Gambling with an acute mental health problem

Problem gambling in India is a ‘major’ public health issue but there are only two institutions to address this clinically.

When a 36-year-old father of two in Chennai murdered his family before killing himself, it was revealed he had borrowed huge sums of money from friends to feed his online gambling addiction.

At that time, a psychiatrist told the media a telephone helpline set up by an NGO received “more calls about gambling debt” than any other forms of health afflictions. She reported she treated “more” patients addicted to gambling that year than in previous years.

Online gambling is booming. It is projected to reach $US100.90 billion in 2024. The World Health Organization (WHO) and the American Psychiatric Association (APA) recognise problem gambling as an “addictive disorder”.

The number of online punters in India is expected to spike in the coming years. Despite this, the laws around online gambling are still developing.

Gambling is now considered a “major public health problem in India” where the prevalence of “lifetime gambling” is said to be 46 percent and problem gambling at 7.4 percent.

Although gambling has strong co-relations with suicide, mental illness, social harms, debt, violence, poverty and homelessness, the problem has not been adequately addressed in India.

It is an addiction that remains in the shadows.

Many years ago, a family friend committed suicide when he found himself in a gambling-related debt trap. Neither his family members nor his closest friends knew about his addiction and the debts he had piled up.

While suicides are rare, gambling – specifically pathological or problem gambling – can cause mental health problems.

Despair, desperation, helplessness and hopelessness often lead victims to committing violence and developing “clinical conditions” such as substance abuse disorders, depression and related problems.

Gambling is addictive

Most research into gambling concludes that it is addictive and can cause mental health disorders.

While conventional wisdom links addiction to alcohol and drugs, human brains can get ‘hooked’ to certain types of behaviours such as gambling.

While people often judge a person for being weak and devoid of willpower, disorders associated with gambling constitute addiction which directly relate to a disease of the brain, which can be chronic and progressive and is characterised by failure to exercise self-control despite severe health, financial and legal consequences.

People with pathological gambling problems are often in denial and end up concealing from family and friends until it is too late.

But the signs and symptoms are quite similar to any drug addiction.

Just as a drug addict needs to progressively increase dosage to achieve a “high”, gamblers stake more and more money to reach the desired level of excitement.

They are unable to cut back even though their involvement may lead them to lie, steal or lose jobs, education and relationships. The worst stage in the life of a problem gambler is to “chase the losses” – after losing money, often returning to try to break even.

Digital technology has added a new dimension to gambling.

The ubiquity of the internet and smartphones has ensured the widespread reach of online gambling platforms and apps. These ensure anonymity, have features which makes gambling even more addictive and go beyond national borders.

Booming online platforms

Online gambling platforms are specially built to be easy to engage with and more addictive. They are far more convenient and accessible, and provide speed, instant payouts and bonuses, from the safe sanctuary of one’s own house. It is believed that online gambling may increase the likelihood of an individual developing a pathological addiction compared to traditional gambling.

While gambling and its associated mental health conditions are not publicly debated as a means to minimise or eradicate the problem, treatment for gambling-related issues is possible.

There is ample research demonstrating the efficacy of both psychosocial interventions (cognitive behavioural therapy and motivational interviewing) and pharmacological approaches.

India’s National Drug Dependence Treatment Centre at the All-India Institute of Medical Sciences (AIIMS) and Bengaluru-based National Institute for Mental Health and Neurosciences (NIMHANS) are at the forefront of addressing mental health disorders arising from problem gambling.

While treatment is possible, there is an acute lack of human resources in India to combat gambling’s mental health consequences. This is compounded by a lack of specialised training, apart from AIIMS and NIMHANS, aimed at curbing gambling in general and problem gambling in particular.

Gamblers are often subjected to stigma and perceived as individuals with poor self-control or a lack of willpower.

However, gambling for many is a disease caused by biological, psychological and social reasons.

Wider social awareness and a focus on prevention and treatment should be part of a larger strategy, both for public and private healthcare initiatives.

Karishma Godara is an Assistant Professor at O P Jindal Global University’s Jindal School Psychology and Counselling, Sonipat. She has interests in addiction medicine, behavioural addiction, epidemiology of drug use, drug policy, violence against women and girls, cyberpsychology and mental health. She earned a PhD from O P Jindal Global University. Her doctoral thesis dwelt on behavioural addiction.

Originally published under Creative Commons by 360info™.