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Gambling Among Seniors: Pasttime or Past Time Jane Reynolds, BA Clinical Coordinator Problem Gamblers Help Network of WV

Gambling Among Seniors: Pasttime or Past Time Jane Reynolds, BA Clinical Coordinator Problem Gamblers Help Network of WV Jane Reynolds, BA Clinical Coordinator

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Page 1: Gambling Among Seniors: Pasttime or Past Time Jane Reynolds, BA Clinical Coordinator Problem Gamblers Help Network of WV Jane Reynolds, BA Clinical Coordinator

Gambling Among Seniors: Pasttime or Past Time

Jane Reynolds, BA

Clinical Coordinator

Problem Gamblers Help Network of WV

Jane Reynolds, BA

Clinical Coordinator

Problem Gamblers Help Network of WV

Page 2: Gambling Among Seniors: Pasttime or Past Time Jane Reynolds, BA Clinical Coordinator Problem Gamblers Help Network of WV Jane Reynolds, BA Clinical Coordinator

Gambling: The New Boom Industry

• The first state lottery started in New Hampshire in 1963

• Now almost ALL states have lotteries• Until 1988, only two states had legalized casino

gaming• Now at least 39 states have legalized casino-style

games • Simulcast, off-track, Internet, Bingo, Pull tabs• AMERICANS SPEND MORE $$$ ON GAMBLING THAN ALL

OTHER FORMS OF RECREATION COMBINED!

• The first state lottery started in New Hampshire in 1963

• Now almost ALL states have lotteries• Until 1988, only two states had legalized casino

gaming• Now at least 39 states have legalized casino-style

games • Simulcast, off-track, Internet, Bingo, Pull tabs• AMERICANS SPEND MORE $$$ ON GAMBLING THAN ALL

OTHER FORMS OF RECREATION COMBINED!

Page 3: Gambling Among Seniors: Pasttime or Past Time Jane Reynolds, BA Clinical Coordinator Problem Gamblers Help Network of WV Jane Reynolds, BA Clinical Coordinator

Government Sponsored/Regulated Gaming

Venues in West Virginia

Page 4: Gambling Among Seniors: Pasttime or Past Time Jane Reynolds, BA Clinical Coordinator Problem Gamblers Help Network of WV Jane Reynolds, BA Clinical Coordinator

Who are we?• First Choice Health Systems, Inc, established

in 1995 as a statewide network of behavioral health providers, manages various state contracts

• Answered RFP in December 1999 to design and implement a statewide gamblers help program

• Provided comprehensive treatment program for gamblers in WV for almost 10 years

• First Choice Health Systems, Inc, established in 1995 as a statewide network of behavioral health providers, manages various state contracts

• Answered RFP in December 1999 to design and implement a statewide gamblers help program

• Provided comprehensive treatment program for gamblers in WV for almost 10 years

Page 5: Gambling Among Seniors: Pasttime or Past Time Jane Reynolds, BA Clinical Coordinator Problem Gamblers Help Network of WV Jane Reynolds, BA Clinical Coordinator

What is Problem Gambling?

• Continuation of gambling behavior in spite of serious, negative consequences

Page 6: Gambling Among Seniors: Pasttime or Past Time Jane Reynolds, BA Clinical Coordinator Problem Gamblers Help Network of WV Jane Reynolds, BA Clinical Coordinator

DSM-IV Symptoms of a Gambling Problem

Page 7: Gambling Among Seniors: Pasttime or Past Time Jane Reynolds, BA Clinical Coordinator Problem Gamblers Help Network of WV Jane Reynolds, BA Clinical Coordinator

Loss of Control

• Makes unsuccessful efforts to stop, control or cut back on gambling.

Page 8: Gambling Among Seniors: Pasttime or Past Time Jane Reynolds, BA Clinical Coordinator Problem Gamblers Help Network of WV Jane Reynolds, BA Clinical Coordinator

Chasing

• After losing money gambling, returns as soon as possible and gambles more to try to win back lost bets

Page 9: Gambling Among Seniors: Pasttime or Past Time Jane Reynolds, BA Clinical Coordinator Problem Gamblers Help Network of WV Jane Reynolds, BA Clinical Coordinator

Preoccupation

Often thinking about gambling and/or obtaining money to gamble

Page 10: Gambling Among Seniors: Pasttime or Past Time Jane Reynolds, BA Clinical Coordinator Problem Gamblers Help Network of WV Jane Reynolds, BA Clinical Coordinator

Lying

• To family members, friends, co-workers, employer, clergy or other important people about gambling

Page 11: Gambling Among Seniors: Pasttime or Past Time Jane Reynolds, BA Clinical Coordinator Problem Gamblers Help Network of WV Jane Reynolds, BA Clinical Coordinator

Escape

• Uses gambling as a away to escape stress, depression, grief, boredom, loneliness, boredom and other negative feelings

Page 12: Gambling Among Seniors: Pasttime or Past Time Jane Reynolds, BA Clinical Coordinator Problem Gamblers Help Network of WV Jane Reynolds, BA Clinical Coordinator

Jeopardized Relationships and Loss of Activities

• Has given up other social or recreational activities

• Jeopardized family, friendships, career or school in order to keep gambling

Page 13: Gambling Among Seniors: Pasttime or Past Time Jane Reynolds, BA Clinical Coordinator Problem Gamblers Help Network of WV Jane Reynolds, BA Clinical Coordinator

Tolerance

• Increased size/frequency of bets to achieve desired excitement

Page 14: Gambling Among Seniors: Pasttime or Past Time Jane Reynolds, BA Clinical Coordinator Problem Gamblers Help Network of WV Jane Reynolds, BA Clinical Coordinator

Bailouts

• Turns to others for money to relieve financial crisis caused by gambling or to get money to gamble

Page 15: Gambling Among Seniors: Pasttime or Past Time Jane Reynolds, BA Clinical Coordinator Problem Gamblers Help Network of WV Jane Reynolds, BA Clinical Coordinator

Withdrawal

• Is restless or irritable when attempting to cut back or stop gambling

Page 16: Gambling Among Seniors: Pasttime or Past Time Jane Reynolds, BA Clinical Coordinator Problem Gamblers Help Network of WV Jane Reynolds, BA Clinical Coordinator

Illegal Acts

• Commits forgery, fraud, theft or embezzlement to get money to gamble or to resolve financial crisis caused by gambling

Page 17: Gambling Among Seniors: Pasttime or Past Time Jane Reynolds, BA Clinical Coordinator Problem Gamblers Help Network of WV Jane Reynolds, BA Clinical Coordinator

DSM-IV Symptoms of a Gambling Problem

5 or more symptoms = Pathological Gambler

1 to 4 symptoms = Problem Gambler

Page 18: Gambling Among Seniors: Pasttime or Past Time Jane Reynolds, BA Clinical Coordinator Problem Gamblers Help Network of WV Jane Reynolds, BA Clinical Coordinator

National Prevalence Rates

• National Council on Problem Gambling, Washington, DC

• 2% to 3% of US Population in any given year

• 6 million to 9 million Americans

Page 19: Gambling Among Seniors: Pasttime or Past Time Jane Reynolds, BA Clinical Coordinator Problem Gamblers Help Network of WV Jane Reynolds, BA Clinical Coordinator

Prevalence Rates in West Virginia?

• Who Knows????

• 37,000 to 54,000 West Virginians???

Page 20: Gambling Among Seniors: Pasttime or Past Time Jane Reynolds, BA Clinical Coordinator Problem Gamblers Help Network of WV Jane Reynolds, BA Clinical Coordinator

Risk Factors

That may contribute to the likelihood that someone

develops a gambling problem

Page 21: Gambling Among Seniors: Pasttime or Past Time Jane Reynolds, BA Clinical Coordinator Problem Gamblers Help Network of WV Jane Reynolds, BA Clinical Coordinator

An Early Big WinGreater than or equal to

one month’s income

Page 22: Gambling Among Seniors: Pasttime or Past Time Jane Reynolds, BA Clinical Coordinator Problem Gamblers Help Network of WV Jane Reynolds, BA Clinical Coordinator

Childhood Abuse, Neglect or Abandonment

Page 23: Gambling Among Seniors: Pasttime or Past Time Jane Reynolds, BA Clinical Coordinator Problem Gamblers Help Network of WV Jane Reynolds, BA Clinical Coordinator

Pre-existing mental health problems

Depression, anxiety, bipolar, alcoholism, drug addiction and others…

Page 24: Gambling Among Seniors: Pasttime or Past Time Jane Reynolds, BA Clinical Coordinator Problem Gamblers Help Network of WV Jane Reynolds, BA Clinical Coordinator

Family history of addictions

alcohol, drugs, gambling and others…

Page 25: Gambling Among Seniors: Pasttime or Past Time Jane Reynolds, BA Clinical Coordinator Problem Gamblers Help Network of WV Jane Reynolds, BA Clinical Coordinator

Stressful life eventDeath of a loved one, divorce, job loss, injury,

illness and others…

Page 26: Gambling Among Seniors: Pasttime or Past Time Jane Reynolds, BA Clinical Coordinator Problem Gamblers Help Network of WV Jane Reynolds, BA Clinical Coordinator

Senior Gambling

LJust having fun? OOr headed for trouble?

Page 27: Gambling Among Seniors: Pasttime or Past Time Jane Reynolds, BA Clinical Coordinator Problem Gamblers Help Network of WV Jane Reynolds, BA Clinical Coordinator

Are Casinos the new Senior Centers?

• Casinos offer many perks to seniors– Free or cheap rooms, food, giveaways– Valet parking or shuttle bus– Provide oxygen tanks, wheelchairs,

places to dispose of diabetic needles– Cash your social security check– Friendship from other patrons, staff

• “We miss you” cards• Remember them on their birthday

Page 28: Gambling Among Seniors: Pasttime or Past Time Jane Reynolds, BA Clinical Coordinator Problem Gamblers Help Network of WV Jane Reynolds, BA Clinical Coordinator

Or, are Senior Centers the new Casinos?

• Many senior centers sponsor trips to casinos

• Most senior centers and nursing home offer gambling activities like Bingo

• Many senior centers sponsor trips to casinos

• Most senior centers and nursing home offer gambling activities like Bingo

Page 29: Gambling Among Seniors: Pasttime or Past Time Jane Reynolds, BA Clinical Coordinator Problem Gamblers Help Network of WV Jane Reynolds, BA Clinical Coordinator

Prevalence of Senior Gambling

• Those over age 65 list gambling as the most common recreational activity

• % of those over age 65 who gambled in past year doubled between 1975-1998 (NORC, 1999)

• Conflicting reports on whether seniors have higher rates of gambling and if they are more likely to become addicted

Page 30: Gambling Among Seniors: Pasttime or Past Time Jane Reynolds, BA Clinical Coordinator Problem Gamblers Help Network of WV Jane Reynolds, BA Clinical Coordinator

Problem Gambling in WV Among Seniors

• 25% of West Virginians are over age 55 (2000 Census)• This table shows WV Lottery player demographics compared

to general population-% of players over 65 is proportionate to population

• 17% of those who have called our

helpline are over age 55

• 25% of West Virginians are over age 55 (2000 Census)• This table shows WV Lottery player demographics compared

to general population-% of players over 65 is proportionate to population

• 17% of those who have called our

helpline are over age 55

Page 31: Gambling Among Seniors: Pasttime or Past Time Jane Reynolds, BA Clinical Coordinator Problem Gamblers Help Network of WV Jane Reynolds, BA Clinical Coordinator

Why Seniors Gamble

• “ Why shouldn’t I throw my money away?• “What else am I going to do with my time?”• “The people at the casino are my only friends”• “I’m so lonely since my husband died”• “Maybe I can make some money to pay bills”• “It makes me forgot about my back pain”• “It’s the only fun I have”• “Its something my wife and I can do together”• “Its so safe here”

• “ Why shouldn’t I throw my money away?• “What else am I going to do with my time?”• “The people at the casino are my only friends”• “I’m so lonely since my husband died”• “Maybe I can make some money to pay bills”• “It makes me forgot about my back pain”• “It’s the only fun I have”• “Its something my wife and I can do together”• “Its so safe here”

Page 32: Gambling Among Seniors: Pasttime or Past Time Jane Reynolds, BA Clinical Coordinator Problem Gamblers Help Network of WV Jane Reynolds, BA Clinical Coordinator

Financial Issues Problems for Senior Gamblers

Page 33: Gambling Among Seniors: Pasttime or Past Time Jane Reynolds, BA Clinical Coordinator Problem Gamblers Help Network of WV Jane Reynolds, BA Clinical Coordinator

Medications and Gambling•Drugs used to treat Parkinson's Disease and Restless Leg Syndrome (Mirapex, Requip) may cause behavioral changes

•As many as 1 in 6 on these meds report behavioral changes

•Increased gambling is one of the most commonly reported problems

•Drugs used to treat Parkinson's Disease and Restless Leg Syndrome (Mirapex, Requip) may cause behavioral changes

•As many as 1 in 6 on these meds report behavioral changes

•Increased gambling is one of the most commonly reported problems

Page 34: Gambling Among Seniors: Pasttime or Past Time Jane Reynolds, BA Clinical Coordinator Problem Gamblers Help Network of WV Jane Reynolds, BA Clinical Coordinator

Treatment implications for Senior Gamblers

• More reluctant to seek help• Cognitive problems may interfere with ability to make

sound decisions• Underlying issues of loneliness, lack of socialization

must be addressed• Financial issues may be more pressing• Family should be involved• Higher rates of suicide

• More reluctant to seek help• Cognitive problems may interfere with ability to make

sound decisions• Underlying issues of loneliness, lack of socialization

must be addressed• Financial issues may be more pressing• Family should be involved• Higher rates of suicide

Page 35: Gambling Among Seniors: Pasttime or Past Time Jane Reynolds, BA Clinical Coordinator Problem Gamblers Help Network of WV Jane Reynolds, BA Clinical Coordinator

How We Help

• Provide outreach to create public awareness

Page 36: Gambling Among Seniors: Pasttime or Past Time Jane Reynolds, BA Clinical Coordinator Problem Gamblers Help Network of WV Jane Reynolds, BA Clinical Coordinator

Outreach and Prevention through Media

Page 37: Gambling Among Seniors: Pasttime or Past Time Jane Reynolds, BA Clinical Coordinator Problem Gamblers Help Network of WV Jane Reynolds, BA Clinical Coordinator

Our Billboard Campaign

Page 38: Gambling Among Seniors: Pasttime or Past Time Jane Reynolds, BA Clinical Coordinator Problem Gamblers Help Network of WV Jane Reynolds, BA Clinical Coordinator

Recruit and provide 30 hours training to licensed clinicians

• Counselors, social workers and psychologists

• Quarterly Clinical Supervisions around the state

• Advanced/Ongoing Continuing Education

Page 39: Gambling Among Seniors: Pasttime or Past Time Jane Reynolds, BA Clinical Coordinator Problem Gamblers Help Network of WV Jane Reynolds, BA Clinical Coordinator

24-hour Help-line1-800-GAMBLER

Page 40: Gambling Among Seniors: Pasttime or Past Time Jane Reynolds, BA Clinical Coordinator Problem Gamblers Help Network of WV Jane Reynolds, BA Clinical Coordinator

All Callers offered free two-hour consult

• Includes loved ones!• Scheduled while on the line• Goal is within 30 miles of

residence• Within 72 hours of call• Referred to other support

services and information mailed

• Includes loved ones!• Scheduled while on the line• Goal is within 30 miles of

residence• Within 72 hours of call• Referred to other support

services and information mailed

Page 41: Gambling Among Seniors: Pasttime or Past Time Jane Reynolds, BA Clinical Coordinator Problem Gamblers Help Network of WV Jane Reynolds, BA Clinical Coordinator

During the Consult

Page 42: Gambling Among Seniors: Pasttime or Past Time Jane Reynolds, BA Clinical Coordinator Problem Gamblers Help Network of WV Jane Reynolds, BA Clinical Coordinator

Full range of services

Page 43: Gambling Among Seniors: Pasttime or Past Time Jane Reynolds, BA Clinical Coordinator Problem Gamblers Help Network of WV Jane Reynolds, BA Clinical Coordinator

What does our staff do when the helpline isn’t ringing?

• Pre-appt courtesy call• Post-assessment follow-up• Treatment pre-certification and utilization

review • 6-month, one-year and two-year follow-up• Compile data• Public awareness activities

• Pre-appt courtesy call• Post-assessment follow-up• Treatment pre-certification and utilization

review • 6-month, one-year and two-year follow-up• Compile data• Public awareness activities

Page 44: Gambling Among Seniors: Pasttime or Past Time Jane Reynolds, BA Clinical Coordinator Problem Gamblers Help Network of WV Jane Reynolds, BA Clinical Coordinator

Program Highlights

Page 45: Gambling Among Seniors: Pasttime or Past Time Jane Reynolds, BA Clinical Coordinator Problem Gamblers Help Network of WV Jane Reynolds, BA Clinical Coordinator

Who is Calling Us for Help?

Page 46: Gambling Among Seniors: Pasttime or Past Time Jane Reynolds, BA Clinical Coordinator Problem Gamblers Help Network of WV Jane Reynolds, BA Clinical Coordinator

Improving Services with Technology

Page 47: Gambling Among Seniors: Pasttime or Past Time Jane Reynolds, BA Clinical Coordinator Problem Gamblers Help Network of WV Jane Reynolds, BA Clinical Coordinator

Our Stats

Page 48: Gambling Among Seniors: Pasttime or Past Time Jane Reynolds, BA Clinical Coordinator Problem Gamblers Help Network of WV Jane Reynolds, BA Clinical Coordinator

Our Stats

Page 49: Gambling Among Seniors: Pasttime or Past Time Jane Reynolds, BA Clinical Coordinator Problem Gamblers Help Network of WV Jane Reynolds, BA Clinical Coordinator

Our Stats

Page 50: Gambling Among Seniors: Pasttime or Past Time Jane Reynolds, BA Clinical Coordinator Problem Gamblers Help Network of WV Jane Reynolds, BA Clinical Coordinator