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Unchanged funding policy hinders gambling treatment quality service

The Young Reporter (2009, March), 41(06), pp. 4.
Author: Kelvin Chan Mankey. Editor: Karen Ho Chui-ying.
Permanent URL - https://sys01.lib.hkbu.edu.hk/bujspa/purl.php?&did=bujspa0015968

Kelvin Chan Mankey

The number of pathological gamblers has been increasing in the past few years but financial support remains unchanged to tackle the mounting demand, putting more burdens on counselling and treatment centre in Hong Kong.

Caritas Addicted Gamblers Counselling Centre (CAGCC), one of the four counselling and treatment centres donated by the Ping Wo Fund to help problem and pathological gamblers, has received over 400 new cases every year since 2006. The centre has dealt with nearly 2,500 pathological gamblers since its establishment in 2003.

Despite increasing number of cases, the centre has received a funding of $3.5 million from the Ping Wo Fund every year since 2003, when the fund was set up.

The CAGGCC wrote to the Home Affairs Bureau last year to call for additional funding to deal with the increasing demand and the operational cost due to inflation, namely higher rental fees and salaries, but the request was rejected.

Mr Joe Tang Yiu-cho, a Social Work Supervisor of the centre, said the number of pathological gamblers are more than the figures showed as there are other counselling centres dealing with pathological gambling problems in Hong Kong.

At present, the Ping Wo Fund finances four counselling and treatment centres to help pathological gamblers.

Apart from the Caritas, the other three centres are operated by the Tung Wah Group of Hospitals, Zion Social Service Limited and the Hong Kong Federation of Youth Groups.

Home Affairs Bureau commissioned the Hong Kong Polytechnic University to conduct an in-depth research to evaluate the cost-effectiveness of the centres and the report was released recently.

Through individual face-to-face interviews with frontline counsellors of the four centres, the HKPU report found out that limited resources pose constraints to these centres to provide high quality services for pathological gamblers and their families, as well as public education.

“Of course there’s only limited number of colleagues ... colleagues cannot take up too many cases at the same time. Finally, because of limited resources, every colleague has to take up gambling casework,” a frontline counsellor told research team members from HKPU.

To start a treatment, counsellors in the centres will first evaluate help-seekers to see if they are pathological gamblers. Such treatment takes time.

Ms Elda Chan Mei-lo, Supervisor of Tung Wah Group of Hospitals Even Centre, told The Young Reporter that treatment duration is about 6 to 12 months, and some may take even longer.

“Some pathological gamblers may have other related problems like domestic violence, mental disorders, or even suicidal thoughts. Counsellors have to deal with these problems besides gambling behaviours.”

The centre also has to follow up the recovered cases. “We hold maintenance group and peer counselling group meetings to support recovered gamblers,” she said.

In Hong Kong, many people have experienced in gambling like playing Mahjong or betting on Mark Six lottery. Mr Tang said it is not problematic even if one is a regular gambler, as long as he or she regards gambling as an entertainment.

If a person cannot stop thinking about gambling or control his or her gambling behaviour to an extent that affects his or her normal life, he or she is a pathological gambler, according to Diagnostic and Statistical Manual of Mental Disorders (DSM) .

Mr Patrick Pang, 44, a pathological gambler who was addicted to gambling four years ago, is now receiving counselling in CAGCC. Under pressure in his life and his career, he bet at casinos in Macau with his friends and used gambling as a way to relieve.

“For me, spending $100,000 in casino is very normal. I had spent even more sometimes,” Mr Pang said. “I had nothing to worry about and I felt relaxed there.”

However, his bets turned to debts afterwards. He lost all his savings and property and he is still owing more than $200,000.

“I feel guilty and heart-broken as my family bear more burdens because of my faults,” he said.

Mr Andrew Liu Shing-fai, a clinical psychologist, said 80 per cent of them will meet a transition period of winning before becoming pathological gamblers. They frequently experience big win in the period, resulting in misconceptions about gambling.

“The experience of big win fundamentally changes gamblers’ conceptions about the way to earn money,” Mr Liu said, adding that gamblers would think gambling is the easiest way to earn money and usually over-estimate the probability of winning games.

Besides cognitive factors, Mr Tang pointed out that convenient betting methods like internet betting or telephone betting also prompt people to bet.

On the other hand, well-decorated casinos also push gamblers to bet irrationally as they attract people to stay there longer and spend more. “A research has shown that the longer you stay in a casino, the more money you spend and the higher chance you will become a pathological gambler,” Mr Liu said.

To get rid of a gambling habit, Mr Liu said it is necessary to help gamblers change their thinking and behaviour.

“We will teach gamblers ... to have dinner with the family on every Wednesday night to avoid putting money on horse racing,” he said.

To help gamblers build up a rational conception about gambling, Mr Tang said counsellors would list out both the advantages and drawbacks of continually gambling to pathological gamblers, to let them realise it is problematic to regard betting as a faster way to earn money.

And will power of gamblers to stop gambling matters too. Some may not be able to resist the temptation and bet again.

“I know some gamblers have given up receiving treatments and betted again. I understand this feeling as it is really painful in the course of getting rid of this habit,” Mr Pang said. “But I keep going to the centre and I set target to myself that I don’t want to make the same mistake again.”

Mr Tang said the centre lacks enough manpower to help the needy and he stressed that more resources should be put to tackle the pathological gambling problem in Hong Kong.

Edited by Karen Ho Chui-ying

Test for pathological gambling

According to diagnostic criteria for pathological gambling as stated in Diagnostic and Statistical Manual of Mental Disorders-Version IV (DSM-IV), one is diagnosed as a pathological gambler if he or she has persistent and recurrent maladaptive gambling behaviour as indicated by five (or more) of the following:

·Is preoccupied with gambling (e.g., preoccupied with reliving past gambling experiences, handicapping or planning the next venture, or thinking of ways to get money with which to gamble) .

·Needs to gamble with increasing amounts of money in order to achieve the desired excitement.

·Has repeated unsuccessful efforts to control, cut back, or stop gambling.

·Is restless or irritable when attempting to cut down or stop gambling.

·Gambles as a way of escaping from problems or of relieving a dysphoric mood (e.g., feelings of helplessness, guilt, anxiety, depression) .

·After losing money gambling, often returns another day to get even (“chasing” one’s losses) .

·Lies to family members, therapist, or others to conceal the extent of involvement with gambling.

·Has committed illegal acts such as forgery, fraud, theft, or embezzlement to finance gambling.

·Has jeopardized or lost a significant relationship, job, or educational or career opportunity because of gambling.

·Relies on others to provide money to relieve a desperate financial situation caused by gambling.

Remarks:

·This assessment must be conducted with the Diagnostic Clinical Interview for Pathological Gambling of DSM-IV.

·The accuracy of the assessment should be explored with counsellors.

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