The current restrictive measures required by law to reduce the risk of gambling disorders – distance meter and limitations on the number of bets and time slots – they are not very effective, for health workers and pathological players who “agree: today there are not enough measures to make a person with a gambling addiction problem find systems that can help him to exclude himself. There is a discrepancy between what is considered more or less effective, by those who do not have the problem compared to those who experience it “, he explains Mauro Pettorrusopsychiatrist and researcher at the Gabriele d’Annunzio University of Chieti, among the authors of the pilot study ‘Preventive strategies in gambling disorder: a survey investigating the opinion of gamblers in the Lazio region’, coordinated by the Italian Society of Psychiatry (Sip) , published in the ‘Evidence based Psychiatric Care Journal of the Italian Society of Psychiatry’.
Gambling disorder is an increasing phenomenon around the world. In Italy its prevalence is about 1.01% and mainly affects men (average age 27 years). To date, many international governments have adopted restrictive measures to contain and prevent the transition from social behavior to problematic to pathological, but with little effectiveness. This observational and cross-sectional study was developed precisely to explore the views of both gamblers and mental health professionals to identify the best prevention strategies.
I studymade in the Lazio region, he investigated – with a questionnaire distributed in gaming rooms, clinics, hospitalization facilities and online – opinions on the impact of various legislative measures on subjects who had played at least 5 times in the previous year (sports betting, poker, online games or slots). The sample – with a strong prevalence of males compared to women, ratio 4 to 1 – included 289 pathological players (Pg), 259 problematic players (Prg) and 385 non-pathological players (Npg) indicated according to the Sogs assessment tool (South oaks gambling screen), the best known and most used for general screening of gambling disorders. The data were compared with what was expressed in another online questionnaire by professionals (psychiatrists, psychologists, psychiatric rehabilitators).
“The main result of the study – observes the psychiatrist Pettorruso – it’s about differences in the perception of the problem, on the part of healthy and pathological subjects, on what are a series of measures for the containment and prevention of pathological gambling ”. Three issues highlighted some difference of opinion in the three groups. The measure of limiting the number of games in a period of time is useless for 61% of pathological players, against about 40% of non-pathological and problematic players. Also on the limits in the opening hours of the gambling halls, a certain discrepancy was seen between the pathological players who do not consider the measure effective (60%) compared to almost 50% of the other two groups.
Particularly interesting is the judgment on the distance meter – established by law 189/2012 – which provides for a minimum distance between gaming rooms and meeting or worship centers. Only 38% of pathological players rate this measure positively, compared to 50% of other players. “The distance meter – observes Pettorruso – it is an ineffective measure for the majority of pathological players and for a third of doctors. Instead, it is considered more effective by people who do not have actual gambling addiction, and this risks having a paradoxical impact. People who have developed an addiction problem, making use of their personal experience, seem to tell us that for them it is not the physical distance that limits the relentless urge to play (craving) due to addiction “.
Commenting on the results of the study, Pettorruso notes that “to counter the problem of gambling addiction it is more effective to set up the self-exclusion register, to provide information on the risks of gambling, but also to limit its advertising in addition to prohibiting access to gambling halls for children under the age of 18, who are particularly fragile “. Precisely for these measures, the highest percentages of appreciation by the sample were recorded (all over 80%).
The most welcome proposal concerns the creation of exclusion registers (88.2% of pathological players are in favor) which prevent members from entering places where gambling is practiced. It is the players themselves who join (self-exclusion registers), but in some countries they can be registered by relatives or even on the proposal of mental health professionals. This measure was introduced in Germany and Spain – where you need to insert your health card to play – “with promising results in the long term, especially if integrated with local services for mental health ”, as stated in the study. “The players, when it comes to looking at their own experience on measures to limit access to the game – notes the psychiatrist – direct us to help them in making and protecting a care decision. Like a person who quits smoking: instead of moving the tobacconist out of the city, he asks to help him so that he cannot sell him cigarettes “.
Other possible measures deemed effective by the players involved in the study, to prevent addiction, concern the revision of the game parameters of the devices, such as the insertion of a maximum limit on the bet amounts (promoted by 67.8% of pathological players), directing those at risk to the network of care services in the area and improving psychoeducation (70-80% of the sample). “In the light of these data – concludes Pettorruso – we must consider gambling problems, such as addictive diseases, with qualified and integrated interventions. A push would be needed to strengthen dedicated health services and to finance the search for innovative and effective treatments to cure these diseases with a devastating social impact “.
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