Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Health Services Research
Published in: BMC Health Services Research 1/2016

Open Access 01-12-2016 | Research article

“Talk with me”: perspectives on services for men with problem gambling and housing instability

Authors: Sara J. T. Guilcher, Sarah Hamilton-Wright, Wayne Skinner, Julia Woodhall-Melnik, Peter Ferentzy, Aklilu Wendaferew, Stephen W. Hwang, Flora I. Matheson

Published in: BMC Health Services Research | Issue 1/2016

Login to get access

Abstract

Background

Problem gambling and homelessness are recognized as important public health concerns that significantly impact individuals, their friends and families, communities and broader society. We aimed to explore the experiences with health and social services of men who had histories of problem gambling and housing instability in Toronto, Ontario.

Methods

We used a community-based participatory approach with a multi-service agency serving low-income individuals. We conducted qualitative interviews with men (n = 30) who had experienced problem gambling and housing instability. Our interviews employed open-ended questions to elicit men’s perceptions of services related to housing instability, problem gambling and other comorbid conditions (e.g., mental illness, substance use). We reviewed relevant themes related to experiences with services (e.g., Use of and feedback on: health and social services, housing services, justice/legal aid services, substance use services, gambling services; stigma; goals; triggers; physical health; coping strategies; finances; relationships; barriers to services and recommendations for services).

Results

The concept of person-centred engagement was identified as a main overarching theme, and seemed to be lacking in most of the men’s experiences of services. Person-centred engagement for these men entailed empowerment and autonomy; empathy, compassion and sincerity; respectful communication; and tailored and holistic life plans. While there was a strong emphasis placed on independence, the men identified the importance of positive therapeutic relationships as being critical aspects of the recovery process. Based on our analyses, several recommendations were identified: 1) Increasing general awareness of services for problem gambling; 2) Delivering integrated services in a one-stop-shop; 3) Addressing mental health with psychotherapy and pharmacotherapy; 4) Providing timely access to prevention and recovery services; and 5) Enhancing life skills with peer support.

Conclusions

Our study highlighted that most of the men we interviewed were not having their health and social needs met. Services need to address the intersection of problem gambling, housing instability, and other comorbidities. Ensuring services are grounded in person-centred engagement appears to be critical for optimal service delivery.
Appendix
Available only for authorised users
Literature
1.
Korn DA, Shaffer HJ. Gambling and the health of the public: adopting a public health perspective. J Gambl Stud. 1999;15(4):289–365.CrossRefPubMed
2.
Cowlishaw S, Kessler D. Problem gambling in the UK: implications for health, psychosocial adjustment and health care utilization. Eur Addict Res. 2015;22(2):90–8.CrossRefPubMed
3.
Begin P, Casavant L, Chenier NM. Homelessness. Ottawa: Library of Parliament; 1999.
4.
Hwang SW. Housing and population health. Toronto: Centre for Applied Social Research, University of Toronto; 1999.
5.
Echenberg H, Jensen H. Defining and enumerating homelessness in Canada. Ottawa: Library of Parliament; 2008.
6.
Rogers N, Button E, Hume A. Safe as houses: an exploration of the link between gambling and homelessness. In: Research report. Adelaide: South Australian Department for Families and Communites; 2005.
7.
Delfabbro P. Problem and pathological gambling: a conceptual review. J Gambl Bus Econ. 2013;7(3):35–53.
8.
Neal P, Delfabbro P, O’Neil M. Problem gambling and harm: towards a national definition. Melbourne: Department of Justice; 2005.
9.
Brown SLC. Queen of hearts: the needs of women with gambling problems. Melbourne: Financial & Consumer Rights Council; 1997.
10.
Stucki S, Rihs-Middel M. Prevalence of adult problem and pathological gambling between 2000 and 2005: an update. J Gambl Stud. 2007;23(3):245–57.CrossRefPubMed
11.
Gattis M, Cunningham-Williams R. Housing stability and problem gambling: is there a relationship? J Soc Serv Res. 2011;37(5):490–9.CrossRef
12.
Crane M, Byrne K, Fu R, Lipmann B, Mirabelli F, Rota-Bartelink A, Ryan M, Shea R, Watt H, Warnes AM. The causes of homelessness in later life: findings from a 3-nation study. J Gerontol Ser B Psychol Sci Soc Sci. 2005;3:S152–9.CrossRef
13.
Antonetti E, Horn M. Gambling the home away: a study of the impact of gambling on homelessness. South Melbourne: Hanover Welfare Services; 2001.
14.
15.
16.
Shaffer HJ, Korn DA. Gambling and related mental disorders: a public health analysis. Annu Rev Public Health. 2002;23:171–212.CrossRefPubMed
17.
Abdollahnejad R, Delfabbro P, Denson L. Psychiatric co-morbidity in problem and pathological gamblers: investigating the confounding influence of alcohol use disorder. Addict Behav. 2014;39(3):566–72.CrossRefPubMed
18.
Dowling NA, Cowlishaw S, Jackson AC, Merkouris SS, Francis KL, Christensen DR. Prevalence of psychiatric co-morbidity in treatment-seeking problem gamblers: a systematic review and meta-analysis. Aust N Z J Psychiatry. 2015;49(6):519–39.CrossRefPubMedPubMedCentral
19.
Grodsky PB, Kogan LS. Does the client have a gambling problem? J Gambl Stud. 1985;1(1):51–8.CrossRef
20.
21.
Nadelmann EA. Drug prohibition in the United States: costs, consequences, and alternatives. Science. 1989;245(4921):939–47.CrossRefPubMed
22.
Smyth NJ, Kost KA. Exploring the nature of the relationship between poverty and substance abuse -- knowns and unknowns. J Hum Behav Soc Environ. 1998;1(1):67–82.CrossRef
23.
Shaffer HJ, Freed CR, Healea D. Gambling disorders among homeless persons with substance abuse disorders seeking treatment at a community center. Psychiatr Serv. 2002;53(9):1112–7.CrossRefPubMed
24.
National Research Council. Pathological gambling: a critical review. Washington, DC: The National Academies Press; 1999.
25.
Ferentzy P, Wayne Skinner WJ, Matheson FI. Illicit drug use and problem gambling. ISRN Addiction. 2013;2013:11. Online.CrossRef
26.
Matheson FI, Devotta K, Wendaferew A, Pedersen C. Prevalence of gambling problems among the clients of a toronto homeless shelter. J Gambl Stud. 2014;30(2):537–46.CrossRefPubMed
27.
Sharman S, Dreyer J, Aitken M, Clark L, Bowden-Jones H. Rates of problematic gambling in a British homeless sample: a preliminary study. J Gambl Stud. 2015;31(2):525–32.CrossRefPubMed
28.
Sadler MA. Escaping poverty: risk-taking and endogenous inequality in a model of equilibrium growth. Rev Econ Dyn. 2000;3(4):704–25.CrossRef
29.
Holdsworth L, Tiyce M. Further from home? Homelessness and gambling: exclusion, identity and place. In: Threadgold S, Kirby E, Germov J, editors. Local lives/gobal networks: the annual conference of the Australian sociological association. Canberra: Australian Sociological Association, University of Newcastle; 2011.
30.
Devotta K, Woodhall-Melnik J.R., Pedersen C, Wendaferew A, Dowbor T.P., Guilcher S.J., Hamilton-Wright S, Ferentzy P, Hwang S.W., Matheson F.I. Enriching qualitative research by engaging peer interviewers: A case study. Qual. Res. 2016 (Advanced Online). DOI: 10.​1177/​1468794115626244​.
31.
Macaulay AC, Commanda LE, Freeman WL, Gibson N, McCabe ML, Robbins CM, Twohig PL. Participatory research maximises community and lay involvement. BMJ. 1999;319(7212):774–8.CrossRefPubMedPubMedCentral
32.
Green LW, Mercer SL. Can public health researchers and agencies reconcile the push from funding bodies and the pull from communities? Am J Public Health. 2001;91(12):1926–9.CrossRefPubMedPubMedCentral
33.
Canadian Institute for Health Information. Guide to knowledge translation planning at CIHR: integrated and End-of-grant approaches. Ottawa: Her Majesty the Queen in Right of Canada; 2012.
34.
Toce-Gerstein M, Gerstein DR, Volberg RA. The NODS-CLiP: a rapid screen for adult pathological and problem gambling. J Gambl Stud. 2009;25(4):541–55.CrossRefPubMedPubMedCentral
35.
Wickwire Jr EM, Burke RS, Brown SA, Parker JD, May RK. Psychometric evaluation of the national opinion research center DSM-IV screen for gambling problems (NODS). Am J Addict. 2008;17(5):392–5.CrossRefPubMed
36.
Hodgins DC. Using the NORC DSM screen for gambling problems as an outcome measure for pathological gambling: psychometric evaluation. Addict Behav. 2004;29(8):1685–90.CrossRefPubMed
37.
38.
Kessler RC, Andrews G, Colpe LJ, Hiripi E, Mroczek DK, Normand SL, Walters EE, Zaslavsky AM. Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychol Med. 2002;32(6):959–76.CrossRefPubMed
39.
WHO Assist Working Group. The alcohol, smoking and substance involvement screening test (ASSIST): development, reliability and feasibility. Addiction. 2002;97(9):1183–94.CrossRef
40.
Ferris J, Wynne H. The Canadian problem gambling index: final report. Ottawa: Canadian Consortium for Gambling Research; 2001.
41.
Stevens M, Young M. Gambling screens and problem gambling estimates: a parallel psychometric assessment of the Soutt Oaks gambling screen and the Canadian problem gambling index. Gambl Res. 2008;20(1):13–36.
42.
Glaser BG. The discovery of grounded theory : strategies for qualitative research. Chicago: Aldine Pub. Co.; 1967.
43.
Burnard P. A method of analysing interview transcripts in qualitative research. Nurse Educ Today. 1991;11(6):461–6.CrossRefPubMed
44.
Andrews G, Slade T. Interpreting scores on the Kessler Psychological Distress Scale (K10). Aust N Z J Public Health. 2001;25(6):494-497.CrossRefPubMed
45.
Holdsworth L, Haw J, Hing N. The temporal sequencing of problem gambling and comorbid disorders. Int J Ment Health Addict. 2012;10(2):197–209.CrossRef
46.
Pulvirenti M, McMillan J, Lawn S. Empowerment, patient centred care and self-management. Health Expect. 2014;17(3):303–10.CrossRefPubMed
47.
Zoffmann V, Hornsten A, Storbaekken S, Graue M, Rasmussen B, Wahl A, Kirkevold M. Translating person-centered care into practice: a comparative analysis of motivational interviewing, illness-integration support, and guided self-determination. Patient Educ Couns. 2015;99(3):400–7.CrossRefPubMed
48.
Russell A, Abidi SR, Abidi SS. Shared decision making: using theories and technology to engage the patient in their health journey. Stud Health Technol Inform. 2014;205:303–7.PubMed
49.
Rogers S, Howard G. Patient and community engagement: the approach at university health network. Healthc Q. 2014;17(3):70–3.CrossRefPubMed
50.
Phillips RL, Short A, Kenning A, Dugdale P, Nugus P, McGowan R, Greenfield D. Achieving patient-centred care: the potential and challenge of the patient-as-professional role. Health Expect. 2014;18(6):2616–28.CrossRefPubMed
51.
52.
Absolom K, Holch P, Woroncow B, Wright EP, Velikova G. Beyond lip service and box ticking: how effective patient engagement is integral to the development and delivery of patient-reported outcomes. Qual Life Res. 2015;24(5):1077–85.CrossRefPubMed
53.
Treloar C, Rance J, Grebely J, Dore GJ. Client and staff experiences of a co-located service for hepatitis C care in opioid substitution treatment settings in New South Wales. Australia Drug Alcohol Depend. 2013;133(2):529–34.CrossRefPubMed
54.
Orr LC, Elliott L, Barbour RS. Promoting family-focused approaches within adult drug services: the potential of the ‘Senses Framework’. Int J Drug Policy. 2014;25(5):888–96.CrossRefPubMed
55.
Thompson L, McCabe R. The effect of clinician-patient alliance and communication on treatment adherence in mental health care: a systematic review. BMC Psychiatry. 2012;12:87.CrossRefPubMedPubMedCentral
56.
Gainsbury S, Hing N, Suhonen N. Professional help-seeking for gambling problems: awareness, barriers and motivators for treatment. J Gambl Stud. 2014;30(2):503–19.CrossRefPubMed
57.
Harris MG, Baxter AJ, Reavley N, Diminic S, Pirkis J, Whiteford HA: Gender-related patterns and determinants of recent help-seeking for past-year affective, anxiety and substance use disorders: findings from a national epidemiological survey. Epidemiol Psychiatric Sci 2015:1–14 (Advanced Online). DOI: http://​dx.​doi.​org/​10.​1017/​S204579601500087​6.
58.
Baxter A, Salmon C, Dufresne K, Carasco-Lee A, Matheson FI. Gender differences in felt stigma and barriers to help-seeking for problem gambling. Addictive Behaviors Reports. 2016;3:1–8.CrossRef
59.
Campanelli PC, Lieberman HJ. Integrating consumer health care with supportive housing services. Psychiatr Serv. 2009;60(4):553.CrossRefPubMed
60.
Achab S, Chatton A, Khan R, Thorens G, Penzenstadler L, Zullino D, Khazaal Y. Early detection of pathological gambling: betting on GPs’ beliefs and attitudes. BioMed Res Int. 2014;2014:360585.CrossRefPubMedPubMedCentral
61.
Schuler A, Ferentzy P, Turner NE, Skinner W, McIsaac KE, Ziegler C, Matheson F: Gamblers Anonymous as a recovery pathway: A scoping review. J Gambl Stud Accepted, in press.
62.
63.
Seguin M, Boyer R, Lesage A, McGirr A, Suissa A, Tousignant M, Turecki G. Suicide and gambling: psychopathology and treatment-seeking. Psychol Addict Behav. 2010;24(3):541–7.CrossRefPubMed
64.
Hollander MJ, Prince MJ. Organizing healthcare delivery systems for persons with ongoing care needs and their families: a best practices framework. Healthc Q. 2008;11(1):44–54. 42.CrossRefPubMed
Metadata
Title
“Talk with me”: perspectives on services for men with problem gambling and housing instability
Authors
Sara J. T. Guilcher
Sarah Hamilton-Wright
Wayne Skinner
Julia Woodhall-Melnik
Peter Ferentzy
Aklilu Wendaferew
Stephen W. Hwang
Flora I. Matheson
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2016
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-016-1583-3

Other articles of this Issue 1/2016

BMC Health Services Research 1/2016 Go to the issue

Research article

Implementing a video-based intervention to empower staff members in an autism care organization: a qualitative study

Research article

Comparing routine administrative data with registry data for assessing quality of hospital care in patients with myocardial infarction using deterministic record linkage

Research article

A framework to assess patient-reported adverse outcomes arising during hospitalization

Research article

Implementation of the Quebec mental health reform (2005–2015)

Research article

Physician drug dispensing in Switzerland: association on health care expenditures and utilization

Research article

The league of extraordinary generalists: a qualitative study of professional identity and perceptions of role of GPs working on a national after hours helpline in Australia