Ask about gambling during mental health consultations, NICE urges

Health professionals are being urged to ask people about gambling if they attend a health check-up or appointment for a mental health problem.

The recommendation from the National Institute for Health and Care Excellence (NICE) has been directed at NHS professionals and GPs but could be just as relevant for consultations within occupational health.

NICE has suggested this could be done in a similar way to how people are asked about their smoking and alcohol consumption.

NICE has identified that when people present at appointments with depression, anxiety, or thoughts about self-harm or suicide or in relation to a possible addiction (for example, alcohol or drug misuse), they may be at increased risk of harm from gambling.

In draft guidance, NICE is therefore recommending this needs to be identified and addressed by healthcare professionals. People should be encouraged to assess the severity of their gambling by completing a questionnaire available on the NHS website, it has also recommended.

This is based on the Problem Gambling Severity Index (PGSI), a standardised measure for at-risk behaviour. A score of eight or above indicates that they may need to seek support and treatment from a specialist gambling treatment service while those with lower scores may also benefit from available support.

The draft guidance recommends healthcare professionals discuss with people whether they can use blocking software or tools to limit their online gambling and that cognitive behavioural therapy (CBT) should be a treatment option.

Research shows CBT is an effective treatment for harmful gambling and can be used to help people identify and manage the triggers to their behaviour, and find ways to better cope with the feelings, thoughts and urges that may precede a gambling episode, NICE has said.

NHS England has opened 12 gambling treatment clinics across England since 2019, with a further three due to open in the coming months. These clinics are expected to see 3,000 people a year. All the clinics are fully NHS-commissioned and funded, NICE has said.

The draft guidance has also recommended that healthcare professionals consider involving a partner, family member or other person close to the person experiencing gambling-related harms in their treatment, if that is what both want.

Professor Jonathan Benger, chief medical officer and interim director of the centre for guidelines at NICE said: “Harmful gambling causes immense misery to all those who experience it. We want those needing help or who are at risk to be identified sooner and receive appropriate help.

“The independent committee who made these draft recommendations included both clinicians and people with personal experience of harmful gambling. They scrutinised all the available evidence to identify treatments and therapies that have been shown to work and offer good value for money,” he added.

Earlier this year, the government published its High stakes: gambling reform for the digital age white paper.

This includes the introduction of a statutory levy paid by gambling operators to fund research, prevention and treatment of gambling-related harm. The government will publish a consultation on the details of the statutory levy in the coming weeks.

The consultation on the draft guidelines will close on 15 November.