Should GPs be screening for problem gambling in young poeple?

A few weeks ago I felt quite happy (smug even!) at reaching a mini-milestone for the development of my health risk screening app: I delivered the final set of questions for the app (to be filled out by young people prior to their doctor’s appointment) to the software developers.

The questions are based on the Home, Education/employment, Eating, peer Activities, Drugs, Sexuality, Suicide/depression and Safety (HEEADSSS) approach to assess for psychosocial health in young people (more info here). As part of the process of transforming the quite lengthy interview guidelines into a brief questionnaire, I adapted a recently developed e-heeadsss tool for headspace centres and consulted with young people and general practitioners (GPs). And I felt pretty good about the final list being a representative and appropriately youth (and GP)-friendly!

Gambling was not an issue that had been included or suggested nor did it occur to me either. However, listening to a recent Background Briefing podcast investigating problem sports betting among young males has made me look further into the issue. The podcast makes for sobering listening, detailing the insidious tactics betting companies undertake to ‘groom’ their customers.

As an Australian Rules football fan, who’s seen betting advertising increasingly saturate the experience of watching it via television, radio and even at the ground (there is no escape!) this wasn’t a massive surprise. That said, the amount of money lost by the young men was breath-taking, losses that they may never be able to repay.

What the investigation did not really explore in much depth was the incidence and whether there are any health effects to problem gambling.

In terms of the incidence, the Problem Gambling Research and Treatment Centre report that young people are at higher risk of problem gambling compared with adults. A median of 73% of young people have gambled during the past year, with 4-8% falling into pathological gambling (which is 2-4 times the rate of the adult population). An additional 10-15% are at risk of problem gambling.

Apart from the obvious financial stress and problems, the report outlines how problem gambling is also associated with a range of psychosocial problems. Youth problem gambling is associated with anxiety, depression and suicide ideation. It is also associated with substance use, physical violence, and poor academic achievement. The additional problem with gambling is that it is often hidden and people don’t seek treatment.

So it would suggest that GPs are actually ideally positioned to screen for this and make referrals to appropriate support.  And including it in my app would be a very good idea.

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