I quit gambling about fourteen years ago, but for four years before that it was all I could think about. Prior to smartphones, the most addictive and lucrative form of gambling for the industry was digital roulette on Fixed Odds Betting Terminals, machines in betting shops that, until 2019, permitted stakes of £100 per 20-second spin. I lost all the money I had and had access to chasing losses on those machines, which put me in years’ worth of debt.
Worse than the monetary loss was the impact on my mental health. The feeling I had no agency following a losing session led to suicidal ideation, but when I wasn’t gambling, I felt a crippling anxiety. Gambling had become the escape from the problems gambling had caused. Once I quit, it took longer for my mind to reset than it did for me to repair my finances.
When we talk about mental ill-health, it’s often in the context of encouraging people to be open about any challenges they’re facing and, if it’s appropriate, to recommend support. Treatment-centred discussions have been an important aspect of normalising therapies and medications, making mental health problems seem equivalent to physical ailments in terms of how we’re expected to respond to them.
But a parity of esteem between physical and mental health is not adequately reflected in guidance on how we might be able to guard ourselves against mental ill-health and addiction. While the harm to mental health caused by alcohol is well documented, for example, guidance on consumption is framed predominantly around its impact on physical rather than mental health. The lack of comparative information on gambling is made worse by the fact some digital gambling products can lead to significantly more mental health difficulties than others.
We already know gambling can lead to addiction, which induces its own consequential mental health harms that may require treatment to overcome. Research from Landman Economics using the Understanding Society Survey found those engaged specifically in online slots and casino gaming in the seven days prior to being interviewed had significantly worse mental health than the rest of the population who had not participated in that form of gambling the previous week. Online slots and casino gamblers were also more likely to have depressive disorders.
These products account for over half of online gambling sector revenues, and the gambling industry receives significantly more revenue per gambler overall from online slots and casino products than other forms of gambling. Landman Economics found ‘a clear positive relationship between revenue per gambler and the prevalence of mental health problems’. In other words, the types of gambling — like online slots and casino games such as roulette and blackjack — with higher per-player revenues also have a higher proportion of mental health problems associated with them.
While this type of analysis cannot prove a direct causal link, we can infer a risk to mental health either from interacting with these products or from the consequences of doing so. The average online slots and casino gambler loses £2,254 in a year, compared to £929 for the average racing and sports bettor. This is not surprising when you consider that 45 percent of those who use online slots and casinos are either addicted or at-risk.
Earlier this year the government recognised the harms associated with these particular products by introducing an online slots maximum stake of £2 for under 25s and £5 for those over. Stakes were previously uncapped, and remain so for online casino games, which will instead be limited to one spin every 5 seconds.
These measures are a step in the right direction, but they will not sufficiently curtail the harm associated with such accessible, addictive games. For the first time in human history, we have placed slots, roulette, and blackjack on devices people carry everywhere with them. Gambling apps optimise inducements like bonus offers and free spins through push notifications and well-timed emails to either keep you engaged or get you back to their platform. There is no longer friction between the decision to gamble and the action of doing so. For decades, these products were confined to casinos; now they are promoted as something you might do on your commute to work.
In far too many cases, the resulting mental ill-health has led to suicide. While we regularly acknowledge that suicide is the biggest killer of men under 40, it’s less well known that between 4 and 11 percent of suicides are gambling-related — equating to as many as 496 deaths a year.
At the recent inquest into the suicide of Jack Ritchie, who tragically took his life as a result of a gambling addiction, Dr Matt Gaskell spoke about the huge impact gambling has on the brain. While the perception of gambling-related suicide is that it results from stress or debt, it’s clear that gambling itself causes shifts in brain chemistry. Major changes take place as addiction develops. That’s why higher-risk gambling behaviours enabled by rapid online slots and casino content are associated with a higher risk of suicidality, and those with a gambling disorder are six times more likely to have suicidal thoughts and fifteen times more likely to make an attempt on their own life — a risk of suicide higher than any other addiction.
There are tools out there to help combat this reality. Software like Gamban, which I co-founded, blocks access to gambling sites and apps on devices (you can get it for free through TalkBanStop.com). Signing up to GAMSTOP will also prevent you from opening an account with any licensed gambling operator. But when it comes to preventing addiction, we have to look at the industry as much as the individual. While gambling companies place the onus on consumers, urging them to ‘gamble responsibly’ or ‘Take Time To Think’, they fall short of explaining what responsible consumption might actually look like — perhaps because doing so would mean deterring people from their lucrative online casinos.
888 were recently the subject of a backlash against advertisements on London’s public transport network that used slogans such as ‘This carriage is now a casino’. This would not have happened had Mayor Sadiq Khan made good on his last manifesto pledge to ban gambling advertising on TfL. If we can’t run advertising campaigns to suppress participation in the most harmful forms of gambling, the very least we can do is stop it being encouraged for profit. For the sake of Mental Health Awareness Week and all those struggling, let’s end the promotion of products that are disproportionately harming our mental health.