Moving in the right direction

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Review and Plan

2012-2015

Moving in the right direction

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Foreword

2011/12 has been a good year for GamCare. We have received more calls and treated more people than ever before. We have developed new initiatives for prevention and education, as well as treatment. And we have agreed three year funding contracts with the Responsible Gambling Trust to deliver the national HelpLine/NetLine and expand treatment services through to 2015.

This means we can plan more securely, and strategically, for the future – the first time we have really been able to do so since GamCare was founded some fifteen years ago. So this year we have chosen to supplement our Annual Review by including our latest analysis of the issues facing us, and setting out the key elements of our plans for the next three years.

This vote of confidence in GamCare is good news for us, of course, but more importantly it is very good news for anyone suffering because of gambling.

We look forward to playing our part in putting in place a truly effective, and national, strategy for prevention, education and treatment.

Andy McLellan Chief Executive

GamCare Moving in the right direction

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Part 1 What is problem gambling?

GamCare We know about gambling We care about you

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Review and Plan 2012-2015 | www.gamcare.org.uk

The nature of problem gambling

Gambling becomes a problem for individuals when it ceases to be enjoyable and turns into dependence. Winning is no longer pleasurable. The money gained is immediately reinvested in gambling.

The life of a problem gambler revolves around gambling. They are constantly preoccupied with the next bet, the next game, to the exclusion of relationships, family, job and other things in their lives. Many stop caring about themselves, their personal hygiene, appearance and health.

Problem gamblers are often able to hold down a job, can seem to be in control of their lives and so may give the appearance of functioning effectively (unlike people with an alcohol or drug problem, who may show obvious symptoms of their addiction). Nor does every problem gambler have financial problems.

Gambling may be a way to suppress other issues, allowing the gambler to manage intolerable feelings – sadness, frustration, lack of self- esteem - or providing a way to gain a temporary sense of control and power when otherwise they feel helpless facing their problems. It may also be a form of self-harm, with losses representing the punishment for being

“worthless”, “a bad person”.

Very few – perhaps less than 1%¹ - of those who might benefit from treatment actually receive it. When problem gamblers do ask for help, they are often in a state of real crisis and in need of immediate emotional as well as practical support. A number of our callers and clients have

considered or attempted suicide. After a huge loss the financial breakdown and the impact on family and

relationships as well as on the individual often leads to feelings of hopelessness from which there is no return.

Many problem gamblers may also have co-morbid mental health conditions. Recent research estimated that 58% of problem gamblers had a diagnosed substance use disorder, 38% had a mood disorder (for example clinical depression) and 37%

an anxiety disorder². These clients may also be receiving (or need) treatment or support from other agencies, the criminal justice system, social services or the NHS, requiring close liaison between all the agencies involved.

The impact of gambling goes beyond the individual: each problem gambler may have an adverse impact on 10–15 other people - partners, children, parents or siblings, employers, co-workers etc³. Children may be neglected as a result of the debts accrued by the parent who gambles; because of the parent’s preoccupation with their habit; or because of the tensions caused in their parents’ relationship. Family members may try to help by bailing out the gambler, probably doing more harm than good (to themselves and the gambler). This is why it is important that treatment and support services are available for both the problem gambler and the affected other.

1 Review of RET Final Report and Recommendations, para 7.28 Gambling Commission, Oct 2008

2 Lorains FK, Cowlishaw S, Thomas SA.(2011) Prevalence of comorbid disorders in problem and pathological gambling: systematic review and meta-analysis of population surveys. Addiction. Mar;106(3):490-8.

3 Lesieur HR, Custer RL. (1984) Pathological gambling: roots, phases, and treatment. Ann Acad Poll Soc Sci.474:146-156.

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How big is the problem?

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The latest evidence from the 2010 British Gambling Prevalence Survey⁴ (BGPS) showed that:

• 73% of the adult population (some 35.5 million) had gambled within the past year, compared with 68% in 2007

• problem gambling prevalence (using a measure that showed a statistically significant change) was higher in 2010 (0.9%) than in 2007 and 1999 (0.6% for both years). This equates to around 450,000 adults aged 16 and over in Britain

• problem gambling is more prevalent among men and younger age groups; and significantly associated with being of Asian/Asian British or Black/Black British origin

• problem gambling prevalence rates observed in Great Britain were similar to rates observed in other European countries, notably Germany (0.6%), Norway (0.8%) and Switzerland (0.8%); lower than countries like the USA (3.5%), South Africa (1.4%)and Hong Kong (5.3%); and higher than Sweden (0.3%), Canada (0.5%) and New Zealand (0.4%)

The BGPS also found that a further 1.8% of the population – over 900,000 people - were at “moderate risk” of becoming problem gamblers, and 5.5% - over 2.7 million people - displayed some risk factors.

The BGPS excludes data on some specific groups - such as prisoners, students, the homeless and under-16s - who are at particular risk in respect of gambling. The most recent research⁵ suggests that the prevalence of problem gambling amongst prison

4 British Gambling Prevalence Survey 2010, National Centre for Social Research, prepared for the Gambling Commission, 2011

5 OffGam Pilot Study, Summary Report July 2011, University of Lancaster

6 Ipsos MORI (2009): ‘British Survey of Children, the National Lottery and Gambling 2008-09: Report of a quantitative survey’, London, NLC

7 Grinols, E L. and Mustard, DB. 2001. “Business and Social Profitability: Evaluating Industries with Externalities, The Case of the Casino Industry.” Managerial and Decision Economics, vol. 22: 143-162.

8 “Tackling Problem Drug Use” Report by the Comptroller and Auditor General, NAO, March 2010

9 “Alcohol misuse; how much does it cost?” Cabinet Office 2003

populations may be as high as 10%

for men and 6% for women, with a further 17% men and 12% women at medium risk. Students are particularly vulnerable: away from home and perhaps managing money for the first time, immediately in debt through the loan system and so under pressure to find income, and very possibly encountering peers who claim to gamble successfully (perhaps because they have developed the necessary skills for certain activities) yet poorly informed themselves about the risks.

The most recent source of information on under-16s comes from a 2009 IPSOS Mori survey⁶which found that 2% (some 60,000) 12-15 year olds were problem gamblers; whilst showing a reduction from previous surveys, this is still a significantly higher prevalence rate than for adults.

Our latest analysis of need across Great Britain (Annex 1) takes into account evidence from the latest BGPS. Nearly one third of the population (31%) has no access to locally-delivered, specialized treatment.

Drawing on research in North America (none has been undertaken in Britain) we have assessed the costs of problem gambling to Great Britain at some £3.6 billion per annum, based on an estimated average annual social cost per problem gambler of around £8000 pa (Grinols &

Mustard, 2001)⁷ and using the 2011 prevalence figure of 450,000. This compares with an estimated annual cost of £15 billion for problem drug use⁸ and £9 billion for drink-related costs to the NHS and associated anti- social behaviour.⁹

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In recent years awareness of, and accessibility to, gambling opportunities has increased considerably, due in particular to the:

• growth in advertising, sponsorship and media endorsement

(facilitated by the 2005 Gambling Act)

• availability of gambling products via new channels: online, mobile technology, digital television etc

• advent and rapid development of social media

• accelerating development of and innovation in gambling products by the industry, both land-based and online

• increase in licensing of remote operators by other jurisdictions who target the UK market, facilitated by

“white listing” arrangements under the Act¹⁰

At the same time, the growth of the National Lottery, has contributed to a more general acceptance by society that gambling is an acceptable leisure pastime for many. Whilst playing the National Lottery on its own figures hardly at all as a factor amongst those contacting us for help, no-one has researched whether there is any evidence that Lottery playing leads vulnerable people into other forms of gambling.

All of these factors are likely to lead to an increasing number of people gambling, and so reinforce the need in the short term to ensure that adequate and effective support and treatment mechanisms are in place for those affected by gambling, and in the longer term to develop effective education and prevention measures.

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What is changing?

10 The Government has recently announced their intention that all remote operators targeting the UK market will require a Gambling Commission licence. This change in policy requires primary legislation the timetable for which has not been announced, so the change is unlikely to be implemented for at least 1-2 years, if not longer.

3 Jean’s Story

Jean’s realisation that her husband had a gambling problem was sudden and shocking. Following the recent death of her mother, Jean went to the building society intending to make investments for her children as part of their inheritance from their grandmother. She discovered that the mortgage on the family home was double the amount it should be. Her husband had forged her signature to re-mortgage their home to fund his gambling. Then she discovered the secret credit card bills – sent to a friend’s address. All Jean’s late mother’s estate was swallowed to pay the debts.

Jean felt isolated, betrayed and frightened. She questioned whether she really knew the man to whom she had been married for many years. She felt cheated by the friends who had colluded to keep his gambling secret.

She also felt that this was in some way her fault – that she had failed to keep her husband happy and safe. Through GamCare counselling, Jean was able to explore these feelings, come to terms with what had happened, and decide how she wanted her life to proceed. She was able to tell herself that her husband’s gambling was not her fault – and believe it. As a result of counselling, Jean has overcome the depression and fears she was experiencing. Jean and her husband have now re-built their relationship.

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Our priorities

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GamCare’s priorities are therefore to:

• provide help and support for those in need by maintaining, expanding and developing the existing delivery infrastructure, and by continuing to innovate in the provision of treatment. In particular, we will seek to ensure that

counselling is available in every part of the country by completing the network of partners we have been putting in place over recent years

• encourage collaboration rather than competition between providers, and so ensure that limited resources are used to best effect

• make sure that gamblers, non-gamblers, other support agencies, such as GPs are much better informed about the risks of gambling and that help is available

• develop an effective education and prevention strategy, with a particular focus on young people, their teachers and parents to be able properly to assess the risks of gambling and so equip them to be able to gamble responsibly and enjoyably within the law if they choose to do so

• focus research, other than prevalence work, on establishing what works in respect of treatment, education and prevention, and feeding this back into policies and practice

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Whilst awareness of GamCare – its HelpLine/NetLine and counselling services – is high amongst gamblers thanks particularly to marketing and publicity in gambling venues and on gambling websites, more general awareness of the risks of gambling, the signs of problem gambling, how to gamble responsibly and where to go for help is very low. This is true not just of the general public but also of those who might be expected to be better informed including GPs, teachers, debt advisers, social workers.

Reaching these professionals, who are in a good position to identify people who may be affected by gambling, and also the general public is vital to any successful responsible gambling strategy. Non-gambling partners, family members and friends can play a vital part in helping gamblers recognise and admit that they have a problem and encouraging them to seek help – but only if they know the risks, the indicators, and where to go for help. Our marketing effort needs increasingly to tackle this lack of awareness.

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Part 2 Our achievements 2011/12

GamCare We know about gambling We care about you

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Keelin’s Story

Keelin had for many years worked in the gambling industry and enjoyed placing the occasional bet. She liked to go to bingo on Sundays. Her life took a dramatic downturn with the death of her 13 month old baby. Born with an intestinal problem, he died whilst waiting for transplant surgery.

Keelin could not cope with the trauma the loss of her baby had wrought and the massive hole she felt was left in her life. The deep despair she felt turned her occasional bet into a gambling problem as a way to escape her sorrow. For that short period of time while she was gambling, she could zone out and be released from the pain she felt inside. She found it impossible to walk past a betting shop without venturing inside. At her lowest point, she was so out of control that she felt life was not worth living. It was then that Keelin went to Gamblers Anonymous and there heard about GamCare. Through her involvement in Gamblers Anonymous and her GamCare counselling sessions she was finally able to face her grief and come to terms with her sadness. Keelin’s treatment is now complete and she has managed to stop gambling. Moreover, she has learned how to enjoy life again and is able to cope with life’s stresses and strains.

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Making the call

Taking the first step to ask for help can be difficult. GamCare’s FrontLine services are the telephone HelpLine, its online equivalent, NetLine, and the online Forum and Chat Rooms.

Our Advisers are highly skilled and trained to know how to listen and respond immediately to the issues our callers raise.

Our HelpLine and NetLine provide a source of confidential advice and emotional support which many people use in addition to counselling or other services, as well as in moments of stress or crisis. These services are for partners, family members, friends, gambling industry and health professionals seeking advice, as well as for problem gamblers.

GamCare’s trained Advisers are ready to answer that call for help every day from 8am to midnight – 0808 8020 133, www.gamcare.org.uk

The total number of calls received in 2011/12 was up by 7% on 2010/11 and answerable calls by 4%. GamCare continued to answer a high volume of calls – close to 700 per week - and the trend for more callers to use NetLine continues. We also saw a slight increase in the number of calls appropriate to the service – “target” calls; people asking for information about the National Lottery continued to be the most common source of non-target calls.

Our success rate in answering calls fell – particularly for NetLine - largely due to reduced staffing levels because of uncertainty about funding until well into the second half of the year. One third of our callers use mobile phones and a further 15% block the number from which they are calling, showing their concern for privacy and confidentiality.

Call volumes

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2011/12 2010/11

Total calls 54,154 50,600

Answerable calls 46,093 44,282

Calls answered 35,857 36,917

Success rate 78% 83%

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How do callers find us?

Who called us?

Almost half (45%) of our HelpLine and NetLine callers now find out about GamCare through the web. One in five of our callers found us through information leaflets, posters, stickers etc available in gambling locations, highlighting the importance of working with the gambling industry to promote GamCare services.

The majority of our callers were men – close to 70%, consistent with 2010/11.The vast majority of male callers contacted us to discuss their own gambling problem (90%), whereas more than half of female callers wanted advice on how to get help for a family member, partner or friend. Around a quarter of our callers had called us before. Although this is a slight reduction on 2010/11 (29%) it demonstrates that a significant number of callers find it helpful to keep in touch for continuing support.

*Variation in figures 2010/11 to 2011/12 is due to improved recording of information

Source of information

l Website excluding GamCare (primarily Google) l Industry leaflets, stickers, tickets etc.

l Telephone Directories l Word of mouth l GamCare Website

l Health Professionals and other agencies l Media and Other*

Caller Type 2011/12 2010/11

All female male All female male

Family Member / Friend / Partner 22% 57% 7% 21% 55% 6%

Gambler 74% 35% 91% 75% 39% 91%

Health professionals and other agencies 3% 7% 1% 3% 6% 2%

2011/12 2010/11

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Age of callers

Ethnicity of callers

Close to two thirds of our callers were aged between 19 and 35 and this group were also the highest NetLine users – consistent with data for 2010/11. Over half of our callers have been gambling for less than five years, while just over 20% have been gambling for up to ten years.

The vast majority of our callers (89%) classify themselves as White. Some 8% of our callers are Asian, Asian British or Asian Chinese, and just 2% are Black/Black British. Research indicates that some 3.5 million people in Great Britain are thought to be in the low to moderate risk categories in terms of likelihood of developing a problem with their gambling. Black and Asian men feature significantly in this grouping.

The majority of our callers take part in a number of different types of gambling. The most commonly cited were betting (around one third of all callers); FOBT/roulette machines were mentioned by 28% of callers. Fruit/slot machines, while the next most frequently cited, were mentioned by only 17% of callers. As last year, male callers were more likely to mention betting (40%) than women (10%). This was also true of FOBTs where 31% of men and 10% of women played these machines (down from the 18% reported in 2010/11). Women were more likely than men to have played fruit machines/slots: 43% women (an increase on the 35% reported in 2010/11) and 12% men.

What are our callers gambling on?

*Each caller can give more than one gambling activity. Includes land based and remote gambling activities. Percentages are of all activities disclosed.

** FOBT (Fixed Odds Betting Terminals): virtual gaming machine mostly located in betting shops; Roulette machines: virtual and electronic roulette machines in casinos.

Gambling activities* 2011/12 2010/11

All HelpLine NetLine All HelpLine NetLine

Betting 34% 33% 32% 31% 30% 33%

Bingo 4% 3% 5% 4% 3% 5%

FOBT/Roulette Machines** 28% 34% 23% 29% 36% 22%

Fruit/Slot Machines 17% 15% 19% 16% 14% 18%

National Lottery Draw 1% 1% 1% 1% 1% 1%

Other 0% 1% 0% 1% 1% 1%

Poker 4% 3% 5% 5% 4% 6%

Scratchcard 2% 3% 2% 2% 3% 2%

Table Games 10% 7% 13% 10% 8% 13%

Age of Caller 2011/12 2010/11

17-18 2% 1% 3% 2% 1% 1%

19-25 31% 24% 39% 32% 26% 42%

26-35 33% 30% 36% 31% 28% 36%

36-45 18% 21% 16% 19% 23% 14%

46-55 10% 14% 5% 10% 14% 5%

56-65 4% 7% 1% 4% 5% 2%

66+ 2% 3% 0% 2% 3% 0%

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Signposting from the HelpLine and NetLine*

l GamCare HelpLine, NetLine, Forum and website l GamCare Counselling services **

l Self Exclusion

l Gamblers Anonymous and GamAnon l Other Agencies

l Software to block online gambling sites l Other Counselling

2011/12 2010/11

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Where do our callers gamble?

What help do we give?

Almost half of our callers mentioned gambling in betting shops. Male callers were much more likely to visit betting shops than women (52% men and 14% women) with betting shops showing increased popularity with men aged between 46 and 65 years. Around one third of callers gamble on the Internet – around one half of women and one third of men. This is an increase for our female callers where the figure for 2010/11 was 44%.

GamCare Advisers give help and advice to deal with the immediate issues which our callers raise. Advisers will also guide callers to a range of other ways to get continued support and advice.

Many of our callers were advised to get continued support from GamCare’s HelpLine and NetLine and online services as well as to take steps to protect themselves from the immediate risk of gambling further beyond their means. Our Advisers regularly discussed self exclusion both from online sites and from gambling establishments as well as use of blocking software on home PCs. Around one fifth of callers were advised to consider sustained counselling through GamCare or other counselling agencies. Gamblers Anonymous and GamAnon were recommended as alternatives or to supplement counselling treatment.

Many were referred to other specialist advice such as debt advisers.

Of those callers who gave feedback, 86% rated Gamcare’s service as Excellent or Very Good.

* Each caller can give more than one gambling location. Includes land based and remote locations. Percentages are of all locations disclosed.

*Callers can be signposted to more than one destination

**For regions covered by current GamCare Partners go to www.gamcare.org.uk/partners.php

Gambling locations 2011/12 2010/11

Arcade 3% 4% 3% 4% 5% 3%

Betting Shop 46% 55% 38% 48% 53% 40%

Bingo Hall 2% 2% 1% 2% 2% 2%

Casino 8% 8% 8% 8% 8% 8%

Internet 34% 21% 45% 31% 24% 42%

Pub / Club 3% 3% 3% 3% 3% 3%

Other 4% 7% 2% 4% 5% 2%

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Counselling

For people who are looking for sustained help to support them to deal with their gambling problems, GamCare counselling is offered through our teams in London, Manchester and online, and through a network of partnerships in other areas of Great Britain

In 2011/12 we provided counselling for 2716 clients - up 3% on 2010/11, which in turn represented a 26% increase on the previous year. This is an impressive result given that our funding for 2011/12 was frozen. 92% of our counselling clients were gamblers while 8% were partners or family members of a problem gambler. Almost without exception the partners we have treated are female and it seems that men are reticent to seek help if affected by the gambling of others. Overall the ratio of male to female clients exceeded 4:1.

Financial difficulty is frequently a trigger for people to realise they need help. Amongst clients disclosing their debts, 3%

reported debts of over £100,000 and a further 2% reported bankruptcy. For 17% of our clients, financial problems were not the reason for seeking help but they were prompted by problems with sustaining relationships, mental health – including some who had contemplated suicide – or physical health.

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Gambling Activities*

l Betting l Bingo

l FOBT/Roulette Machines**

l Fruit/Slot Machines l National Lottery Draw l Other

l Poker l Scratchcard l Table Games

2011/12 All

Jason’s Story

Jason came to GamCare for counselling at the request of his wife who felt their marriage was in jeopardy. A particularly unmotivated client, during his first session Jason described the frenzied nature of his gambling.

At the age of seven Jason parents went through a nasty divorce and soon after his mother married a violent,

domineering man. Jason received regular beatings and was routinely punished. His only respite was occasional visits to his paternal grandmother where they all enjoyed watching horseracing. One Saturday Jason’s grandfather put a bet on the Grand National for him; the horse won and the memory of winning was one of the fondest of his childhood.

Jason spent years of his childhood with his violent, jealous stepfather and became increasingly anxious for his mother’s attention. It was his gambling that activated a response from her. Jason visited the betting shop several times a day in moments snatched from work. He would back a horse, turn to the FOBT and ‘before he knew it’ would have ‘fed’ £250 into it. Chasing his losses, Jason would dash to the cashpoint for more funds, resulting in further financial loss.

Determined to change, after several counselling sessions Jason decided to try not to gamble. At the end of therapy Jason had learned to control his gambling. Most importantly, he described an increasing ability to manage difficult feelings and to tolerate and reflect upon challenging situations without recourse to gambling as a means of avoiding them.

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*Each client can give more than one gambling activity. Includes land based and remote gambling activities. Percentages are of all activities disclosed.

** FOBT (Fixed Odds Betting Terminals): virtual gaming machine located in betting shops/Roulette machines: virtual and electronic roulette machines in casinos.

What do our clients gamble on?

Our clients regularly participate in more than one gambling activity. In line with our callers’ experience, the most frequently mentioned gambling activity was betting (one third of clients), followed by FOBT/Roulette machines (close to a quarter). Fruit and slot machines were mentioned by 16% of our clients. Betting activity increased with the age of client.

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* Each caller can give more than one gambling location. Includes land based and remote locations. Percentages are of all locations disclosed.

Where do our clients gamble?

In line with the gambling activities most frequently cited by our callers, betting shops were the most frequently mentioned locations for gambling followed by the Internet, which showed a significant increase on the previous year.

Does treatment work?

In 2011/12 we spent some £1.72 million in total on treating 2716 clients – around £630 per client. 92%

- 2497 – were gamblers, and some 80% of these - 2032 – were problem gamblers. Around 76% (1543) of these clients are no longer problem gamblers at the end of treatment, representing an annual saving to society of some £12.3 million (1543 x £8,000) - a return on investment of nearly 7:1. This compares with 2.5:1 for the treatment of problem drug users, where the mean cost of treatment is £4,900 for a mean benefit of £12,000 (NAO, 2010).

Gambling locations*

l Arcade l Betting Shop l Bingo Hall l Casino l Internet l Pub / Club l Other

2011/12 2010/11

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Stopping problems before they start

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Our treatment services are there for people who have already fallen into difficulty. GamCare is equally concerned to prevent problems happening. We know that in addition to the 450,000 adults who at any one time will have a gambling problem, a further three million are considered to be at moderate risk of developing a problem. We also know that young people are more likely to engage in risky behaviours than adults. Our prevention work is designed to raise awareness of the risks of problem gambling and encourage those who do wish to gamble to do so in a safe and controlled way.

All of our prevention work is taken forward on a charged for basis or has been made possible by private sponsorship or funding through charitable trusts.

Working with the gambling industry

Our work with the gambling industry is central to our prevention programme. Frontline staff, customer service teams and managers working in the industry are well placed to spot customers who may be getting into difficulties. We provide training to raise awareness of problem gambling, to enable industry staff to understand the issues and know when and how to intervene. GamCare Trade Services provides consultancy, training and accreditation – our GamCare Certification programme - to industry operators in Great Britain and internationally.

In 2011/12 we:

• launched our new e-learning programme: GamCare ExTra

• issued 28 new and renewal GamCare Certification awards

• ran training sessions in social responsibility in Great Britain as well as Antigua, Gibraltar and Ireland

• generated an income of

£132,000

2011/12 also saw the culmination of our Knowledge Transfer Partnership (KTP) with Salford University. Its purpose was to work with remote operators to improve player protection, and our contribution of £42,000 over two years, which has been provided through our own fundraising, levered in a further £86,000 over the lifetime of the KTP. As a result, we have developed and launched an online Forum – PlayRight - enabling secure discussion and exchange of good practice and support for those with responsibility for player protection across the online industry. The KTP also enabled us to take forward work on self-exclusion, and particularly

to research existing practice and literature, and explore the feasibility of developing an online multi- operator self exclusion programme.

Both of these projects represented a significant advance in intra-industry co-operation on social responsibility.

We are keen to ensure that we continue to drive forward the multi operator self exclusion project to implementation stage and that the Forum is used as a think tank to generate new ideas for player protection initiatives. We also hope to expand the scope of the self- exclusion work to encompass land- based as well as remote operators.

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Improving and influencing 4

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GamCare is the leading authority on problem gambling in the UK. We are widely known and respected internationally. We want to make sure that all aspects of our work are delivered to the highest standard.

HelpLine Accreditation

During 2011/12 GamCare began the process to achieve accreditation from The Helplines Association for all our frontline services: HelpLine, NetLine, Forum and ChatRooms.

This is a rigorous, comprehensive accreditation process which includes scrutiny of all policies and procedures, site inspection, staff interviews, and crucially feedback from our callers.

We expect to be accredited in Autumn 2012.

Information Standard

During 2011 GamCare achieved the Royal Society of Public Health Information Standard. The Information Standard is a quality mark awarded to organisations which have in place a rigorous process of quality control for production of public health information. The Information Standard provides assurance to all who read our leaflets and publications or visit our website that the information we provide is reliable, accessible and can be used with confidence.

GamCare is first and foremost an advice and treatment organisation, but we use the knowledge and expertise we gain from working with our callers and clients to engage in public debate and influence change.

Education

In 2011 the Government launched a public consultation on the review of the Personal, Social, Health and Economic education curriculum.

GamCare seized this opportunity to press home the case for the need for education about responsible gambling to be part of the Key Stage 4 curriculum in the same way that education about drugs, alcohol and safe sex are already included. GamCare’s submission to the consultation can be seen at www.gamcare.org.uk/data/files/

DfEPSHEReviewfinal. The Government is yet to publish its response to the consultation.

Culture, Media and Sport Select Committee on Gambling

GamCare submitted written evidence and appeared before the Culture, Media and Sport Select Committee during Autumn 2011.

Amongst the recommendations which GamCare put to the inquiry was a call for a public information campaign to educate people about responsible gambling. GamCare is pleased to note that this has been included in the recommendations from the Committee as have recommendations on the need for multi-operator self exclusion. We await the Government response.

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Part 3 Our plans 2012-2015

GamCare We know about gambling We care about you

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Objective 1

Objective 2

Objective 3

Objective 4 Objective 5

Our aim and objectives

In November 2011 we set ourselves a new and ambitious aim, that:

By 2015 everyone affected by gambling should have, and know how to get, access to information, advice and locally-delivered treatment; and all adults who choose to gamble, and all teenagers and their parents, should know how to gamble responsibly.

To deliver this we have set ourselves five, measurable objectives:

We have developed a suite of performance targets which take into account our strategic analysis, our funding agreements with the Responsible Gambling Trust covering the HelpLine and Treatment programmes, and our fundraising targets from other sources for our other programmes. These are set out in Annex 2.

To provide and promote an effective, high quality and impartial HelpLine service for problem gamblers and affected others, serving the whole of Great Britain.

To provide and promote an effective, high quality and responsive treatment service for problem gamblers and affected others in Great Britain.

To help and support operators and regulators in the development and implementation of effective responsible gambling policies, measures and practices.

To contribute to the development of policy and best practice in research, education and treatment.

To run GamCare efficiently, effectively and with proper regard to our impact on the environment.

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The HelpLine Our programmes

Our own review of our clinical services in 2010 identified that we could improve the efficiency of our front line services through greater technical integration of the HelpLine and NetLine, and that we could develop the services we offer to our callers by delivering brief interventions (for example, using motivational interviewing techniques) over the phone or online for those requiring greater support. We also identified the need to provide specific and tailored advice, information and support for under-16s, and to make use of SMS and social networking sites.

Our plans for the HelpLine, encompassing the NetLine and our online Chat Rooms and Forum include:

• 8am – midnight service, 365 days a year

• integration of the HelpLine and NetLine delivery systems to ensure an improved service and a more efficient use of resources

• establishment of dedicated services for under-16s, affected others and, in later years, non- English speakers

• introduction of brief interventions delivered by HelpLine staff

• development of social media to improve reach and effectiveness

• acquisition of The HelpLine Association’s accreditation

1

During 2012 we will also provide a freephone service for a trial period from April, running alongside our existing number, and will evaluate its effectiveness over a 12 month period. The independent evaluation will be conducted by The Helpline Association and we have deliberately extended its scope to provide us with a thorough and objective evaluation of the telephone helpline service as a whole, not just the freephone service.

+ ²⁰

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Treatment

We currently offer treatment for gamblers and others affected by gambling through face to face, online and group counselling. Face to face counselling is available in some 70% of Great Britain. We very rarely treat anyone under 16.

Our immediate priorities are to expand capacity to meet demand for face to face counselling in existing areas and progressively to expand services to cover at least 95% of Great Britain. We will achieve this by 2015 by expanding our own directly delivered services in London and the North West and by developing and adding to our existing Partner network. Our plans for expansion take into account our assessment of need (Annex 1), and

will give early priority to establishing a service in Wales and Cornwall. As part of this work we will review and strengthen our commissioning and Partner management processes and capacity. We will work closely with the National Problem Gambling Clinic to ensure the closest cooperation with local NHS provision by building on our model of joint working in London.

We will also increase and broaden the types of treatment available, in particular through:

• further development of online counselling

• greater use of group work alongside individual counselling

2

• exploration and evaluation of different and innovative approaches to treatment

• introduction of bespoke treatment provision for under-16s, including the development of a dedicated website and use of social networking

• development of provision for high- risk groups such as offenders and students in years 2 and 3, including pursuit of potential matching funding

We will continue to use the DSMIV screen to assess gamblers at the beginning and end of treatment, and explore how best to gather data post-treatment to evaluate whether behaviour change is sustained. We will also introduce the PGSI screen, and add customer satisfaction assessments during and at the end of treatment.

We will continue to work with “affected others” – those harmed by the activities of a problem gambler, including partners and families. In 2012 we will introduce a dedicated affected other online chatroom and we will also pilot and introduce an outcome measure to assess the effectiveness of our interventions with this group.

We intend to apply for BACP accreditation of our in-house counselling, and external

accreditation of our in-house training, in 2012/13.

As part of the development of the national Gamcare Partner treatment network we will strengthen arrangements for the strategic and operational coordination of treatment planning and provision, as well as strengthening our own processes for commissioning.

+ ²¹

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Youth services

To build on our analysis of teenage problem gambling Beating the Odds: Preventing Teenage Problem Gambling’ published in 2010 we have developed plans for a coherent education and awareness programme for teenagers, parents and teachers. The overall aim of the programme is to raise awareness of the risks of problem gambling for young people aged 12-18; provide channels for peer-to-peer discussion;

and to signpost young people already experiencing problems to where they can find help. We plan to do this by:

• developing the presence of GamCare on the Internet and other new media platforms in such a way that attracts young people, allowing us effectively to deliver information to this audience – both through our own website and using outlets such as YouTube, Facebook, and Twitter. We are taking this work forward in close cooperation with Gambleaware given the clear need for synergies between the two websites and the need to provide a seamless transition from information giving to treatment interventions where needed

• running outreach pilots based in schools, colleges, pupil referral units and youth groups in two English regions working with our existing GamCare Partners. These will offer awareness raising sessions for young people, parents/carers and teachers

The youth website, which we will launch in Autumn 2012, is an essential part of our awareness raising strategy and will enable us to reach out to a new young audience which we are currently not engaging through our existing programmes. It will provide a continuum of services: awareness raising/information provision;

assessment and self help; dedicated forums and chat rooms and, where appropriate, pathways through to more sustained support including online and other counselling.

We have secured an £80,000 grant from the Esmée Fairbairn Foundation to develop and run a £95,000 education pilot in Bristol, working with our existing treatment Partner ARA.

Starting in October 2012, this will deliver a programme of outreach, education and support for more than 2000 14-18 year olds over two years. We are also working with a Partner in East Anglia to raise funding for a similar pilot there. The pilots will allow us to trial and evaluate different approaches and materials and so form the basis for a national programme which could begin to roll out from 2015.

3 John’s Story

John started playing as a child and felt that gambling had “taken over”

his life.

John entered a programme of online counselling with a GamCare counsellor. Through this John discovered that his drive to gamble came from his sense of powerlessness and lack of direction, after giving up his dream of becoming an actor to please his wife. Even though he was successful, he saw himself as a puppet of other people’s ambitions.

Counselling gave him a fresh perspective and motivation. He learned that playing the machines gave him an illusion of control and that arcades had been his childhood refuge when his parents were emotionally unavailable:

“I developed a relationship with a machine that provided me with what I felt was lacking.”

John had 12 sessions with his counsellor. In his final e-mail to his counsellor, John said: “I am happy to report I have not gambled or wanted to since our last chat, making it over a year in total now and I can’t tell you how good that makes me feel. I have been able to commit myself to other pursuits and have got a lot of my passion back for the parts of my life I had just about lost. My new focus on my work is paying off and I am achieving the goals I had set out to do many years ago. I have come so far in this last year and I am feeling very optimistic for the future. Although I believed I would stop I thought it would take a lot longer than it did.”

+ ²²

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Prevention 4

+ ²³

Our prevention work with the industry is increasingly moving away from direct delivery of training to industry staff.

More operators are now delivering their own training, in-house. Our role now is focussed more on advice, consultancy and the extension of GamCare certification.

The main opportunities for new certification are likely to be in the online industry, and this is where most benefit for UK consumers is also to be had. The DCMS’s announced intention to require all operators to acquire Gambling Commission licences is unlikely to be implemented for at least 1-2 years (it requires primary legislation), and in the meantime we will seek to work with operators seeking to demonstrate their commitment to social responsibility.

We will continue to develop GamCare ExTra – designed particularly for customer-facing staff with online companies, and explore whether there is a demand for other e-learning packages for other sectors. There are also opportunities for us to provide training and consultancy to other, non-industry stakeholders – new media platform providers, regulators, debt advisers, the health sector which we will explore. We will continue work to explore and develop collaboration within the industry on multi-operator self-exclusion and best practice in player protection.

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Management and organisation

Our resources 6

5

+ ²⁴

Our main services – helpline and counselling – are delivered by a combination of employed and self- employed staff, providing flexibility to respond quickly to changing circumstances whilst ensuring the organisation maintains sufficient in- house expertise and experience. As at April 2012, 52 people were working for GamCare either full or part-time – the equivalent of nearly 37 full-time staff.

The planned growth of our Partner counselling operations means that we are taking steps to strengthen our commissioning and delivery management function. We are conducting a performance review of each of our existing Partners and

developing a new approach to performance measurement designed to improve information on outcomes and value for money. This will lead to the introduction of a new approach to commissioning and contract management from October 2012 onwards.

At present our trading activities are conducted through our trading company, GamCare Trade Services.

After a review of the costs and effectiveness of these arrangements, informed by an external expert, we have decided to bring all trading activities back under the aegis of the charity itself and to close the separate trading company.

The majority of our funding comes in the form of grants from the Responsible Gambling Trust, which support our main services.

The Trust has agreed funding levels for three years for both the helpline and treatment services, subject to performance and availability, allowing us to plan ahead with a greater level of security.

We supplement the grants from the Responsible Gambling Trust from our trading income, and from other grants and donations.

These other sources of funding are increasingly tied to the delivery of specific projects – for example we have raised over £24,000 to fund the development of our Young Persons’ website, and we have obtained £80,000 from the Esmée Fairbairn Foundation towards our GamCare/ARA Bristol education pilot. We will continue to pursue other funding opportunities, whether they be grants, partnerships, sponsorship or donations, and will develop and implement a new fundraising strategy in the second half of 2012/13.

Income £,000 Actual 2011/12 Plan 2012/13 Plan 2013/14 Plan 2014/15

Responsible Gambling Trust: HelpLine 860 885 910 925

Responsible Gambling Trust: Treatment 1,770 1,930 2,075 2,400

Trading 132 165 170 180

Education Pilots 0 42 38 0

Other 58 78 80 90

Total 2,820 3,100 3,273 3,595

Of which Responsible Gambling Trust 2,630 (93%) 2,815 (91%) 2,985 (91%) 3,325 (92%) We will take forward four major IT development projects during 2012, each of which will improve the

efficiency and effectiveness of services but which also have implications for resources over the next three years.

These are:

• creation of a young persons’ website

• helpLine/NetLine integration

• database development

• main website rebuild Our new client database will be operational from November 2012. It will provide the infrastructure necessary to support the new performance management framework being developed for our treatment services.

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+ ²⁵

11 Funding only agreed for first six months

Most of our expenditure goes on our frontline services – the HelpLine, NetLine, Forum and Chat Rooms – and treatment.

In 2011/12 the frontline services accounted for 30% and treatment for 63% of our spend. The rest went on our prevention work with the industry (5%), which is self-funding, leaving 2% for development work – primarily with young people and player protection. 70% of the treatment budget was used to commission, manage and fund counselling delivered by our Partner network around the country. Whilst expenditure on the HelpLine is planned to increase by 4% over the planning period, the major areas for new investment are the expansion of existing and new treatment services to encompass 95% of Great Britain by 2015 and the launch of our services for young people. Expenditure on youth services shifts from Research

&Development to its own line from 2012 onwards.

In 2011/12, 53% of our total expenditure went on staff and 30% on grants to the GamCare Partners programme; just 6% went on overheads (rent, utilities, stationery etc). IT expenditure in 2012 reflects the number of significant development projects underway, including the youth website and database. Development budgets in 2013/14 and 2014/15 will provide for new areas of work yet to be fully scoped, eg work with offenders, students and non-English speakers.

Expenditure by programme £,000 Actual 2011/12 Plan 2012/13 Plan 2013/14 Plan 2014/15

Helpline (inc NetLine, Forum, Chatroom) 847 879 877 896

Treatment (inc Partners) 1,725 1,898 2,109 2,400

Youth 0 120 93 94

Prevention (trading) 133 164 166 170

Other (R&D) 67 7 21 30

Total 2,772 3,068 3,266 3,590

Expenditure by category £,000 Actual 2011/12 Plan 2012/13 Plan 2013/14 Plan 2014/15 Staff: salaries, NI, pensions, contracted

staff, training, supervision etc 1,479 1,484 1,532 1,579

Rent, utilities etc 201 182 187 194

IT 82 244 147 150

Payments to Partners 837 970 1,200 1,465

Payments to Youth Pilots 27 27 26

Marketing 65 64 66 66

Legal & professional 28 24 23 15

Development 0 0 13 22

Other 80 73 71 73

Total 2,772 3,068 3,266 3,590

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n Over-16 population (81.39%)

n Estimated problem gambler Population (Over 16) 0.9%

n Estimated ‘at risk’ population (1.8%)

+ ²⁶

Annex 1

GamCare assessment of need, Great Britain, January 2012

GrEAT BrITAIN

ENGLAND SCOTLAND

LONDON NOrTH EAST

NOrTH WEST

WEST MIDLANDS WALES

EAST MIDLANDS

EAST OF ENGLAND

SOuTH EAST SOuTH WEST

YOrKSHIrE AND

THE HuMBEr

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+ ²⁷

Annex 2

Performance targets, 2011/12 – 2014/15

Notes

Inbound calls = Total calls received (includes out of hours, callers hanging up etc) Answerable calls = Calls received in business hours and not abandoned by caller Answered calls = Calls answered by advisers

Target calls = Calls relevant to the purpose of the helpline (most common non-target calls are from people asking for information about the National Lottery) GamCare counselling = directly delivered: London, Salford, online

Partner counselling = delivered by GamCare Partners under Service Level Agreements

Client totals include gamblers and non-gamblers (i.e. affected others)

Gambling clients are assessed at the beginning and end of treatment using the DSM-IV screen. A score of 3 or more signifies a problem gambler, of 5 or more a pathological gambler. The % figures at assessment and end of treatment relate to a sample of gambling clients.

TBD = To be determined. These targets depend on the development of the new treatment performance framework and the introduction of client satisfaction feedback, both planned for October 2012

HelpLine/NetLine Actual 2011/12 Actual 2012/13 Actual 2013/14 Actual 2014/15

Inbound calls (Forecast) 54,154 58,640 60,200 62,000

Answerable calls (a) 46,093 51,150 52,650 54,250

Answered calls(b) 35,857 44,000 45,800 47,750

Success rate (b/a%) 78 86 87 88

Target calls (c) 15,728 21,120 22,900 23,850

Target/answered (c/b%) 44 48 50 50

Caller satisfaction: % rating service Excellent/VG 86 85 85 85

Cost per answered call £ 20.59 18.72 17.94 17.58

Chat Room/Forum

Chat hours offered 696 680 680 680

Counselling

Clients treated:

London 210 265 310 325

Manchester 159 160 175 200

Online 109 135 180 225

Partners 2238 2440 2935 3500

Total 2716 3000 3600 4250

Cost per client £ 633 642 621 612

% all clients completing treatment 43 TBD TBD TBD

% problem gambling clients no longer PG at

end of treatment 20 TBD TBD TBD

Client satisfaction: % rating service Excellent/VG NA TBD TBD TBD

Prevention/education

Companies with GamCare certification 40 45 50 55

14-18 year olds receiving education (Bristol pilot) 0 1000 1100 0

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HelpLine

0808 8020 133 NetLine

www.gamcare.org.uk

GamCare 7-11 St John’s Hill London SW11 1TR

T 020 7801 7000 F 020 7801 7033 E [email protected]

The full set of data on which this review is based is available on our website

www.gamcare.org.uk

A charitable company registered in England no. 3297914. Charity no. 1060005

Moving in the right direction

Review and Plan

2012-2015