Gambling and mental health during lock-down: Dr Steve Sharman talks to the SSA
It will be a long time before we know how the lockdowns of 2020 affected people who gamble. Last month, researchers from King’s College London published research based on data from April 2020 on how the first lockdown affected the mental health of people who gambled compared with people who did not.
The SSA caught up with first author, and SSA fellow, Dr Steve Sharman to find out more.
“Problems come both in lockdown and outside of lockdown, when reliance on a given coping mechanism becomes the source of the depression, anxiety and stress.”
SSA: Your research looked at people who gamble and the impact of lockdown on their mental health. Can you summarise what you found?
Dr Steve Sharman: “The aim of the study was to examine if the initial lockdown had any initial impact on the mental health of people who gamble, compared to those who didn’t. In this study, we looked at depression, stress and anxiety. We found that it didn’t seem to matter if the person gambled or not – the sample was, on average, more depressed, more stressed, and more anxious in lockdown than pre-lockdown.”
“When looking between groups – non gamblers, non-problem gamblers and potential problem gamblers, participants who were potential problem gamblers were more depressed, anxious and stressed to begin with, and stayed that way in lockdown. Each group showed increases across all constructs, although not all increases were significant. We also saw that the magnitude of the change in scale scores did not differ between groups. For example, the increase in depression scores before and during lockdown for the non-gambler group, was not significantly different from that observed in the potential problematic gambler group.”
In your study, levels of depression, stress and anxiety increased across all groups, but this increase appeared to be more significant among non-gamblers and non-problematic gamblers – why do you think this was?
“That’s good question, and the answer is not straight-forward. There was concern going into lockdown that behaviours such as gambling, and even drinking and smoking would increase, as people leant a little harder on pre-existing coping mechanisms, or developed knew coping mechanisms. Whilst in this study we didn’t measure any substance use increase, it is possible that individuals without that pre-existing, coping mechanism were less well equipped to cope with the changes – they didn’t have that existing crutch to initially lean on. However, problems come both in lockdown and outside of lockdown, when reliance on a given coping mechanism becomes the source of the depression, anxiety and stress.”
“I think it’s also important to point out however, that the magnitude of the increases in all constructs across the groups didn’t differ. So although stress and anxiety appear to have increased more in the non-gambler groups, the significance only comes when looking within groups – when comparing the magnitude of change scores (pre and during lockdown), there were no significant group differences.”
Outside of COVID-19, people who gamble are more at risk of having mental health problems than people who do not gamble – what do you know about the associations between gambling and mental health problems?
“This is a really complex area, as it’s really difficult to measure the direction of a specific relationship. We know from more than one high quality systematic review that gamblers are significantly more likely than non-gamblers to report depression and anxiety; however, it’s not always clear whether the depression and anxiety is a direct result of the gambling, or whether gambling started as a release from existing depression and anxiety problems. Either way, it is likely that the problems serve to exacerbate one another, so the individual gets stuck in a cycle of feeling down, so trying to do something to relieve those feelings, in this case gambling, which results in more negative feelings, so more gambling etc. etc.”
“For some gamblers, lockdown may have been a catalyst for stopping gambling, for others, it may have been a trigger to gamble more.”
This research was based on data from April 2020, are there any indications about the long term impact of lockdown for people who gamble?
“Yes, we actually have another paper under review that looks at more gambling behaviour related changes, and our findings pretty much match the other data that was available at the time – that people who already gambled, and were maybe experiencing gambling harm have increased their gambling. But as you say this data was collected quite quickly right at the start of lockdown, as at that stage we had no idea we’d be a year down the line and still in the same situation!”
“Our initial data showed that the migration from sports betting to more harmful forms such as slots, casino games etc., wasn’t as dramatic as was first feared, although there was some evidence it was there on a smaller scale. Since then, there has been some evidence from the Gambling Commission indicating that certain forms of online gambling, so slots, casino games etc., have shown increases during lockdown periods and some evidence that for some gamblers, lockdown has proved to be an extremely difficult time, so this is something that needs to be watched very closely as the consequences could be extremely harmful.”
“However, in terms of long-term impacts; we’re approaching 12 months since the initial lockdown now, and we’ll be collecting data to measure the impact on both mental health and gambling behaviour. We’ll expect to see a clearer picture emerge of how things have changed over the last 12 months compared to that initial month we measured in this study.”
We also have to factor in how gambling itself as an activity was affected; in that initial period, almost all sport was suspended. We then had the reintroduction of some sports, of football in different countries, and then the premier league, but all whilst the bookmakers shops, and casinos stayed shut. We had sports restarting, but the only way to bet being through an online account. So, the impacts of this might become apparent over an extended time frame – for some gamblers, lockdown may have been a catalyst for stopping gambling; for others, it may have been a trigger to gamble more. For some, lockdown may have been the time they first gambled online and created an account, therefore any consequences of that may not become apparent for months, or even years.”
Where should people who are interested in gambling and mental health issues look for more information?
“So, online and mobile services are clearly in demand more right now than face-to-face services. If anyone is feeling like they are having problems with gambling, or indeed if they know someone, or are affected by someone else’s gambling, then there is help available. There is the National Gambling Helpline (0808 8020 133), plus Gamcare offer free information and support to gamblers both online and face-to-face. The NHS runs clinics in London, Leeds, Manchester and Sunderland. The Gordon Moody Association offers residential courses for men and women who have problems with gambling and can be contacted via email (firstname.lastname@example.org), by telephone (01384 241292), or via the Gambling Therapy website. Online meetings are also available through Gamblers Anonymous, and GamAnon.”
The original research was published in Frontiers in Psychiatry and is available here
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