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Gambling addiction, similar to many other problems, is a multifaceted issue with no singular solution.
The approaches to addressing problem gambling can vary greatly, just like the individuals affected by it.
As the month of Gambling Awareness comes to an end, supporters are focusing on the significance of incorporating diversity, equity, and inclusion in treatment approaches.
A focus on Diversity, Equity and Inclusion in problem gambling treatment
Less than 5% of individuals in the community actively pursue treatment for gambling disorder, as stated by Deborah G. Haskins, Owner and Chief Consulting Counselor at MOSAIC Consulting.
Around 100,000 individuals within the state have faced challenges associated with a gambling disorder. However, not everyone pursues treatment due to a multitude of reasons.
People belonging to communities of color or minority groups often experience heightened reasons due to a lack of trust or faith in the system’s ability to work in their favor.
Haskins expressed that his mission statement will consistently emphasize the question, “How can we effectively engage the remaining 95%?” He emphasized the need for us to contemplate this moving forward, even if it requires us to completely alter our current approach.
Haskins is highlighting the significance of incorporating DEI (diversity, equity, and inclusion) into the strategy for addressing gambling addiction treatment.
- In order to foster inclusivity for individuals seeking assistance, it is essential that treatment staffs mirror the diversity of the community they serve.
- Equity emphasizes that diverse communities may necessitate additional or distinct resources to ensure effective treatment, contrasting with equality.
- Promoting inclusion involves ensuring that every community feels valued and acknowledged, fostering a sense of belonging among them.
As Haskins illustrates, equity plays a major role in solving this puzzle.
She stated that our goal with equity is to acknowledge that not everyone begins from the same point. To ensure access and promote well-being, we must acknowledge within our mission that various community members will require different accommodations. While we may believe that everyone enjoys equality and equal opportunities, and that they can access healthcare equity and resources in the same manner, this is not the reality even with the Affordable Care Act.
ACEs play a key role in risk for gambling addiction
During our examination of youth gambling concerns, we briefly discussed the impact of Adverse Childhood Experiences on both gambling disorder and diversity.
There exist 10 ACEs that are frequently researched due to their correlation with gambling frequency. These ACEs include:
- Physical abuse
- Sexual abuse
- Verbal abuse
- Physical neglect
- Emotional neglect
- A relative who is experiencing depression or has been diagnosed with other mental health conditions
- A family member struggling with alcohol or substance addiction.
- Relative incarcerated
- Observing a mother enduring abuse
- Experiencing the loss of a parent due to separation, divorce, or death
According to the 2018 Nevada Behavioral Risk Factor Surveillance System data, individuals who experienced three or more Adverse Childhood Experiences (ACEs) were found to have a 69% higher likelihood of engaging in frequent gambling, compared to those who had no ACEs.
Adverse Community Environments often accompany Adverse Childhood Experiences. These encompass:
- Poverty
- Discrimination
- Community Disruption
- Lack of economic opportunities
- Inadequate housing conditions or unaffordability
- Violence
The presence of these challenges increases the risk of problem gambling, particularly affecting minority communities disproportionately.
Haskins pinpointed additional specific problems within various communities.
African Americans
According to Haskins, the black community places importance on the choice of words.
According to her, within the community, gambling is seen as a solution rather than a problem. Therefore, when treatment uses terms like “problem” and “addiction,” it can discourage people from seeking immediate assistance.
She stated that if we label all of our awareness efforts as “problem gambling,” we won’t be able to reach certain individuals. Once they come across the word “problem,” they will instinctively feel that it doesn’t pertain to them because they don’t perceive themselves as having an issue.
In addition, Haskins emphasized that the living conditions, social needs, and laws and policies were significant barriers obstructing the provision of adequate treatment for individuals of color.
Haskins emphasized the importance of acknowledging race and cultural context from the outset in treatment approaches. It is crucial to express your understanding, even if you cannot fully comprehend the experiences of being a person of color, and to demonstrate cultural empathy while actively seeking to learn more. Failing to do so will likely deter community members from seeking your services. As a profession, we have been hesitant to openly discuss race, but avoiding this conversation sends a message that we do not recognize the authenticity and validity of their living conditions.
Latinos
In a study published in the 2016 Journal of Gambling Studies, it was found that nearly 80% of mental wellness patients of Latino descent reported engaging in gambling activities within the previous month.
Many people hesitated to seek treatment due to trust concerns. They preferred seeking assistance from a trusted family member before considering clinical help.
Immigrants in the U.S. encounter added difficulties as they experience heightened pressure to support their families while earning meager incomes.
According to Haskins, individuals who immigrate to the United States often find English to be one of the most difficult languages to master. This challenge is not limited to non-native speakers alone; even native English speakers can struggle. The process of adaptation involves not only learning the language but also finding employment opportunities. In some cases, immigrants may have had a specific professional identity in their home country, but upon arriving in the United States, they may face difficulties in achieving the same occupational status. These various factors contribute to acculturation stress, resulting in psychological, spiritual, financial, and family challenges.
Native Americans
Due to their involvement with the industry, the Native American community is susceptible to the negative consequences of problem gambling.
Although the industry has brought success to numerous tribes nationwide, it can have detrimental consequences for certain individuals who may develop addiction.
Nevertheless, the majority of treatment guides fail to mention the optimal approach to be adopted within their respective communities.
Haskins brings attention to the absence of comprehensive treatment methods, which holds great significance within the Native American community.
Haskins questioned, “In the year 2022, do our theories, techniques, and prevention methods align with the cultural communities we serve?” He further highlighted the lack of a practitioner guide addressing diversity, equity, and inclusion in problem gambling disorder.
How to make gambling addiction services more inclusive
Haskins suggests three vital strategies that must be adopted to enhance services for everyone.
- It is crucial to truly understand the community – taking into account individuals who have vested interests in the community and comprehending its limitations – when considering treatment options.
- Adopt a health equity/social justice perspective to assess the community’s strengths and weaknesses, aiming to establish sustainable wellness plans. These plans should address various aspects such as transportation, land use, recreation, and housing to ensure long-term well-being.
- Create a comprehensive DEI strategy for promoting wellness by assembling a diverse team that shares a strong commitment to DEI as a core focus for their agency or unit. This team should possess a deep understanding of the community’s culture and be proficient in delivering appropriate messaging. Additionally, they should demonstrate exceptional problem-solving skills.
In addition, Haskins emphasized the importance of treatment services conducting self-evaluations and expanding the range of choices available to their patients. These options may encompass:
- Options are available for individuals who do not speak English.
- Therapy provided at home for individuals facing transportation challenges or limited availability of resources.
- Additional alternatives for patients who are deaf
- Additional choices for the LGBTQ+ community
- Increasing the presence of individuals actively engaged within the community.
- Enhanced language to address the matter more effectively
Haskins emphasized the importance of truly meeting people where they are. If we genuinely understand this, we would recognize that terms such as problem gambling or disordered gambling are inadequately centered on deficiencies. These terms place too much emphasis on pathology, resulting in increased stigma for individuals. Hence, it is crucial for us to be highly sensitive and employ alternative messaging strategies.
To learn more about equity in the prevention of problem gambling, we recommend referring to the Our Voices Matter study conducted in May 2021.
If you or someone you are acquainted with requires assistance with a gambling-related concern, please dial 1-800-270-7117, the Problem Gambling Helpline of the Michigan Department of Health and Human Services.