Problem Gambling and Suicide Prevalence

Work in Progress – Malmo June 2005

Problem Gambling and SuicideA Deadly Game

PREPARED FOR:

Work in Progress6 th European Conference on Gambling

Studies and Policy IssuesBrian Carlson BSc; MSW; CPGC

Centre for Addiction and Mental HealthProblem Gambling Project and Service

Brian CarlsonProblem Gambling Project

CAMH2

Work in Progress – Malmo June 2005Stretch your mindWhat are the Odds??

• Choose a number between 1 and 10• Multiply by 2• Add 8• Divide by 2• Subtract original number• With A=1; B=2; C=3 and so on think of a country

whose name begins with the corresponding number• Got it! Now think of an animal whose names begins

with the second letter of the country’s name.

Brian CarlsonProblem Gambling Project

CAMH3

Work in Progress – Malmo June 2005

Brian CarlsonProblem Gambling Project

CAMH4

Work in Progress – Malmo June 2005

Why did gambling expand??

To generate revenues for government

To stimulate the economy

To assist certain populations (First nations, etc.)

To rehabilitate areas & to rebuild cities

To stimulate tourism

To reduce illegal gambling

Brian CarlsonProblem Gambling Project

CAMH5

Work in Progress – Malmo June 2005

Gambling Overview

• Ontario (2003)• Casinos 10• Lotteries ~ 83• Racetracks (Slots) 16• Online Bingo Halls 70• Revenues $5.5 Billion

• Canada (2000)• Casinos ~ 50• Slot Machines ~ 21000• VLT’s ~ 38,000• Bingo Events ~ 20,000• Racetracks ~ 44

Brian CarlsonProblem Gambling Project

CAMH6

Work in Progress – Malmo June 2005

New Ontario Gaming Strategy

• No additional commercial or charity casinos• No additional racetrack slot facilities• No VLT’s• No slot machines in Bingo Halls, etc• No involvement in Internet gaming.

Brian CarlsonProblem Gambling Project

CAMH7

Work in Progress – Malmo June 2005

New Ontario Gaming Strategy

• Customer service centres staffed by problem gaming counsellors

• $4 million for problem gaming public awareness

• Education and training programs for retailers and employees

Brian CarlsonProblem Gambling Project

CAMH8

Work in Progress – Malmo June 2005

Some Features of Problem Gambling

• Competitive/energetic/restless/easily bored

• Prone to stress-related illnesses

• Distortions in thinking re: gambling ability*

• High rates of suicidal ideation / attempts*

Brian CarlsonProblem Gambling Project

CAMH9

Work in Progress – Malmo June 2005

Gambling Related Suicides

National Council of Welfare 1996 report:

• Attempts by PG more frequent than general population

• Attempts more common with PG than other addictions

• Survey of GA (US) – 48% considered and 13% attempted

Brian CarlsonProblem Gambling Project

CAMH10

Work in Progress – Malmo June 2005

Tracking Suicides• ~ 4000 Canadians die by suicide each year• 11.7 deaths per 100,000 people• 10.7 United States • 10.1 United Kingdom• 13.4 Sweden• 12.1 Norway• 14.3 Denmark• 38.7 Russian federation• 14.5. World rate

Brian CarlsonProblem Gambling Project

CAMH11

Work in Progress – Malmo June 2005 TrackingGambling Related Suicides

• 2002 – only eight provinces asking questions about gambling when investigating suicides

• 2003 – Coroners from across the country agree to track suicides related to gambling

Brian CarlsonProblem Gambling Project

CAMH12

Work in Progress – Malmo June 2005

Gambling Related SuicidesCanada

• Nova Scotia - 6.3%• NL - 6%• ON - 6 deaths • Manitoba -12 cases• BC - 1 case• QUE – 129 cases• AL – 9.5%

• Estimates

• Safety Council 360 –400

• Newspapers - 85

Brian CarlsonProblem Gambling Project

CAMH13

Work in Progress – Malmo June 2005

Why the Increasing Numbers???• Financial stresses• Relationship issues• Work related problems• Legal concerns• Hidden• Sudden realization• Total desperation

Ensuing mental health issues

Brian CarlsonProblem Gambling Project

CAMH14

Work in Progress – Malmo June 2005

Problem Gambling, Mental Health& Suicide

What’s The Connection?• Reduce feelings of loneliness and depression

• Depression as a result of gambling

• Reoccurring bouts of depression & anxiety

• Downward Spiral

Brian CarlsonProblem Gambling Project

CAMH15

Work in Progress – Malmo June 2005

Problem Gambling and Mental Health

• 92% -Major psychiatric disorder (LT)

• 54% - Psychiatric disorder (T of T)

Brian CarlsonProblem Gambling Project

CAMH16

Work in Progress – Malmo June 2005

Problem Gambling and Anxiety

– 3x higher rates of anxiety disorders

– 5x higher rates of agoraphobia

– 6x higher rates of OCD

Brian CarlsonProblem Gambling Project

CAMH17

Work in Progress – Malmo June 2005

Problem Gambling and Depression

• 50-75% -experienced depression (Inpatient)

• 20% - depression after stopping gambling

Brian CarlsonProblem Gambling Project

CAMH18

Work in Progress – Malmo June 2005

Indicators of SuicideEmotional

• Desperate

• Angry

• Sad

• Ashamed

• Guilty / Worthless

• Lonely

• Disconnected

• Hopeless / Helpless

Brian CarlsonProblem Gambling Project

CAMH19

Work in Progress – Malmo June 2005

Indicators of Suicide Behavioral

• Putting affairs in order

• Withdrawal from friends

• Impulsivity

• Giving away possessions

• Loss of interest in hobbies

• High-risk behaviours

Brian CarlsonProblem Gambling Project

CAMH20

Work in Progress – Malmo June 2005

Indicators of SuicidePhysical

•Lack of interest in things

•Disturbed sleep

•Lack of physical energy

•Loss of sexual interest

•Increased substance use

•Adverse life situations

•Lack interest in appearance

•Talk of successful suicides

Brian CarlsonProblem Gambling Project

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Work in Progress – Malmo June 2005

Indicators of SuicideCognitive

• “All of my problems will end soon.”

• “No one can do anything to help me now.”

• “I just can’t take it anymore.”

• “I wish I were dead.”

• “Everyone will be better off without me.”

• “I can’t do anything right.”

• “How could I be so stupid!”

Brian CarlsonProblem Gambling Project

CAMH22

Work in Progress – Malmo June 2005

Assessing Suicidal RiskRisk Factors used to estimate Suicide Risk:

7 Age6 Gender5 Stress

4 Symptoms3 Resources

2 Prior Suicidal Behaviour1 Current Suicide Plan

Brian CarlsonProblem Gambling Project

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Work in Progress – Malmo June 2005

Suicide Intervention

Assessing Risk:– Current Suicide Plan– Prior Suicidal Behaviour– Resources

These are the 3 highest risk factors (immediate) when people are contemplating suicide.

Brian CarlsonProblem Gambling Project

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Work in Progress – Malmo June 2005

How to respondDo:

Be availableBe attentive, sincere Be respectfulTell them you care

DON’T:Be judgmentalDon’t give advice or lectureDon’t leave them aloneDon’t interrogate

Brian CarlsonProblem Gambling Project

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Intervention Techniques

• Internal Resources• Self – esteem

• Self – confidence

• Coping skills

• Problem Solving abilities

• Employability

• Others….

Brian CarlsonProblem Gambling Project

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Work in Progress – Malmo June 2005

Intervention Techniques• External Resources

• Emergency ( short –term ) supports

• Long term

• Lifetime

Brian CarlsonProblem Gambling Project

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Survivors of Suicide• Usually experience

– Shock– Guilt– Denial– Shame– Self-blame– Depression– Stress– Despair– Overwhelmed

Brian CarlsonProblem Gambling Project

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Family Members

Brian CarlsonProblem Gambling Project

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Canadian ResourcesCanadian Association on Suicide Prevention http://www.suicideprevention.ca.

Understanding Suicide Prevention – Canadian Mental Health Association-Wellington Dufferin Branchhttp://www.cmhawdb.on.ca/suicide.htm

Suicide Information and Education Centrehttp://www.suicideinfo.ca/

For further local resources for Ontario check the following website: http://www.suicideinfo.ca/csp/go.aspx?tabid=86

Brian CarlsonProblem Gambling Project

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Work in Progress – Malmo June 2005

International Resourceswww.who.int/mental_health/prevention/suicide/country_reports/en/index.html

www.suicide-helplines.org 51 Countries

www.befrienders.org 15 Languages

www.survivorsofsuicide.com

September 10, 2005 WORLD SUICIDE PREVENTION DAYInternational Association for Suicide Prevention(Co-sponsored by the WHO)

Brian CarlsonProblem Gambling Project

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Work in Progress – Malmo June 2005

Thank you !!