Whilst recommendations have been made to ensure the identification of problem gambling, a lack of available services and educational messaging could be hindering overcoming gambling addiction in Indigenous communities.

The National Aboriginal Community Controlled Health Organisation (NACCHO) and the Royal Australian College of General Practitioners (RACGP) published the third edition of The National Guide to a Preventative Health Assessment for Aboriginal and Torres Strait Islander People in 2018. The document is an evidence-based series of recommendations for primary health care.

With Indigenous Australians at a higher risk of developing problem gambling, the document recommends primary health care workers screen for problem gambling during health checks. It’s recommended workers then assess the impact of problem gambling on families and children, and refer people with identified problem gambling to financial counselling and legal support services.

Dr Mary Belfrage is the clinical lead for the NACCHO and RACGP partnership working group which, in 2019, reviewed and updated the Aboriginal and Torres Strait Islander annual heath check templates.

“For gambling in primary care, there can be huge impacts on people’s mood and general wellbeing. People can even be suicidal; I have definitely seen that. There is also often shame and stigma around problem gambling so a lot of it can be hidden,” said Dr Belfrage.

Dr Belfrage said someone may need psychological support, support with secondary addictions such as drugs or alcohol, or access to financial support services.

“We’re aiming to get people out of crisis, by recognising the problem and providing support … this includes financial advice and help … as well as the possibility of referring people to services to do targeted work to change the gambling behaviours.”

The revised templates provide recommendations which aim to bring visibility to problem gambling and develop prevention strategies.

“So, what does prevention look like? Well, equity is a major issue … problem gambling can be a marker of trauma, depression and poverty,” she said.

“I think the normalisation of [gambling] in society and the messaging around it is important.

“There is also calling it out and naming problem gambling, and calling out the shame and stigma—hidden things often fester and do more harm because they stay hidden.”

Gamilaroi man and former NRL star, Ashley Gordon, has worked in counselling and Aboriginal gambling research for almost two decades.

Gordon is the Executive Director of the NSW Aboriginal Safe Gambling Services, a role which sees him facilitate the Warruwi Gambling Help program. The program targets Aboriginal communities and gambling help organisations across the state.

“I believe that between 15 and 18 per cent of Aboriginal people are currently experiencing harm caused by gambling, it is nearly one in five,” Gordon said.

“I believe a lot of our health services have probably missed the opportunity to help some people. That is why I’m glad that now they ask the [gambling screening] question.”

Gordon said both prevention and streamline services are important to combat problem gambling in community.

“From this question, our health staff have to now be up to speed on what to do,” he said.

“I’m currently talking to a training provider to try and get the education model changed. So, before you become an Aboriginal Health Worker, you are trained in handling that conversation. But for current staff there’s nothing happening.”

With different services catering to different communities, Gordon noted the importance of being aware of what is operating.

“No matter where you are, whether you’re in Sydney, Darwin, or out [in] remote and regional areas, you have to know what services are around you,” he said.

“There are non-Aboriginal services … but what are the local services we have? Health care workers can send them to healing programs, or parenting programs, or financial literacy programs.”

Gordon is committed to educating mob about the effects of problem gambling, but knows that the outcomes for community remain in the hands of community.

“It has to come from community, they need to recognise it, and from recognising it comes ownership and change,” he said.

“We have to get to the point of making people aware and educating our mob. It’s not about making laws and rules, the public health approach is the key … we need prevention.

“Healthcare workers, in any field, need to know that the people they are working with may have issues with problem gambling and need to know how to help them.

“At the end of the day, we are an at-risk group, we have trauma and grief. A lot of our mob are still struggling and they’re leaning into drugs, alcohol and gambling, and we need to know that so we can change that.”

If you are seeking support for problem gambling, call or visit the online resources below:

By Rachael Knowles