Problem gambling is a growing issue in the UK, but a London clinic is leading the way in treating sufferers and developing world class research says Dr Henrietta Bowden-Jones, Consultant Psychiatrist, Central and North West London NHS Foundation Trust and Director, National Problem Gambling Clinic.
In 2008, a National Problem Gambling Clinic was founded as a direct result of the general public’s concerns about potential harm from gambling, at a time when the British government was contemplating the construction of several more casinos and when advertising gambling products on TV had become legal.
Based in south west London, the National Problem Gambling Clinic is the first and only NHS clinic dedicated to the treatment of pathological gambling. Funding for the clinic comes from multiple sources including lecturing fees and research grant applications but primarily from the Responsible Gambling Trust, a government charity set up to distribute voluntary donations from the gambling industry to avoid a compulsory levy based on earnings.
The clinic was established to provide patients suffering from gambling addiction with a gold standard, evidence-based, time-limited service providing specialist treatment and support. After opening (and since), the clinic experienced a large volume of referrals and quickly became the focus of treatment, research, training and teaching of this subject at a national level.
Treatment usually involves eight sessions of cognitive-behavioural therapy treatment developed from work conducted by Nancy Petry (Petry et al; 2006). The types of topics covered in these sessions include: stimulus control, rewards, coping with cravings, increasing pleasant activities, trigger management, understanding lapses, coping with gambling thoughts and managing lapses.
We also offer a Money Management assistance service which, in the UK, is funded by the banking world to assist people with mental health issues. This service provides both a session of psycho-education around managing finances and individual help with setting up repayment plans to help people to manage debt.
Of the people who attend our clinic, 84% have committed illegal acts to fund their gambling at some point in their lives, 20% have lost their jobs due to gambling and 50% have lost significant relationships such as their marriage due to gambling. It is a condition which – if left untreated – can have a devastating impact on a person’s life and wider society. There are considered to be at least 500,000 pathological gamblers in the UK, with as many more scoring as exhibiting ‘at risk’ behaviours (Natcen 2011, HSE 2012).
In addition to leading the field in providing treatment to problem gamblers, we are also committed to identifying ways to better treat and prevent harmful gambling behaviour through world-class research and feeding into policy debates. A problem will not be found overnight, however we believe that there are a series of fundamental societal needs that will help to protect gamblers in the short to mid- term. These include: properly enforced self-exclusion policies (i.e. allowing problem gamblers to ask gambling providers to prevent them from being able to gamble with them for a set length of time); the protection of children and young people from the proliferation of gambling products; more stringent laws around advertising gambling activities and ensuring enough attention is paid to the quality of treatment services at a national level, if and when they fall outside the remit of the NHS.
Our hope is that policy makers will recognise the need to fund problem gambling treatment throughout the UK and include pathological gambling in the illnesses it wishes the NHS to treat.