The Productivity Commission categorised a number of sources available to help people with gambling problems (Figure 21). These include designated gambling counselling agencies (eg Gambling Care and Clubcare in the ACT), a range of other professional services (eg generic welfare services, private counsellors), group support services (eg Gamblers Anonymous) and informal social networks.
As previously noted, however, the 2001 ACT Gambling Survey and 2001 Needs Analysis found that gambling support services in the ACT at the time were not meeting the demand from people seeking help for their gambling problems. People often turned to families and friends, or to other generic community agencies for help.
Moreover, these studies found that the particular needs of cultural groups and women were not being met.
Many studies of help-seeking behaviour also have found that problem gamblers often do not seek help for their problem until they have a crisis of some sort – for example with relationships, suicidal feelings or financial problems. Women are more likely to cite financial problems as a key motivation to seek help. A recent study to evaluate intervention strategies available to problem gamblers and others affected by problem gambling in Victoria also found that pressure from families and friends was a key trigger for some problem gamblers seeking assistance. 243
240 Brown, S. et al. (1997) op cit; Brown et al. (2000) op. cit.
241 Brown, S. et al. (1999) op. cit.
242 Brown, S. et al. (2000) op. cit, pp.105-115.
243 New Focus Research Pty Ltd (2004) op. cit, p.15.
Figure 19. Avenues for problem gamblers to access help services
People affected by problem
gambling
PROBLEM GAMBLING TELEPHONE INFORMATION AND
REFERRAL SERVICES G-line
Amity Community Services (NT)
PROBLEM GAMBLING COUNSELLING SERVICES
Break Even network Anglicare Relationships Australia Wesley Gambling Services
etc INFORMATION AT
GAMBLING VENUES 'Smart play' advice
Brochures/leaflets Signs/notices
OTHER INFORMATION AND REFERRAL SOURCES Informal social networks (partner/family/friends)
Telephone book Print/electronic media
GPs, etc
OTHER HELP SERVICES Problem gambling
Self help guides OTHER PROBLEM GAMBLING
COUNSELLING or TREATMENT SERVICES
Hospitals/Clinics Individuals
PROBLEM GAMBLING GROUP SUPPORT SERVICES Gamblers Anonymous
GABA (Tasmania)
COMMUNITY EDUCATION PROGRAMS Responsible gambling GENERIC HELP SERVICES Community Health Services Emergency relief services
Other welfare services
GENERIC COUNSELLING SERVICES
Financial Relationship
Legal, etc
Source: Productivity Commission (1999) Australia’s Gambling Industries. AusInfo, Report No. 10, Figure 17.1.
Barriers to help seeking for women with gambling problems include, but are not restricted to:
• Stereotypical views of a woman’s role as home-maker and the resulting shame and disappointment if they are not fulfilling this role;244
• Cultural perceptions that women are the strong nurturers and the shame associated in admitting a problem;245 and
• Fear that social benefits will be taken from them if the extent of their gambling is known.246
A large body of empirical research across a wide range of public health areas have shown that ‘men are reluctant to seek help from health professionals’ for problems
244 Brown, S. et al. (1999) op. cit., p.25 245 ibid, p.24
246 ibid, p.30
such as physical and psychological problems and stressful life events.247 Gambling studies have also consistently found that men of different ages, ethnicities and social backgrounds are, on average, less likely than women to seek professional help.248 The differences in help seeking behaviour between men and women have been identified as crucial barriers to early interventions that address gambling-related problems.
These common gender differences in help-seeking behaviour have been explained by relationships between masculine gender-role socialisation, social norms and ideologies about masculinity.
Brown et al. found that women in different cultural groups had very different views of the meaning of gambling and its impact on their lives.249 They also found that different communities had different views about the supports available to them and preferred different ways of getting help for gambling problems, shaped by the cultural background and social environment of the particular groups. The 2001 ACT Needs Analysis also found that service providers were not being accessed by gamblers from non-English speaking backgrounds who were experiencing problems. Only a small proportion of GAFCS clients in the ACT who had sought help for gambling problems were from a non-English speaking background.250 Even when gamblers from non- English speaking backgrounds had sought help they were likely to encounter difficulties.
For many cultural groups, especially those with limited English speaking skills, seeking help for gambling problems outside the family is often difficult. While barriers to help-seeking can vary in relation to cultural background, the most common factors identified include251:
• Cultural factors and suspicion of mainstream services: Mistrust of government services can be a barrier, particularly if they have suffered government persecution in their country of origin. Reliance on family support and personal problem management strategies are preferred to consulting professional support agencies. For some Asian groups confiding personal problems to an ‘outsider’ is unacceptable; others lack trust and confidence in counsellors.252
• Shame and loss of face: For many cultural groups, gambling is often a ‘hidden issue that is rarely discussed in public’.253 In such communities, problem gambling is a ‘private issue, rarely discussed outside the family’,254 and an
‘even greater issue of shame and stigma than for mainstream Australians’.255
• Language barriers: As well as barriers to accessing services and understanding, language and communication differences can also make the
247 Addis, M.E. and J. R. Mahalik (2003) op. cit.
248 For example, Productivity Commission (1999) op. cit.; J. McMillen et al. (2001b) op. cit.
249 Brown, S. et al. (2000) op. cit, pp.85-93.
250 ibid.
251The following categories are derived from S. Scull et al. (2002) op. cit., p.30
252 ibid; McMillen, J. et al. (1998) op. cit.
253 ibid, p.33; Efstratiou, N. (1997) op. cit.
254 Scull, S. et al. (2003) op. cit., p.19 255 ibid, p.33
counselling process more difficult. For example, in close communities it is possible that the client needing translating assistance will know the translator.
• Concerns about trust and confidentiality: Seeking help is difficult in close-knit communities where the problem could become more widely known. Others are concerned that by accessing mainstream help agencies, details of their gambling problem will be given or accessed by other government bodies; 256
• Unfamiliarity with and resistance to the concept of counselling:
Misconceptions about what counselling involves. Many cultural groups are not familiar with western psychological counselling practices and prefer financial and practical assistance. Some cultures understand a counsellor to be an advisor and expect to be told what to do. 257
• Lack of information: Members of cultural groups with limited English literacy skills may be unaware that support services exist or how to contact them.
Others are unaware that gambling agencies can provide support to the family and friends of gamblers; 258
• Lack of culturally appropriate services: As found in the 2001 ACT Needs Analysis, a common finding in Australian research is that gambling support services are not always sensitive to and appropriate for the needs of different cultures. For example, indigenous and Arabic women are reluctant to discuss problems in front of men and vice versa. Cultural difficulties can arise when only mixed sex group sessions are available, or when there is perceived male domination of group discussion.
If people do seek help outside the family, they are more likely to contact close members of their church or community leaders, rather than mainstream counselling or government services.259 Yet the shame associated with gambling problems can make gamblers reluctant to use even those sources of help, especially where the cultural community is small and closely connected.