Gambling Disorders

Most people easily enjoy purchasing an occasional lottery ticket, playing poker with some buddies, betting on the office sports pool or even taking a weekend trip to a casino. For them, gambling is a harmless form of entertainment. However, for millions of Americans, the desire to gamble is so strong it can lead to negative health and personal consequences such as loss of significant family relationships or employment, alcohol or drug abuse, depression, anxiety and financial hardship.

There are more opportunities to gamble than ever before. The number of casinos and other gaming locations are growing across the country and the online gaming market is expected to reach $41.3 billion this year, tripling in growth over the past decade. According to the National Council on Problem Gambling (NCPG), approximately 2 million U.S. adults meet the criteria for gambling disorder and 4 to 6 million are considered problem gamblers. The impact of problem gambling is far reaching, affecting friends and family members in addition to making a costly impact on state social and economic resources due to crime, medical and behavioral treatment, lost work time, bankruptcy, unemployment and homelessness.

Gambling disorder, previously defined in the Diagnostic and Statistical Manual of Mental Disorders as pathological gambling, is re-categorized as an addictive disorder. As suggested by the American Psychiatric Association, this new classification reflects research findings that gambling disorder is similar to substance use disorders in clinical expression, brain origin, comorbidity, physiology, and treatment.

Gambling disorder is characterized by:

  • Increasing preoccupation with gambling
  • A need to bet more money more frequently
  • Gambling when feeling helpless, guilty, anxious or depressed
  • Restlessness or irritability when not able to gamble
  • Denial and lying
  • “Chasing” losses to recover monies lost on gambling
  • Continuing to gamble in spite of mounting, serious, negative consequences

Many people with gambling disorder are also struggling with co-occurring substance use disorders or psychiatric issues. A recent study reported that 73% of diagnosed gamblers had an alcohol abuse problem; 38% had a drug use disorder; 50% had a mood disorder; and 61% has a personality disorder. People with gambling disorder may also have a greater risk of suicide.

Gambling disorder is a diagnosable behavioral health condition that can be treated with the help of licensed behavioral health professionals. Beacon has the tools, resources, and proven clinical processes to help identify persons with gambling addiction and connect them to the appropriate resources—typically Certified Problem Gambling Counselors—to help overcome this disorder.

BEACON’S KANSAS EXPERIENCE

ValueOptions-Kansas, a Beacon Health Options company, administers the State of Kansas’ Problem Gambling and Other Addictions Fund (PGAF) program on behalf of the Kansas Department for Aging and Disability Services (KDADS). The PGAF program is funded by 2% of the net lottery, bingo and casino revenue. The program offers subsidized, affordable behavioral health treatment—many times completely free—for those facing a gambling addiction. Services include individual, group and family therapy; inpatient care; case management; and formal interventions.

Working closely with the state, we helped develop the PGAF program beginning in 2011. We created the provider certification process; program criteria; intake, concurrent review and discharge processes and forms; and the data collection system. We collaborated with state agency leaders to develop updated credentialing criteria for the PGAF provider network, a new contract addenda for Problem Gambling and a current state-issued Kansas Problem Gambling counselor certificate. We leveraged our existing credentialing system to incorporate the newly developed criteria to credential both new and existing providers. Our staff also worked closely with the Kansas liaison to develop a PGAF provider guide. Finally, we coordinated the selection and management of an advisory committee to help develop policy relative to PGAF program funding and implementation.

During the first 17 months of the PGAF program:

  • One-third of PGAF program participants reported a decrease in gambling preoccupation
  • 46.2% of participants reported fewer gambling related consequences
  • 46.2% of participants also reported abstinence from gambling
  • Participation in self-help programs increased by 18%

ACCESSING CARE

The two major referral sources for PGAF treatment are the Kansas Problem Gambling Help Line and secondly, the gambler’s family, friends or treatment professionals. The help line is available 24/7 to gamblers or others concerned about a person who may be a problem gambler. Help Line staff answer questions and make referrals to one of our 40 certified problem gambling counselors.

We also identify potential problem gamblers through our providers themselves. As the administrator of Kansas’ Substance Use Disorder
(SUD) network, we instruct our SUD providers to screen members for problem gambling symptoms and make referrals to the PGAF network as warranted. In fact, 56% of our PGAF providers are cross-credentialed as SUD specialists.

Providers are assured quick response to service requests and prompt entry of authorizations into our proprietary database once a Kansas Behavioral Services Regulatory Board licensed clinician makes a determination on medical necessity criteria. This way, we ensure provider claims are paid quickly and accurately.

We have policies and procedures in place to manage the PGAF consistent with KDADS’ requirements that ensure individuals are eligible and meet medical necessity for problem gambling treatment. Providers are required to complete and submit assessment, concurrent review and discharge forms to authorize, continue and complete treatment. We are integrating these forms into our Web-enabled provider portal, so we can capture the PGAF data elements electronically.

Beacon has experience building a problem gambling treatment system from the ground up and in direct collaboration with our state partner. Based on our customized solutions, proven technologies and clinical expertise, we can effectively and efficiently address your concerns related to program gambling.