Barriers in Access to the Treatment for People with Gambling Disorders. Are They Different from Those Experienced by People with Alcohol and/or Drug Dependence?

Abstract

A prevalence of gambling disorders is diversified depending on the region of the world. Almost three quarters of pathological gamblers had never sought a professional treatment as well as an assistance in self-help groups. Reasons why they do not initiate a treatment are complex. The aim of the article is to compare barriers to the treatment for people with gambling disorders found in presented study and barriers to alcohol and drug treatment identified in the available literature. The semi structured interviews were applied and conducted with people with gambling disorders, social workers, therapists employed in the addiction treatment facilities, General Practitioners and psychiatrists. Selection of the respondents was based on purposive sampling. In total, 90 interviews were completed. Respondents identified individual barriers as well as structural ones. Individual barriers include internal resistance and a fear of the treatment. In turn structural barriers apply to the organization of the therapy, infrastructure, personnel, and the therapeutic program. A comparison of barriers experienced by people with gambling disorders and substance use disorders showed that they are largely similar, but people with gambling disorders also experience specific barriers. Empirical studies focused specifically on treatment needs of people experiencing gambling disorders may improve an offer of help for them. More adequate treatment options could contribute to the increasing in the number of people who start the treatment. It can result in improving their quality of life and may have positive impact on public health.

Primary and Secondary Diagnoses of Gambling Disorder and Psychiatric Comorbidity in the Swedish Health Care System—A Nationwide Register Study

“…However, barriers to treatment may also be related to actual or perceived problems of availability or dissatisfaction related to how treatment is provided ( 20 ). Barriers may also be of organizational or structural nature; routes to treatment may be unclear and the responsibility for the treatment of this disorder may be unclearly defined and under-dimensioned ( 21 , 22 ). Treatment availability may be limited to a lack of knowledge or confidence in non-specialized settings ( 23 ), and gambling as a health concern may be less readily adopted in general practice than many other disorders ( 24 ).…”

Recommendations for improving the availability and the quality of treatment service for gambling disorder persons

“…Respondents' recommendations associated with increasing the availability of treatment as well as its quality and adequacy are significant from the point of view of barriers people encounter identified in the study [24,30]. Decisions to publicise treatment by persons with gambling disorders are determined by exactly such barriers.…”

“…Rekomendacje respondentów związane ze zwiększeniem dostępności leczenia oraz jego jakości i adekwatności są istotne z punktu widzenia zidentyfikowanych w badaniach barier, jakie napotykają osoby podejmujące terapię [24,30]. Decyzja o rozpoczęciu leczenia przez osoby z zaburzeniami hazardowymi jest determinowana przez te właśnie bariery.…”

“…The low-level of social knowledge of gambling disorders and the perception of gambling in moral rather than medical terms influences the social acceptance of behaviours of this kind and may determine the manner in which these problems are dealt with by independent coping rather than the seeking of specialist help [2,4,[20][21][22]. Apart from that, various social, cultural and individual factors associated with the structure of the aid system may contribute to the failure to seek treatment [11,23,24]. Similarly, as in the case of most other dependencies, treatment is the most costly answer to the problems created by substance use and other behavioural dependencies.…”

“…Niewielka wiedza o zaburzeniach hazardowych w społeczeństwie i postrzeganie hazardu w kategoriach moralnych, a nie medycznych ma wpływ na społeczną akceptację dla takich zachowań i może determinować sposób radzenia sobie z problemami: samodzielne radzenie sobie zamiast korzystania ze specjalistycznej pomocy [2,4,[20][21][22]. Oprócz tego do niepodejmowania leczenia mogą przyczyniać się różne czynniki -społeczne, kulturowe, indywidualne i związane ze strukturą systemu pomocy [11,23,24]. Podobnie jak w przypadku większości innych uzależnień, lecznictwo jest najbardziej kosztowną odpowiedzią na problemy, jakie rodzą używanie © 2017 Institute of Psychiatry and Neurology.…”