Expanding problem gambling screening environments: A public health approach to early identification of problem gambling in non-clinical settings

Abstract

Increasing gambling opportunities, new gambling technologies, and presentation of problem gambling alongside multiple co-existing conditions, present the challenge of minimising harm within fast changing, continually expanding gambling environments. In layman’s logic, this suggests a need for more eyes and ears to identify individuals who may be experiencing gambling harms and ensure timely support. This is precisely the logic reflected in the Effective Screening Environments problem gambling public health (PGPH) service, funded by the New Zealand Ministry of Health. The Effective Screening Environments service, aims to expand problem gambling screening and referral practices beyond clinical settings, to include pertinent stakeholder organisations that are likely to come into contact with individuals experiencing gambling harms (e.g. social services, debt agencies, health services, and corrections). A review of literature found a few studies exploring the role of general practitioners in problem gambling screening but limited evidence of similar state-funded services elsewhere, suggesting this PGPH service’s novelty. Evaluation findings in relation to the delivery of this service by eighteen providers (extracted from a wider multi-methods evaluation of five PGPH services which involved analysis of provider progress reports and data from a staff survey and a staff focus group discussion) are presented. Reported outputs included delivery of awareness-raising presentations and training on brief screening, tailoring screening tools to meet stakeholder organisation needs, and development of culturally appropriate screening and referral approaches. Outcomes included increased awareness among stakeholder organisations about the significance of gambling harms and implementation of screening practices among some organisations. Providers reported a number of challenges in delivering this service and documented approaches used to overcome some. Based on the principle that open sharing of both challenges and best practices can lead to service improvement, this presentation summarises key aspects (inputs, outputs, outcomes, barriers and external influences) of practical relevance to similar PGPH initiatives.