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Gambling addiction, much like other problems, is a multifaceted issue that lacks a singular solution.
The approaches to treating problem gambling can vary greatly, just like the individuals seeking help.
As the month dedicated to raising awareness about gambling comes to an end, advocates are emphasizing the significance of incorporating diversity, equity, and inclusion into treatment approaches.
A focus on Diversity, Equity and Inclusion in problem gambling treatment
Less than 5% of community members actively pursue gambling disorder treatment, as stated by Deborah G. Haskins, Owner and Chief Consulting Counselor at MOSAIC Consulting.
Around 100,000 individuals in the state are facing challenges associated with gambling addiction; however, not all of them pursue treatment due to a variety of reasons.
The lack of trust or belief in the system is magnified for individuals who belong to minority communities or are people of color.
Haskins expressed that his mission statement will constantly prioritize reaching the remaining 95%. He emphasized the need for us to consider this perspective as we progress, even if it entails making significant changes to our current approach.
Haskins is emphasizing the significance of incorporating DEI (diversity, equity, and inclusion) into the approach towards gambling addiction treatment.
- To foster inclusivity for individuals seeking assistance, it is important that treatment staffs mirror the diversity present within the community.
- Equity emphasizes that various communities may need additional or diverse resources to ensure effective treatment, distinguishing it from equality.
- Inclusion: Ensuring that every community feels acknowledged and possesses a sense of belonging.
As Haskins demonstrates, equity could be the most significant component of this puzzle.
She stated that our goal with equity is to acknowledge that individuals do not begin their journey from the same starting point. To ensure access and promote well-being, we must acknowledge that various community members require different accommodations. While it is commonly believed that everyone has equal opportunities and access to health equity, along with the resources provided by the Affordable Care Act, this is not the reality.
ACEs play a key role in risk for gambling addiction
During our examination of youth gambling concerns, we briefly discussed how Adverse Childhood Experiences contribute to the development of gambling disorder and its impact on diversity.
There are ten ACEs that are frequently researched due to their correlation with the frequency of gambling. These ACEs include:
- Physical abuse refers to the act of inflicting intentional harm or injury on another person by using physical force or violence.
- Sexual misconduct
- Rephrased: The act of using words to harm or demean someone.
- Neglect involving physical care or attention.
- Neglecting one’s emotional needs.
- A relative who is experiencing depression or has been diagnosed with another mental disorder
- An individual within the family who struggles with alcohol or substance addiction.
- Relative incarcerated
- Observing a mother enduring abuse
- Experiencing the departure, dissolution, or passing of a parent
According to the 2018 Nevada Behavioral Risk Factor Surveillance System data, individuals who experienced three or more adverse childhood experiences (ACEs) were 69% more likely to engage in frequent gambling compared to those with no ACEs.
Adverse Community Environments frequently accompany Adverse Childhood Experiences. These may consist of:
- Poverty
- Discrimination
- Disruption within the community.
- Insufficient economic opportunities
- Housing that is either of low quality or unaffordable.
- Violence
The presence of these challenges poses a heightened risk for problem gambling, disproportionately affecting minority communities.
Haskins discovered various specific problems within the diverse communities.
African Americans
According to Haskins, the black community places significance on the use of appropriate language.
According to her, gambling is seen as a solution rather than a problem within the community. Therefore, when treatment terms it as a “problem” or an “addiction”, it may discourage individuals from immediately seeking assistance.
She stated that if we label all of our efforts to raise awareness about gambling as ‘problem gambling’, we will fail to reach certain individuals. When they see the word ‘problem’, they won’t feel that it applies to them because they don’t perceive themselves as having any issues.
In addition, Haskins highlighted that the living conditions, social needs, and laws and policies also presented significant barriers to achieving adequate treatment for individuals of color.
Haskins emphasized the importance of incorporating race and cultural context into treatment approaches right from the start. It is crucial to express your understanding, despite not having firsthand experience of being a black or brown person and living through those experiences. However, demonstrating cultural empathy and actively seeking to learn more about it will help create a safe space for individuals seeking help. Failing to do so may deter community members from accessing your services. As a profession, we have been hesitant to openly discuss race, perhaps due to the difficulty of the conversation. But by avoiding the topic, we unintentionally convey to individuals that we do not acknowledge the truth and validity of their living conditions.
Latinos
In a study published in the 2016 Journal of Gambling Studies, nearly 80% of Latino individuals seeking mental wellness reported engaging in gambling activities within the previous month.
Many people faced trust issues when seeking treatment, as their initial approach was often seeking assistance from a trusted family member rather than seeking clinical help.
Immigrants who have come to the U.S. encounter added difficulties as they experience heightened expectations to support their families while earning meager incomes.
According to Haskins, for individuals who immigrate to the United States, mastering English can be extremely challenging. This difficulty is not limited to non-native English speakers, as even native speakers can find it tough. Furthermore, these individuals not only have to learn the language but also navigate the job market. They may have had a specific occupation in their home country, but in the US, they might not be able to attain the same professional status. Consequently, these factors contribute to significant acculturation stress, which leads to various psychological, spiritual, financial, and familial challenges.
Native Americans
The Native American community is at risk of being adversely affected by problem gambling due to their close ties with the industry.
Although the industry has brought success to numerous tribes nationwide, it can also come with a steep price in terms of fostering addiction for certain individuals.
Nevertheless, the majority of treatment guides fail to provide clear instructions on the most effective approach to follow within their respective communities.
The Native American community emphasizes the importance of holistic approaches to treatment, an aspect that Haskins brings attention to.
Haskins inquired, “In 2024, are our theories, techniques, and prevention methods aligned with the cultural communities we serve? Currently, there is a lack of a practitioner guide specifically addressing diversity, equity, and inclusion in problem gambling disorder.”
How to make gambling addiction services more inclusive
Haskins suggests three essential strategies that must be incorporated to enhance services for individuals.
- It is crucial to have a deep understanding of the community – not just superficial knowledge, but a true comprehension. This entails involving individuals who are invested in the community and comprehend its constraints when designing treatment options.
- Through the lens of health equity and social justice, it is crucial to recognize the strengths and weaknesses of the community in order to develop a sustainable long-term strategy for promoting wellness. This approach should address various aspects such as transportation, land use, recreation, and housing to ensure equal access and opportunities for all community members.
- Create a comprehensive wellness plan with a focus on diversity, equity, and inclusion (DEI): Engage a diverse group of team members who prioritize DEI and possess a deep understanding of the community’s culture. These individuals are skilled in crafting appropriate messaging for the community and excel at finding effective solutions to challenges.
In addition, Haskins emphasized the importance of treatment services conducting self-evaluations and expanding their range of options for patients. These options may encompass:
- Options are available for individuals who do not speak English.
- Therapy provided in the comfort of your own home, designed for individuals facing transportation challenges or limited access to resources.
- Additional choices for patients who are deaf
- Additional choices for the LGBTQ+ community
- Increase the presence of individuals in the local community.
- Enhanced language to address the matter
Haskins expressed the importance of truly meeting people where they are, emphasizing that the terms “problem gambling” and “disordered gambling” are inadequate as they solely focus on the negative aspects. This approach places an emphasis on the pathology, leading to increased feelings of stigma among individuals. Haskins stressed the need for sensitivity and the use of alternative messaging in order to address this issue effectively.
To delve deeper into the subject of equity in problem gambling prevention, we encourage you to explore the Our Voices Matter study conducted in May 2021.
If you or someone you are acquainted with requires assistance with a gambling-related problem, please reach out to the Michigan Department of Health and Human Services Problem Gambling Helpline at 1-800-270-7117.
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