Problem gambling and non-help-seeking: Perspectives of intimate partners, gambling venue staff, and gamblers

Author: Ben Riley

Riley, Ben, 2022 Problem gambling and non-help-seeking: Perspectives of intimate partners, gambling venue staff, and gamblers, Flinders University, College of Medicine and Public Health

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Despite substantial harms inflicted on individuals and their families caused by problem gambling and a range of available treatments, most individuals in need do not seek formal assistance. Given their contact with people with gambling problems who are not actively seeking help, both gambling venue staff and families have been indicated as potential opportunities to facilitate help-seeking. To understand these opportunities, this thesis examines the experiences of venue staff and intimate partners of individuals with gambling problems who are not seeking help, along with individuals with lived experience of problem gambling.

Five studies: three literature reviews and two qualitative studies, were conducted. The first literature review comprised peer-reviewed and grey literature and examined the role of gambling venue staff in gambling venues that operate electronic gaming machines, in facilitating harm reduction and help-seeking. The second literature review systematically examined peer-reviewed evidence concerning the impact of gambling-related harm on concerned significant others.

Qualitative study 1 involved in-depth interviews with 15 participants and examined the lived experiences of partners living with a person with a gambling problem who was not seeking help. Qualitative study 2 examined the experiences of gambling venue staff and gamblers concerning the identification and engagement of individuals with gambling problems in gambling venues and involved three focus groups and nine in-depth interviews.

Role conflict and ambiguity emerged as dominant themes across the two qualitative studies. As such, a third literature review was performed to examine peer-reviewed sources regarding the current knowledge and theories concerning role conflict and role ambiguity more broadly and to consider how this literature related to and informed the findings of the two qualitative studies.

The results of this thesis can be summarised in four broad findings. First,

managing the effects of a person’s gambling problem can be hampered by role conflict: a perceived conflict between venue staff promoting harm reduction while encouraging gambling impaired effected engagement between staff and gamblers around help-seeking; and a reorganisation of roles within intimate couples to manage the effects of problem gambling added further strain to the relationship. Second, engaging non-help-seeking individuals with gambling problems about their gambling is complicated by perceived stigma. Third, detecting problem gambling behaviour reliably is difficult. While venue staff felt confident that they could identify visible problem gambling behaviours, they were less confident in identifying a patron as having a gambling problem, and intimate partners described difficulty in detecting more covert gambling behaviours. Fourth, a disproportionate emphasis on individual accountability for responsible gambling is not working. The findings of this research have shown that waiting for people to actively seek help or exhibit signs of gambling-related harm, is too late. This thesis has indicated a need for a shift away from a responsible gambling paradigm of individualism to a more holistic multifaceted approach with a focus much earlier in the help-seeking process; one that better engages with and supports families and gambling venue staff to provide support to the gambler to recognise and seek help earlier.

Keywords: problem gambling, families, venue staff, lived experience, role conflict

Subject: Public Health thesis

Thesis type: Doctor of Philosophy
Completed: 2022
School: College of Medicine and Public Health
Supervisor: Sharon Lawn