Young people leaving home for the first time and patients with mental health problems should be asked about their gambling habits when they visit the GP, health leaders have said.
People who have problems with gambling should be identified “as early as possible” and offered support, according to new guidance from the National Institute for Health and Care Excellence (Nice).
Health leaders described the “massive” and “devastating” impact problem gambling can have on people’s lives.
The 2023 Gambling Survey for Great Britain suggests that as many as one in 40 (2.5%) adults who responded to the poll may gamble in a problematic way.
An additional 12% of people who responded to the survey appear to gamble in a way that puts them at increased risk of gambling-related harms, Nice said.
The new Nice guidance says that people who seek help for mental health issues should be asked about problem gambling in the same way they are asked about drugs, smoking and alcohol.
Healthcare workers and those working in social services should ask people about gambling habits in a number of situations, including GP appointments or health checks, Nice said.
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People at risk of gambling harms include those with depression, anxiety, post traumatic stress disorder (PTSD), personality disorder or thoughts about self-harm or suicide, it said.
Those who have just left home for the first time should also be quizzed about their gambling, along with people who have acquired brain injuries which may make them more impulsive, according to the Nice document.
People who take drugs which affect impulse control – which can include certain Parkinson’s medications – and people with attention deficit hyperactivity disorder (ADHD) may also be at risk, Nice said.
And those who seek help for a possible addiction – including alcohol or drug dependence – are also at risk.
Those with a family history of gambling problems may also need targeted support, Nice added.
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It said that people should be urged to assess the severity of their problem using a questionnaire on the NHS website.
Those with a score of eight or above should be referred to a specialist NHS gambling clinic while people who score lower on the severity scale may also be offered other support available, Nice said.
People experiencing gambling-related harms should be asked directly about suicidal thoughts and supported, it added.
They should also be counselled on practical ways to stop gambling, including blocking software, Nice said.
Staff have been reminded that some people may not seek help due to the stigma surrounding problem gambling and have been urged to ask direct questions to those at risk.
The Nice document also suggests people should be asked about gambling “at each key contact with the criminal justice system”, including police, courts and prisons.
On urging health workers to consider asking people about gambling if they are a young person who has recently flown the nest, the Nice guidance adds: “The committee identified, based on their own experience, that young people leaving home for the first time may be particularly at risk, and so they added this to the recommendations.”
Professor Jonathan Benger, Nice’s chief medical officer, said: “Gambling-related harm has a devastating impact on those who experience it, and the people close to them.
“Our useful and usable guideline will help healthcare professionals and others to identify those needing help earlier and ensure they get the treatment and support they need.”
NHS England’s national clinical director for primary care, Dr Claire Fuller, said: “We welcome Nice’s decision as gambling can have a massive impact on people’s lives and the lives of the people that care for them, and as healthcare professionals we need the right tools to help tackle gambling-related harms.
“Over the past few years, the NHS has made significant progress in expanding treatment for gambling addiction with the rollout of 15 specialist clinics across the country.
“So, if you’re worried about your gambling, there is support available, and you can directly refer yourself to your local NHS gambling clinic.”
Liz Ritchie, who co-founded the charity Gambling with Lives with her husband after the suicide of their son Jack – and who was part of the Nice committee that wrote the guideline, said: “This guideline will save lives.
“At last GPs, health and social services professionals will ask about gambling as part of routine checks and they will be trained to recognise the very high suicide risk connected to gambling.
“Gambling suicide is a public health emergency and our NHS is coming to the rescue to save lives across the country.”
Dr Adrian Hayter, medical director for clinical policy at the Royal College of GPs, said: “As GPs, we see the devastating impact that gambling-related harms have on our patients and their families, but compared with other addictions, the signs of problem gambling can be well hidden.
“We know that patients often only ask for help once gambling has already negatively impacted their lives and this Nice guidance aims to encourage people to discuss their issues around gambling with a trusted healthcare professional in a confidential space before their problems worsen.
“However, we have to acknowledge the constraints of a 10-minute appointment that is already too short to accommodate the increasingly complex needs of our patients.
“The current gambling addiction service enables self-referral, and more community-based resources and signposting should be available at a local level through voluntary organisations as part of an integrated approach, rather than a medical model of referral and gatekeeping by GPs.”
A spokesperson for the Betting and Gaming Council (BGC), said the “overwhelming majority” of British people who gamble “do so safely and responsibly”, adding: “BGC members voluntarily contributed over £170 million over the last four years to tackle problem gambling and gambling related harm, including £50 million in 2024, funding an independent network of charities currently caring for 85% of all problem gamblers receiving treatment in Britain.
“The most recent NHS Health Survey for England estimated that 0.4% of the adult population are problem gamblers.”
Gambling minister Baroness Twycross said: “We welcome this guidance from Nice on identifying, assessing, and managing gambling-related harms, which will support those experiencing harmful gambling to get access to the right support.
“We know that clinical treatment is not necessarily right for everyone, but it is important that there is a full spectrum of support as we strengthen treatment options.
“The Government’s plans to introduce a statutory levy, which will generate £100 million each year, will provide the investment needed to further expand the support and treatment on offer for those in need.”
– To take the NHS’s gambling assessment visit: https://www.nhs.uk/live-well/addiction-support/gambling-addiction/