Gambling Harm – A Conceptual Framework
Gambling involves risking something of value in an activity where the outcome is determined by chance. This can include playing a game of chance (such as bingo or scratch cards) or betting on sporting events or online pokies.
There is a growing body of research that suggests gambling may have harmful effects. These can range from mild to severe and include problems with mood, anxiety or substance use.
Harm minimisation is an important focus in public health approaches to gambling. However, harm minimisation is a complex process that requires an accurate and precise definition of the scope and experience of gambling related harm and appropriate measurement tools for use in assessing harm.
The literature on gambling related harm lacks a consistent, coherent definition and this has contributed to a degree of uncertainty around the assessment of harm from gambling in public health practice. Typically, gambling related harm is measured using either behavioural indicators or diagnostic criteria and these do not necessarily provide a reliable and stable measure of harm.
Rather, a more systematic approach to measuring harm from gambling is needed, which can be achieved by developing a new conceptual framework of gambling related harm that provides an understanding of the breadth and experience of harm at different levels of engagement and behaviour with gambling. This framework will allow a more coherent understanding of gambling harm to be developed across treatment providers, policy makers and researchers.
To develop this framework, a range of methods were used including semi-structured interviews and focus groups. These were conducted in person and via telephone with a sample of individuals who identified as having experienced harm from their own gambling or affecting others through their gambling (n = 25).
Focus groups explored the breadth of gambling related harm to be experienced at the three different levels of the person who gambles, affected others and broader community. These included experiences of harm from the index case to intergenerational and legacy effects. The focus group sessions were moderated by trained psychologists and the interviewer used a semi-structured approach.
Participants were able to choose which of the three levels they identified with. They were then asked to categorise the harms they had experienced at each level.
We found that harms could be grouped into two distinct themes and these were further identified through a number of comparisons of data. This allowed a more coherent interpretation of harms to be made and also provided an initial understanding of the relationships between the different types of harms.
The first group of harms identified were those relating to the person who gambled and these can be grouped into four categories: i) impulsivity, ii) emotional control, iii) mental health issues and iv) financial loss. This group of harms can be viewed as the primary harms that people experience from their own gambling, whilst the other two are the harms that affect other people.