The past year has seen renewed efforts by the NHS to get those who need it into adequate and appropriately funded treatment for gambling addiction, but the country still needs more. Since February, the NHS has committed to opening two more specialist treatment clinics located in Stoke-On-Trent and Southampton, divesting large amounts of NHS gambling addiction treatment funding from the gambling industry, and boosting its own spending to ultimately fund these crucial treatment services itself.
Delays have come as well. Original commitments stated that the treatment centres would be open in May, but this deadline was rolled forward in the wake of slow-downs. Once complete, these clinics will increase the UK’s number of potentially life-saving specialist treatment centres by 40% – up from our current meagre count of five.
Problem gambling, like many process addictions, is poorly understood by the average individual, but this condition affects 1 in 200 citizens. Researchers and mental health specialists define gambling addiction as ‘the compulsion to engage persistently with an activity, despite associated negative consequences.’ Negative consequences associated with problem gambling devastate many, and include the obvious financial challenges, but may also include social alienation, harm to family dynamics, or similar relational loss.
Process addictions are thought to originate in the brain’s rewards centre – a circuit board that lights up with dopamine when activities, particularly ones with a level of uncertainty or anticipation such as gambling, are participated in. Over time, the influx of dopamine associated with the harmful activity leads to nervous system dysregulation in a pattern very similar to those associated with substance dependence.
NHS Commitments: Divesting and Refinancing Gambling Addiction Services
NHS mental health chief Claire Murdoch stated: ‘The opening of two new gambling clinics in May, as a part of our £2.3 billion investment into mental health services, will mean we can help even more people with the most serious gambling problems.
‘It is also absolutely right that the NHS now funds these clinics independently, recognising the harmful effects this addiction can have on the nation’s mental health, and that predatory tactics from gambling companies are part of the problem, not the solution’
Historically, the NHS has received substantial financial support from private gambling franchises, with averages from last year including:
- £1 million from William Hill
- £4 million from Entain
- £4 million from Bet365
These businesses profit greatly from the development of gambling addictions in adults and teens, and while nascent gambling support services have perhaps not been in a position to reject funding before, it poses unique conflicts of interest. Reflecting on this, Murdoch stated that industry finance ‘has allowed us to roll out treatment services faster than would have otherwise been possible” but also says the time and motivation are right to move into general NHS funding.
‘Additionally, our clinicians feel there are conflicts of interest in their clinics being part-funded by resources from the gambling industry.’
NHS Commitments: The Clinics
The two new clinics in Stoke-On-Trent and Southampton, which are now anticipated to open in the summer, will join the current small host of publicly-funded specialist centres in London, Manchester, Leeds, and Sunderland, as well as the national children’s and teens’ pilot clinic. These openings come in line with an NHS commitment to funding 15 facilities of this kind by 2024.
Last year between April and September, 668 people were referred to the existing specialist care centres throughout the country, up from 575 in the same period in 2020. Presently, only those with the most clinically severe gambling patterns can access treatment in this way, with private care facilities carrying a great deal of the burden of treatment for the time being – there are far more independent clinics than NHS-funded ones offering specialisation in this field. The hope driving this commitment is, of course, to increase access to treatment for all who need it.
Geographical epicentres of the nation’s high-risk gambling populations are grouped in the North of England, representing 4.4% of adults in the Northwest and 4.9% of adults in the Northeast.
What’s Needed: Understanding the Scope and Demand
Current estimates of gambling addiction complicate this story. The harsh reality is that up to 430,000 people in the UK live with clinically treatable gambling addiction, a community of people that is unlikely to be adequately served by the promise of 15 clinics.
Gambling addiction and problem gambling also appear to be on the rise: a 2020 YouGov survey commissioned by GambleAware, a leading treatment advocacy charity, estimated 1.4 million problem gamblers nationwide, or 2.7% of the population. Meanwhile, research published in September 2021 by Public Health England estimated no less than 2.2 million problem gamblers at risk of addiction. Demand for care is high, and the treatment itself also needs to be more varied and preventative to see the best results against this growing epidemic.
Liz Ritchie, co-founder of the charity Gambling with Lives, and mother of Jack Ritchie, a young man who took his own life in 2017 after a long struggle with gambling addiction, has expressed her frustration with the recurrent issue of inadequate services.
Ritchie states: ‘We need a statutory levy on gambling industry profits to pay for more clinics, something that must be delivered in the imminent Gambling Act review White Paper’ She has also called for more early recognition training for nurses and GPs -training that could be invaluable in efforts to improve diagnosis, low-intensity intervention, and eventually referral to a specialist clinic.
However, policy focus needs to engage more than treatment options. Prevention is ultimately the first line of defence against addiction, and in light of struggles to meet demand, may be the most efficient pathway to reducing the untreated population. Ritchie states ‘Public health starts with prevention and we are dealing with a commercial sector that relies on addiction for its business model.‘
Earnest attempts to leap forward with the gambling addiction crisis in the UK need to greatly increase treatment access, but also needs to greatly reel in unsavoury advertising and business techniques by this industry with a history of predatory practices.