GAMBLING is called the ‘hidden addiction’ for several reasons. The main one is that you cannot ‘see’ it in the way that you can see a substance addiction, although even here it’s true that many functioning or highly functioning addicts will hide their state. Gambling addiction has a low public profile; there is generally more ignorance about ir than substance addictions. In service provision for helping those with severe gambling issues, there is little in the way of national strategy and provision, just one NHS clinic in the UK. GPs and probably most psychologists and psychiatrists lack experience of it. Only 5% of people with gambling problems seek help, only 1% receive it. These figures are much lower than, for instance, those for alcohol addiction.

Addiction is a mental health issue. Unfortunately, addiction is often made separate to mental health. Service providers talk about ‘mental health and addiction’ for example. This is despite the fact that the majority of people with addictions also have other mental health problems such as depression, bipolar, anxiety or a second addiction. In this confused state of affairs gambling addiction receives less than the attention it requires. A current statistic is that 0.7% of the polulation have severe gambling problems but in Northern Ireland and Wales the figure is higher. Add to this estimates of less severe but significant and ‘at risk’ gamblers and the figure rises to 5% of the population. Other mental health conditions are classed on scales of severity. Depression for instance is roughly mild, moderate or severe, though other ratings such as Beck’s identify four degrees.

Gathering data for epidemiology of addiction is notoriously difficult, and more so in the case of gambling addiction. While stigmatised heavily still, there is less stigma around substance addiction than gambling. Individuals are more reluctant to reveal a gambling addiction, and it is often harder to spot by those close to them. That is, of course, util the ‘rock bottom’ is reached in most cases. Some people will, though, modify gambling behaviour with lesser shocks.

All mental health problems can affect anybody in society, rich or poor, young or old, educated or not, male or female. However such a statement needs interpreting carefully. In public discourse we tend to hear most from the better educated, usually those with more material assets and cultural capital. It is well known that middle class people are better equipped to access scarce mental health resources. This, of course, is a generalisation and as such can never apply to individuals with unique life stories and contexts.

However, as in the the body politic as a whole, those most voiceless tend to be the more deprived in society. Deprivation can include material, educational and cultural capital. There are unquestionable demographic strata linking deprivation with mental health problems. While those we are likely to hear from most about the impact of gambling addiction provide vital testimonies, we need to be aware that many who suffer the results of gambling have little or no access to having their stories heard.

We are not surprised that bookmakers and their electronic gambling devices cluster in deprved areas. It’s important to recognise that the money lost to gambling by many is phenomenal given the mean disposable income available. Proportionally, like regressive taxation such as VAT, a loss of as little as £50 can lead to a spiral of debt, loss chasing and other negative consequences. It has been repeatedly pointed out the design of machines is responsible for gambling behaviours in those who can least afford to play. The proliferation of machines, not just in bookmakers, but in arcades, pubs and bingo halls, provide enticement to play fast and hard. Whether the stake is £2 or £30 or £100, the impact of any losses will be directly proportional to the circumstances of the player.

It’s true, of course, that as well as slots, similar dangers accrue to online casino-type games. Here, interestingly, research suggests that the heaviest player population is young professional classes. It’s early day sin data gathering but the take-up of online gambling opportunities seems more than likely to increase. With the normalisation of betting and gambling – and this includes not only advertisements on tv around sporting fixtures but lotteries from big charities – a major worry is about children’s behaviour in the future. May of them may already sitin a family setting when watching a football match and their father or sister may be more interested in the time of the first corner, or the score at half time rather than the game itself. In this, as most things, parental guidance and some educational input are important.

It is often pointed out that most people bet and gamble responsibly, which is true. The tension thus arises between regulatory practice and personal freedom (business freedom too).

It does seem, though, that some electronic gambling machines by their very design encourage dangerous gambling habits, firstly in those who already are vulnerable via pre-existing problems, and secondly by enticing new users who become ‘hooked’ on the experience. If ‘reponsible gambling’ is to mean anything, a good share of the responsibility must rest with those who provide the machines. No matter how low the stakes become, if the design does not change the money will keep pouring in from those who can least afford it, the voiceless and largely hidden population suffering the ‘hidden addiction’ affecting the populace as a whole.