Although not everyone who gambles has an associated problem with addiction, problem gambling is an often underestimated factor when it comes to mental health issues. It can easily be classified as a “silent menace” in our modern society, with gambling related suicide receiving little attention. As concerned organisations and citizens around the globe commemorate World Suicide Prevention Day on 10 September 2022, it is highly likely that this ominous link between problem gambling and suicide will be overlooked.
A clear indication of this is the dearth of research being conducted into the confluence of addictive gambling behaviour and mental health issues, especially when gambling addicts are lost by suicide. The most significant impact of this is that gambling addicts and their families are not aware of the causes and symptoms and, most importantly, the avenues for assistance that are available to them.
What do the statistics tell us about gambling addiction and suicide?
A socio-economic impact study on gambling, conducted by the National Gambling Board (NGB) in South Africa in 2017, included a household survey of 4 008 respondents, 1 008 telephonic interviews and 3 000 face-to face interviews. In response to qualitative questions, the majority of interviewees referenced the negative emotional and behavioural issues associated with gambling, especially those related to anxiety brought about by losing money when gambling and the impact of indebtedness from funding gambling pursuits. Some of the verbatim responses relating to depression, suicide and thoughts of suicide include:
“In my experience, I have a friend who committed suicide because of gambling”;
“To start with, like if you lost everything you are in a point of suicide. Before you can even get to the point of suicide, there is stress”;
“Depression from being in debt. When you gamble, you borrow money from people and you get in debt. And then you get depressed because you don’t have money to pay those people.”
A quick internet search reveals only a handful of studies into gambling and suicide that have been done worldwide recently. The most prominent being a 2020 study in Sweden, a 2021 study in the United Kingdom and an East Africa study.
The Swedish study was based on 11 years of data (2005 – 2016) and pointed out that the causes of suicide are multi-dimensional and likely to involve more than one factor, but that gambling disorders were associated with higher average rates of suicide. They cited that individuals with gambling addiction
were 15 times more likely to commit suicide. Other contributing factors which work alongside gambling addiction to increase the likelihood of a suicide attempt include problems with alcohol and drugs.
The most recent study in the UK, compared the gambling behaviour of attempted suicide cases amongst young adults who had been surveyed using the Problem Gambling Severity Index (PGSI). They found that 37% of men and 14.5% of women surveyed as having attempted suicide, also had scores indicative of gambling problems.
A recent East African study by Kaggwa, et.al (2022) asserts that many individuals with a severe gambling disorder have gambling-related suicidality. Using media reports on suicides, although the study sample size was relatively small, they found a correlation between the number of gambling-related suicides and the countries with the most widespread opportunities to gamble. All the suicides where in Kenya (10 out of the 18 cases); Uganda (7 of the 18 cases) and Tanzania (1 case). Interestingly, betting on soccer was the most common type of gambling reported.
Emerging knowledge suggests that problem gambling is rapidly evolving into a public health concern in many international jurisdictions. Problem gambling often occurs concurrently with other behavioural and psychological disorders such as mental health problems and substance abuse which can exacerbate, or be exacerbated by, problem gambling (Griffiths, 2007).
Currently in South Africa, it is unclear whether problem gambling is viewed as a public health or social issue. Although research has explored problem gambling with respect to frequency, amount of gambling, forms of gambling, prevalence and motivation for gambling, little has been explored on the public health implications of problem gambling in South Africa.
For the NGB this is of great concerned, with gambling-related suicide being a clear worst-case outcome of addiction. A thorough investigation of problem gambling in South Africa through a public health lens, that involves an integrated multi-disciplinary approach, is therefore essential and will be explored in the upcoming socio-economic study to be undertaken by the NGB.
The NGB, under its mandate to promote gambling activities in a legal, safe and crime-free environment and protect punters from the over-stimulation of the latent need to gamble, brings you the following signs and symptoms to help you identify problem gambling.
What does gambling addiction look and feel like?
The Problem Gambling Severity Index (PGSI) is a standard tool used to assess risk behaviour in problem gambling. The tool is used by mental health care professionals to identify if an individual is at risk for gambling addiction, using a number of questions and a rating scale (Never, Sometimes, Most of the Time; Always). It is important to note that categorisation through the PGSI is not the same as clinical diagnosis, which requires assessment by a clinician. However, these questions are useful for an individual to start thinking about their behaviour objectively, and to reach out for professional help:
- Have you bet more than you can afford to lose?
- Have you needed to gamble with larger amounts of money to get the same feeling of excitement
- Have you gone back on another day to try to win back the money you lost?
- Have you borrowed money or sold anything to gamble?
- Have you felt that you might have a problem with gambling?
- Have people criticized your betting or told you that you had a gambling problem, whether or not you thought it was true?
- Have you felt guilty about the way you gamble or what happens when you gamble?
- Has gambling caused you any health problems, including stress or anxiety?
- Has your gambling caused any financial problems for you or your household?
Break the silence, reach out for expert help
The World Health Organisation (WHO) spearheads the global campaign for the prevention of suicide, saying that: “An estimated 703 000 people a year take their own life around the world. For every suicide, there are likely 20 other people making a suicide attempt and many more have serious thoughts of suicide. Millions of people suffer intense grief or are otherwise profoundly impacted by suicidal behaviours.” The WHO recommends awareness-raising through their 2021 – 2023 campaign tagline: “Creating Hope through Action”. Above all, this entails the reduction of the stigma that surrounds people who suffer intensely from suicidal thoughts.
The NGB also highly recommends that gamblers or their families, who are concerned about gambling addiction, reach out to the mental health experts at the South African Responsible Gambling Foundation (SARGF) who run the National Responsible Gambling Programme, on the toll-free number 0800 006 008 The Foundation is supported by regulators and gambling operators to run a completely free counselling service to gamblers who find themselves in trouble with addiction. SARGF can be contacted 24 hours a day, seven days a week. Counselling services are provided over the phone or through referrals for face-to-face treatment through a national network of professionals.
