New guidance on identifying problem gambling behaviours and symptoms has been provided to general practitioners (GPs) and other healthcare professionals in the UK by the National Institute for Health and Care Excellence (NICE).
GPs have been provided with practical guidance to help identify, assess, and manage gambling-related harms affecting members of local communities.
NICE serves as an independent organisation that provides guidance on health and social care issues to improve the quality and availability of healthcare services for British patients.
Guidance on problem gambling is recommended, recognising that “stigma, shame and fear of disclosure can prevent people experiencing gambling-related harms from talking about gambling and from seeking and accessing support and treatment.
“In addition, stigma may be a particular issue for certain groups, such as people from marginalised, minority, or under-represented communities.”
The guidelines provided to GPs cover problem gambling criteria, including identification, support, models of care, treatment advice, relapse prevention, and intervention support for friends and family.
To prevent stigma, GPs are recommended to ask patients about their gambling behaviours, “even if they have no obvious risk factors for gambling-related harms”.
Questions on gambling behaviours should form part of a ‘holistic assessment’ of a patient’s health check, considering other factors such as smoking, alcohol consumption, or use of other substances.
Enquiries about gambling behaviours are specifically urged for patients who display or disclose mental health concerns, particularly thoughts about self-harm or suicide, depression, anxiety, psychosis, bipolar disorder, post-traumatic stress disorder (PTSD), personality disorder, or attention deficit hyperactivity disorder (ADHD).
In circumstances where a patient is facing homelessness or financial difficulties/uncertainties, GPs are recommended to question their exposure to gambling harms.
Further recommendations cite that GPs should enquire about gambling harms if a patient reveals they are recovering from other dependencies such as alcohol or substance abuse.
A notice is made for gambling behaviours to be probed if a patient is prescribed medicines that may affect impulse control, such as dopamine agonists for Parkinson’s disease or aripiprazole for psychosis. GPs are advised to check previous guidance issued by NICE.
GPs are advised that “recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available.
When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences, and values of their patients or the people using their service.
It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families, carers, or guardians.”
The NHS responded that it would provide NICE’s new guidance to its network of GPs and healthcare commissioners, as the frontline support in the treatment of problem gambling across local communities.
National Clinical Director for Primary Care, Dr Claire Fuller, said: “We welcome NICE’s decision, as gambling can have a massive impact on people’s lives and the lives of those who care for them – and as healthcare professionals, we need the right tools to help tackle gambling-related harms.”
