Skip to main content

Advertisement

SpringerLink
Log in

Barriers and Facilitators of Responding to Problem Gambling: Perspectives from Australian Mental Health Services

  • Original Paper
  • Published:
Journal of Gambling Studies Aims and scope Submit manuscript

Abstract

Despite high rates of comorbidity between problem gambling and mental health disorders, few studies have examined barriers or facilitators to the implementation of screening for problem gambling in mental health services. This exploratory qualitative study identified key themes associated with screening in mental health services. Semi-structured interviews were undertaken with 30 clinicians and managers from 11 mental health services in Victoria, Australia. Major themes and subthemes were identified using qualitative content analysis. Six themes emerged including competing priorities, importance of routine screening, access to appropriate screening tools, resources, patient responsiveness and workforce development. Barriers to screening included a focus on immediate risk as well as gambling being often considered as a longer-term concern. Clinicians perceived problem gambling as a relatively rare condition, but did acknowledge the need for brief screening. Facilitators to screening were changes to system processes, such as identification of an appropriate brief screening instrument, mandating its use as part of routine screening, as well as funded workforce development activities in the identification and management of problem gambling.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Achab, S., Chatton, A., Khan, R., Thorens, G., Penzenstadler, L., Zullino, D., & Khazaal, Y. (2014). Early detection of pathological gambling: Betting on GPs’ beliefs and attitudes. BioMed Research International, 360585.

  • Berkson, J. (1946). Limitations of the application of fourfold table analysis to hospital data. Biometrics Bulletin, 2, 47–53.

    Article  CAS  PubMed  Google Scholar 

  • Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative research in psychology, 3, 77–101.

    Article  Google Scholar 

  • Brett, E. I., Weinstock, J., Burton, S., Wenzel, K. R., Weber, S., & Moran, S. (2014). Do the DSM-5 diagnostic revisions affect the psychometric properties of the Brief Biosocial Gambling Screen? International Gambling Studies, 14, 447–456.

    Article  Google Scholar 

  • Corney, R. (2011). Continuing professional development for general practitioners in the United Kingdom. Journal of Gambling Issues, 25, 108–112.

    Article  Google Scholar 

  • Cowlishaw, S., Hakes, J. K., & Dowling, N. A. (2016). Gambling problems in treatment for affective disorders: Results from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Journal of Affective Disorders, 202, 110–114.

    Article  CAS  PubMed  Google Scholar 

  • Cowlishaw, S., Merkouris, S., Chapman, A., & Radermacher, H. (2014). Pathological and problem gambling in substance use treatment: A systematic review and meta-analysis. Journal of Substance Abuse Treatment, 46, 98–105.

    Article  PubMed  Google Scholar 

  • Dowling, N. A., Jackson, A. C., Suomi, A., Lavis, T., Koziol-McLain, J., Thomas, S. A., et al. (2014). Problem gambling and family violence: Prevalence and patterns in help-seeking populations. Addictive Behaviors, 39, 1713–1717.

    Article  CAS  PubMed  Google Scholar 

  • Dowling, N. A., Cowlishaw, S., Jackson, A. C., Merkouris, S. S., Francis, K. L., & Christensen, D. R. (2015a). The prevalence of comorbid personality disorders in treatment-seeking problem gamblers: A systematic review and meta-analysis. Journal of Personality Disorders, 29, 735–754.

    Article  PubMed  Google Scholar 

  • Dowling, N. A., Cowlishaw, S., Jackson, A. C., Merkouris, S. S., Francis, K. L., & Christensen, D. R. (2015b). Prevalence of psychiatric co-morbidity in treatment-seeking problem gamblers: A systematic review and meta-analysis. Australian and New Zealand Journal of Psychiatry, 49, 519–539.

    Article  PubMed  PubMed Central  Google Scholar 

  • Goodyear-Smith, F., Arroll, B., Kerse, N., Sullivan, S., Coupe, N., Tse, S., et al. (2006). Primary care patients reporting concerns about their gambling frequently have other co-occurring lifestyle and mental health issues. BMC Family Practice, 7, 25.

    Article  PubMed  PubMed Central  Google Scholar 

  • Goodyear-Smith, F., Coupe, N. M., Arroll, B., Elley, C. R., Sullivan, S., & Mcgill, A. T. (2008). Case finding of lifestyle and mental health disorders in primary care: Validation of the ‘CHAT’ tool. British Journal of General Practice, 58, 26–31.

    Article  PubMed  PubMed Central  Google Scholar 

  • Lubman, D. I., Hides, L., & Elkins, K. (2008a). Developing integrated models of care within the youth alcohol and other drug sector. Australasian Psychiatry, 16, 363–366.

    Article  PubMed  Google Scholar 

  • Lubman, D. I., Hides, L., Scaffidi, A., Elkins, K., Stevens, M., & Marks, R. (2008b). Implementing mental health screening within a youth alcohol and other drugs service. Mental Health and Substance Use: Dual diagnosis, 1, 254–261.

    Article  Google Scholar 

  • Manning, V., Cartmill, T., Dowling, N., Lee, S., Rodda, S. N., Larner, A., et al. (2015). Responding to problem gambling—how does it work in mental health services? Paper presented at the National Association of Gambling Studies, Adelaide.

  • Mays, N., & Pope, C. (2000). Qualitative research in health care. Assessing quality in qualitative research. BMJ, 320, 50–52.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Mccambridge, J., & Cunningham, J. (2007). Against the odds: Should GPs have any involvement with gambling problems. British Journal of General Practice, 2007, 327.

    Google Scholar 

  • Problem Gambling Research and Treatment Centre. (2011). Guideline for screening, assessment and treatment of problem gambling. Melbourne: Monash University.

    Google Scholar 

  • Roberts, B. M., & Maybery, D. (2014). Dual diagnosis discourse in Victoria Australia: The responsiveness of mental health services. Journal of Dual Diagnosis, 10, 139–144.

    Article  PubMed  Google Scholar 

  • Rockloff, M. J., Ehrich, J., Themessl-Huber, M., & Evans, L. G. (2011). Validation of a one item screen for problem gambling. Journal of Gambling Studies, 27, 701–707.

    Article  PubMed  Google Scholar 

  • Rowan, M. S., & Galasso, C. S. (2000). Identifying office resource needs of Canadian physicians to help prevent, assess and treat patients with substance use and pathological gambling disorders. Journal of Addictive Diseases, 19, 43–58.

    Article  CAS  PubMed  Google Scholar 

  • Stinchfield, R., & Mccready, J. (2014). Cross-validation and comparison of seven brief problem gambling screens. Ontario: Ontario Problem Gambling Research Centre.

    Google Scholar 

  • Sullivan, S. (2011). Impulse control disorders in medical settings. In J. E. Grant & M. N. Potenza (Eds.), The Oxford handbook of impulse control disorders. US: Oxford University Press.

    Google Scholar 

  • Sullivan, S., Arroll, B., Coster, G., Abbott, M., & Adams, P. (2000). Problem gamblers: Do GPs want to intervene? New Zealand Medical Journal, 113, 204–207.

    CAS  PubMed  Google Scholar 

  • Sullivan, S., Mccormick, R., Lamont, M., & Penfold, A. (2007). Problem gambling: Patients affected by their own or another’s gambling may approve of help from general practitioners. The New Zealand Medical Journal, 120, 1257.

    Google Scholar 

  • Temcheff, C. E., Derevensky, J. L., St-Pierre, R. A., Gupta, R., & Martin, I. (2014). Beliefs and attitudes of mental health professionals with respect to gambling and other high risk behaviors in schools. International Journal of Mental Health and Addiction, 12, 716–729.

    Article  Google Scholar 

  • Thomas, A. C., & Staiger, P. K. (2012). Introducing mental health and substance use screening into a community-based health service in Australia: Usefulness and implications for service change. Health and Social Care in the Community, 20, 635–644.

    Article  PubMed  Google Scholar 

  • Thomas, A. C., Staiger, P. K., & Mccabe, M. (2012). Implementation and evaluation of brief depression and anxiety screening in clients contacting a drug and alcohol service. Drug and Alcohol Review, 31, 303–310.

    Article  PubMed  Google Scholar 

  • Toce-Gerstein, M., Gerstein, D. R., & Volberg, R. A. (2009). The NODS-CLiP: A rapid screen for adult pathological and problem gambling. Journal of Gambling Studies, 25, 541–555.

    Article  PubMed  PubMed Central  Google Scholar 

  • Tolchard, B., Thomas, L., & Battersby, M. (2007). GPs and problem gambling: Can they help with identification and early intervention? Journal of Gambling Studies, 23, 499–506.

    Article  PubMed  Google Scholar 

  • Volberg, R. A., Munck, I. M., & Petry, N. M. (2011). A quick and simple screening method for pathological and problem gamblers in addiction programs and practices. The American Journal on Addictions, 20, 220–227.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

The authors wish to thank Professor Jayashri Kulkarni for her support and expert advice, as well as the researchers who assisted with project administration and in-depth interviews, including Tomas Cartmill, Andrew Larner and Janette Mugavin. The authors are also grateful to the clinicians, team leaders, practice managers and support workers who participated in this study, as well as those who supported the broader project.

Funding

This project was funded by the Victorian Responsible Gambling Foundation, Victoria, Australia.

Author information

Authors and Affiliations

  1. School of Population Health, University of Auckland, Auckland, New Zealand

    S. N. Rodda

  2. Turning Point, Eastern Health, Fitzroy, Australia

    S. N. Rodda, V. Manning & D. I. Lubman

  3. Eastern Health Clinical School, Monash University, Fitzroy, Australia

    V. Manning & D. I. Lubman

  4. School of Psychology, Deakin University, Geelong, Australia

    S. N. Rodda & N. A. Dowling

  5. Melbourne Graduate School of Education, Melbourne, Australia

    N. A. Dowling

  6. Monash Alfred Psychiatry Research Centre, The Alfred and Monash University Central Clinical School, Melbourne, Australia

    S. J. Lee

Authors
  1. S. N. Rodda
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. V. Manning
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. N. A. Dowling
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. S. J. Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. D. I. Lubman
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to D. I. Lubman.

Ethics declarations

Conflict of interest

The authors have no conflicts of interest to disclose.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Rodda, S.N., Manning, V., Dowling, N.A. et al. Barriers and Facilitators of Responding to Problem Gambling: Perspectives from Australian Mental Health Services. J Gambl Stud 34, 307–320 (2018). https://doi.org/10.1007/s10899-017-9713-3

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10899-017-9713-3

Keywords

Search

Navigation