It is counter-intuitive that a condition as prevalent in the UK as gambling addiction should attract such great shame and stigma – but it very much does.
Numerous studies (see appendix) have highlighted the link between stigma and gambling harms and as a treatment provider, at Ara we are alive to the fact that both stigma (noun: a mark of disgrace associated with a particular circumstance) and shame (noun: a painful feeling of humiliation or distress caused by the consciousness of wrong or foolish behaviour) are two of the biggest factors preventing people stepping forward for free and confidential support for their gambling.
What are the reasons that disordered gambling attracts stigma, disgrace, and humiliation?
Hing et al (2015) suggest it may be due to the perception of those suffering gambling harms having personal responsibility for their actions, and thus culpability for their distress. Hing et al similarly suggest that those living with mental illness may attract less compassion than those with physical disabilities. Livingstone (2021) writing in the Lancet points out that the semantics of gambling addiction have a part to play; the term ‘Problem Gambler’ “…carries with it an implication of irresponsibility and social shame”. Ara and other professionals in gambling research, education and treatment services use more sensitive terms like disordered gambling, but when the public debate remains couched in terms of ‘problem gambling’ we are often unable to prevent sufferers (and affected others) internalising shame and blame, and thus not reaching out for help.
Parallels between stigma in substance addiction and gambling addiction
I attended a conference in November where Dr Vicky Carlisle of the University of Bristol spoke passionately about stigma as a barrier to heroin addicts accessing OST (Opioid Substitution Treatment). It struck me that there are clear crossovers with barriers to treatment for gambling harms. In both instances, the casual use of stigmatising language discourages a public acknowledgement of the need for support for the sufferer.
Social support can buffer stigma, and so by raising awareness of gambling harms via accessible training in commonplace settings (e.g. the workplace), we can bolster this social support and help to de-stigmatise the issue. Dr Carlisle also spoke of the types of stigma – anticipated, enacted, and internalised. Internalised stigma – where one turns on to oneself negative stereotypes and perceptions – is a large barrier to seeking help, and here Ara’s early engagement and intervention work is vital in providing reassurance to clients that they are not unusual, they are not alone, and they too can have a better future free from disordered gambling.
Reducing stigma amongst people with disordered gambling
One way to reduce stigma is to promote autonomy in treatment, and having a breadth of options for clients to engage with is key to improving uptake. The efficacy of free and confidential counselling is formidable (92% felt counselling brought a positive change in their circumstances) – but this only works for those who take up this option! Clients not ready for counselling need an array of self-exclusion, self-help, and digital tools to begin their own, unique journey to recovery. If we attempt a one-size-fit-all solution to what is a complex problem, then (as with those suffering with substance misuse), we will fail a significant proportion of clients as support practitioners, and re-stigmatise people when they don’t improve their lives.
Robbie Thornhill joined ARA as Chief Operating Officer after a career as a management consultant. He is passionate about promoting recovery and supporting those suffering gambling harms, and is proud to represent a vibrant, diverse, and forward-thinking charity like Ara.
APPENDIX
Hing, N., Russell, A.M.T., Gainsbury, S.M., Nuske, E. (2015) ‘The Public Stigma of Problem Gambling: Its Nature and Relative Intensity Compared to Other Health Conditions’, Journal of Gambling Studies. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4993796/
Livingstone, C & Rintoul, A. (2021) ‘Gambling-related suicidality: stigma, shame, and neglect’, The Lancet. Available at: https://doi.org/10.1016/S2468-2667(20)30257-7
Quigley, L. (2022) ‘Gambling Disorder and Stigma: Opportunities for Treatment and Prevention’, Current Addiction Reports. Available at: https://rdcu.be/c11m5
Scott, J. & Carlisle, S. (2021) ‘A pharmacy resolution for 2021: let’s improve the way patients with addiction are treated’, The Pharmaceutical Journal. Available at: https://pharmaceutical-journal.com/article/opinion/a-pharmacy-resolution-for-2021-lets-improve-the-way-patients-with-addiction-are-treated
