Gambling involves risking money or something of value on an event whose outcome is uncertain, such as a game of chance. While for most people gambling is simply a way to have some fun and socialise with friends, for a small but significant number of individuals it can be detrimental to their health. This article describes the risks of gambling, how to recognise problem gambling and seek help, and the various treatment approaches for problem gambling.
In recent years, our understanding of pathological gambling as a mental disorder has undergone a profound change. From a perspective that emphasised individual responsibility and limited the scope of government interventions to address the issue, our thinking has moved towards one that takes into account the role of societal, environmental and industry factors. This change has been reflected in, or at least stimulated by, the evolution of the diagnostic criteria in the American Psychiatric Association’s Manual of Mental Disorders (called the DSM).
The use of the term ‘gambling’ has become controversial, with some people objecting to its inclusion in the list of disorders. Others argue that it is an important part of a broad range of human activities, and is a fundamental component of our societies and cultures. This debate reflects a wider debate about what it is to be human, and how we should understand our relationship with the world around us.
A key reason for the continued controversy about the term is that gambling is a complex activity. To define it in a way that is meaningful, the word ‘gambling’ needs to include all the ways in which humans engage in gambling. This includes activities that take place in private, such as playing card games like poker or blackjack with family and friends, betting on sports events such as football games or horse races, or placing bets on scratchcards or fruit machines. It also involves public activities such as lottery games, casino gaming and playing video poker.
This multifaceted nature of gambling means that there are many different types of problems that can be associated with it. For some people, these issues can be minor and do not require intervention; for others, the effects can be severe. The severity of gambling problems is measured by a number of criteria, including frequency and intensity, and the extent to which they interfere with everyday functioning.
There is no definitive diagnostic test for gambling disorder, and it can be difficult to distinguish between pathological and non-pathological gambling. The best approach is to be aware of the potential harms, and seek support if necessary. This may include calling a helpline, seeing a therapist, or attending a group such as Gamblers Anonymous. For some people, this can be enough to change their behaviour and reduce the harmful impact on themselves, their families, and their communities.