Curbing problem gambling in SA

In the English-speaking world, and some parts of Europe, problem and pathological gambling are treated as a significant public health problem. But for most of those who engage in it, gambling is a harmless leisure activity that may yield public benefits such as contributing more in taxation than other leisure industries, or contributing to out-of-town tourism.

Strategies that combine minimising the harm caused, with maxi-mising the benefits of gambling are therefore crucial for good public policy. Such strategies may also be relevant to other legal and illegal industries, such as those that involve the production and sales of alcohol, where analogous harms and benefits exist.

The South African gambling industry established a National Responsible Gambling Programme (NRGP) which began operating in 1999. It was subsequently agreed that this programme should be overseen by regulators as well as by industry executives through a non-profit company chaired by someone independent of both public and private sector interests.

South Africa has therefore not only pioneered responsible gambling in the developing world, it has also established a unique organisational structure for ensuring that industry executives and regulators collaborate on this issue, each bringing their expertise to the solution of problems.

This work could therefore be of interest to local clinicians and others in South Africa and abroad. The NRGP has three main divisions that work closely within a common structure: treatment, prevention and research.

Treatment begins with the provision of a free counselling line through which problem gamblers and those close to them can get expert, confidential help 24/7. Counsellors are specially trained to help with gambling problems. They refer clients for free treatment to a practitioner in their area who is part of a treatment network. There are 75 treatment professionals distributed in 53 towns and cities in southern Africa.

Prevention consists mainly of educating actual and potential problem gamblers about the dangers of gambling and how to avoid them. This takes the form of awareness campaigns targeted both at the population at large and at vulnerable communities such as the young, the poor and those receiving benefits.

This occurs through print, television and radio advertising, the distribution of promotional and informational leaflets, brochures and newsletters, and participation in community outreach initiatives and special events.

A key aspect of public education is to inform the public that individual treatment is available around the clock and free of charge. Research conducted by Ipsos Markinor in 2010 showed that 75% of South African adults living in Gauteng knew that gambling can become as serious a problem as alcoholism and drug addiction. About the same percentage of casino patrons also knew that free help is available to problem gamblers and their families, and had heard of the work of the NRGP. For patrons of shopping malls these figures fell to 25%.

The NRGP has also developed a specific programme for school-goers to address not only gambling but also decision-making in general, which teachers have rated as highly effective.

The research division includes academics at local universities and collaborators abroad. Its objective has been to understand the nature, causes and prevalence of problem gambling, to facilitate the development of good public policy, and to enhance the effectiveness of prevention and treatment strategies.

The NRGP conducted four prevalence studies between 2001 and 2009. It also conducted follow-up research on selected participants and others into gambling and poverty as well as into the neurophysiology of problem gambling. A book and several scholarly publications in print or under review have resulted from NRGP-commissioned research.

Among the main research findings are that the prevalence of problem gambling has remained more or less stable or has slightly declined since 2000; that the rural poor hardly gamble at all, but excessive gambling at informal and illegal venues is a problem in South African townships; that the lottery produces more problems for township players than in more affluent jurisdictions; and that gambling problems are significantly correlated with other psychological disorders such as substance abuse, depression and anxiety.

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