whether gambling precipitates suicidality, or whether underlying psychiatric problems, such as mood disturbances, lead to both gambling and suicidality. Furthermore, all published data on the association between suicidality and gambling is from high-income countries, and the nature of this relationship in low- and middle-income countries, such as South Africa, has not been explored. Methods The relationship between gambling and suicidality was investigated in individuals who had called the South African National Responsible Gambling Programme's helpline. Associations between sociodemographic factors, severity of gambling symptoms, comorbid psychiatric disorders, family history of psychiatric disorders, and suicidality were assessed. Results Data indicated that suicidality in PG is associated with sociode-mographic factors (female sex, being unmarried, and unemployment), clinical factors (severity of gambling, personal history of comorbid psychiatric disorders, particularly depression), and a family history of psychiatric disorders. Conclusions A knowledge of risk factors for suicidality is important when assessing and counselling individuals who have PG, and may be a useful tool in preventing suicidal behaviors. This study provides additional evidence that treatment of PG should include a focus on comorbid psychiatric illnesses.

In this special issue, critical consideration is given to existing knowledge and understanding regarding harm minimisation in gambling. While the reviews have been written with the British context in mind, we consider that most matters will have some relevance at an international level also. Papers in this issue also consider operational and regulatory matters through identifying priority areas for research and offering initial guidance on how existing research findings could be applied in operator-based approaches to harm minimisation. It should be noted that concurrent work is being done in Great Britain by both the regulator and industry in response to concerns about the impacts of gambling individually and in local communities. The regulator has recently reviewed social responsibility provisions found within its License Conditions and Codes of Practice (LCCP), and this has established where greater degrees of player protection or player monitoring need to be mandated. In classifying approaches according to their source of implementation and management, the papers in this special issue examine the evidence by considering a specific category of harm minimisation that has been referred to here as ‘operator-based’ harm minimisation. The four papers consider the issues in relation to facilitating awareness and control among consumers engaging in gambling; to restricting access to gambling products; and to ensuring that marketing functions operate in a transparent and responsible way.

Research demonstrates that a large proportion of individuals have reduced levels of self-awareness of behaviour when gambling, through a process of dissociation (Powell, Hardoon, Derevensky, & Gupta, 1996) and narrowed attention (Diskin & Hodgins, 1999). This can be detrimental to the decision-making process, especially as players become increasingly stimulated, which can negatively impact upon gambling behaviour. Therefore, in an attempt to limit irrational gambling behaviour, and gambling beyond levels at which one had initially intended, emphasis is placed on harm minimisation approaches that attempt to increase self-awareness of behaviour and increase awareness of the probable outcomes of participation in gambling, by providing easily understood and relevant information in a timely fashion. Fundamentally, this refers to the provision of information pertaining to 1) Personal Behavioural Information - information provided to the player regarding amount of time and money spent gambling, and 2) Game Transparency Information – information that outlines to the player how the game operates e.g. probabilities of winning. Structural and situational characteristics of gambling may not however, be conducive to supporting self-regulation and self-control, making the process of facilitating awareness more challenging than one would initially assume. The following paper reviews evidence for the efficacy of strategies aimed at facilitating awareness during gambling, referring to behavioural information and game transparency, as well as problem gambling information and referral.