Using behavioural insights to increase uptake of remote gambling support and treatment

Roughly 4 in 10 people who have the greatest need for gambling treatment and support do not seek any form of treatment, advice or support.1 The types of harms people experience vary and can include, among others, experiencing financial hardship and relationship difficulties. Gambling support and treatment services offer targeted support to help people experiencing this form of harm to get better. This report sets out potential barriers and enablers to accessing gambling support and treatment, and has explored ways behavioural insights can be used to improve uptake of gambling support and treatment services.

We conducted an evidence scan of high quality empirical evidence on several research databases. We targeted more recent evidence – from 2018 onwards – and focused specifically on findings related to support and treatment that is provided remotely (e.g. over the phone, by text, online). We have chosen to focus on remote support and treatment in this instance due to its wide availability and possibility of scaling. 

In section 1, we summarise how people seek gambling support and treatment, and what forms of support people use as first steps into support and treatment (i.e. Individuals’ first choice of either gambling support or treatment after having decided on seeking gambling support or treatment). We find that self-help (activities, tools, resources and materials people engage with themselves without professional oversight) can be a popular form of support for those who are exploring support and treatment for the first time, compared to more formal types of support such as counselling therapy or cognitive behavioural therapy, group support. Seeking support is often triggered by mental health issues, financial problems, or job loss as a result of gambling. People experiencing gambling harms are less likely to seek support and treatment if they are 55+, male, from a lower socioeconomic background, and from white ethnic backgrounds.

For support and treatment service providers, this means that:

1. Self-help tools and resources are an important stepping-stone for those experiencing harm to get help.
2. However, signposting towards other options at timely moments is essential to ensuring individuals have the appropriate level of support when needed. 
3. Other support and treatment options should be framed as the “next step” after self-help if it is not sufficient in providing the necessary support.  

In section 2, we explore the barriers, enablers and motivators to accessing gambling support and treatment. We find barriers to accessing support and treatment are primarily related to a) how relevant people think support and treatment options are to them, b) awareness and understanding of support and treatment, c) negative perceptions of help-seeking such as shame and stigma, d) and perceived availability and accessibility of support and treatment. In contrast, important enablers and motivators for promoting uptake are awareness of support and treatment options and what channels they can be accessed by, as well as family/friends encouraging help-seeking. These factors vary by demographics, as older people who gamble generally see support and treatment services as being less relevant to them. Practical barriers can have an even larger impact on females who gamble (such as costs and time), and individuals from lower socioeconomic backgrounds (such as knowledge and ease of access).

For support and treatment service providers, this means:

1. At every stage of the user journey, make services easy to access (e.g. by making them available through multiple channels); confidential, and where possible, free, whilst also making these features salient.
2. Focus information campaigns on the ‘signs and symptoms’ of gambling harms, destigmatising help-seeking (e.g. by emphasising its usage among a diverse range of people), and the expected outcomes of relevant support and treatment options.
3. Develop tailored messaging for specific groups where support and treatment is underused:
   1. Increase the perceived relevance of support and treatment among older people who gamble by emphasising and showing usage in campaign creatives.
   2. Build on the work of the Women’s Gambling Harms Prevention Campaign by BeGambleAware, by emphasising the flexibility of support and treatment options that can work around other life commitments e.g. caring responsibilities.
   3. Target awareness campaigns at people who gamble in disadvantaged regions and/or from a BAME background – for the latter groups, test the effectiveness of using creatives that demonstrate an understanding of cultural values. 

In section 3, we set out how the journey from self-help / remote support to more intensive support can be improved. Both self help and more formal forms of initial support and treatment (such as counselling therapy or cognitive behavioural therapy) only provide limited impact on reducing harms. Emerging evidence suggests that for some who require more formal interventions, self-help may delay access to treatment until gambling behaviour results in serious harm. Utilising online mental health services could be an effective next step after initial support and treatment choices, as well as an effective replacement for initial support and treatment choices.

For support and treatment service providers, this means that: 

1. For organisations offering self-help as a first step, signposting about other support and treatment options available following self-help needs to be improved. 
2. Caution needs to be taken when offering self-help resources, especially to high-risk groups, as there is potential for this to result in them delaying access to formal treatment. However, we note for many individuals, self-help remains an important stepping stone to accessing further support.