1. Gambling Among Seniors: Pasttime or Past Time Jane Reynolds, BA Clinical Coordinator Problem Gamblers Help Network of WV Jane Reynolds, BA Clinical Coordinator Problem Gamblers Help Network of WV

2. Gambling: The New Boom Industry The first state lottery started in New Hampshire in 1963 Now almost ALL states have lotteries Until 1988, only two states had legalized casino gaming Now at least 39 states have legalized casino-style games Simulcast, off-track, Internet, Bingo, Pull tabs AMERICANS SPEND MORE $$$ ON GAMBLING THAN ALL OTHER FORMS OF RECREATION COMBINED! The first state lottery started in New Hampshire in 1963 Now almost ALL states have lotteries Until 1988, only two states had legalized casino gaming Now at least 39 states have legalized casino-style games Simulcast, off-track, Internet, Bingo, Pull tabs AMERICANS SPEND MORE $$$ ON GAMBLING THAN ALL OTHER FORMS OF RECREATION COMBINED!

3. Government Sponsored/Regulated Gaming Venues in West Virginia

4. Who are we? First Choice Health Systems, Inc, established in 1995 as a statewide network of behavioral health providers, manages various state contracts Answered RFP in December 1999 to design and implement a statewide gamblers help program Provided comprehensive treatment program for gamblers in WV for almost 10 years First Choice Health Systems, Inc, established in 1995 as a statewide network of behavioral health providers, manages various state contracts Answered RFP in December 1999 to design and implement a statewide gamblers help program Provided comprehensive treatment program for gamblers in WV for almost 10 years

5. What is Problem Gambling? Continuation of gambling behavior in spite of serious, negative consequences

6. DSM-IV Symptoms of a Gambling Problem

7. Loss of Control Makes unsuccessful efforts to stop, control or cut back on gambling.

8. Chasing After losing money gambling, returns as soon as possible and gambles more to try to win back lost bets

9. Preoccupation Often thinking about gambling and/or obtaining money to gamble

10. Lying To family members, friends, co- workers, employer, clergy or other important people about gambling

11. Escape Uses gambling as a away to escape stress, depression, grief, boredom, loneliness, boredom and other negative feelings

12. Jeopardized Relationships and Loss of Activities Has given up other social or recreational activities Jeopardized family, friendships, career or school in order to keep gambling

13. Tolerance Increased size/frequency of bets to achieve desired excitement

14. Bailouts Turns to others for money to relieve financial crisis caused by gambling or to get money to gamble

15. Withdrawal Is restless or irritable when attempting to cut back or stop gambling

16. Illegal Acts Commits forgery, fraud, theft or embezzlement to get money to gamble or to resolve financial crisis caused by gambling

17. DSM-IV Symptoms of a Gambling Problem 5 or more symptoms = Pathological Gambler 1 to 4 symptoms = Problem Gambler

18. National Prevalence Rates National Council on Problem Gambling, Washington, DC 2% to 3% of US Population in any given year 6 million to 9 million Americans

19. Prevalence Rates in West Virginia? Who Knows???? 37,000 to 54,000 West Virginians???

20. Risk Factors That may contribute to the likelihood that someone develops a gambling problem

21. An Early Big Win Greater than or equal to one months income

22. Childhood Abuse, Neglect or Abandonment

23. Pre-existing mental health problems Depression, anxiety, bipolar, alcoholism, drug addiction and others…

24. Family history of addictions alcohol, drugs, gambling and others…

25. Stressful life event Death of a loved one, divorce, job loss, injury, illness and others…

26. Senior Gambling LJust having fun? OOr headed for trouble?

27. Are Casinos the new Senior Centers? Casinos offer many perks to seniors –Free or cheap rooms, food, giveaways –Valet parking or shuttle bus –Provide oxygen tanks, wheelchairs, places to dispose of diabetic needles –Cash your social security check –Friendship from other patrons, staff We miss you cards Remember them on their birthday

28. Or, are Senior Centers the new Casinos? Many senior centers sponsor trips to casinos Most senior centers and nursing home offer gambling activities like Bingo Many senior centers sponsor trips to casinos Most senior centers and nursing home offer gambling activities like Bingo

29. Prevalence of Senior Gambling Those over age 65 list gambling as the most common recreational activity % of those over age 65 who gambled in past year doubled between 1975-1998 (NORC, 1999) Conflicting reports on whether seniors have higher rates of gambling and if they are more likely to become addicted

30. Problem Gambling in WV Among Seniors 25% of West Virginians are over age 55 (2000 Census) This table shows WV Lottery player demographics compared to general population-% of players over 65 is proportionate to population 17% of those who have called our helpline are over age 55 25% of West Virginians are over age 55 (2000 Census) This table shows WV Lottery player demographics compared to general population-% of players over 65 is proportionate to population 17% of those who have called our helpline are over age 55

31. Why Seniors Gamble Why shouldnt I throw my money away? What else am I going to do with my time? The people at the casino are my only friends Im so lonely since my husband died Maybe I can make some money to pay bills It makes me forgot about my back pain Its the only fun I have Its something my wife and I can do together Its so safe here Why shouldnt I throw my money away? What else am I going to do with my time? The people at the casino are my only friends Im so lonely since my husband died Maybe I can make some money to pay bills It makes me forgot about my back pain Its the only fun I have Its something my wife and I can do together Its so safe here

32. Financial Issues Problems for Senior Gamblers Mcaid look back rules Inheritance lost Limited income May have limited productivity time left

33. Medications and Gambling Drugs used to treat Parkinson's Disease and Restless Leg Syndrome (Mirapex, Requip) may cause behavioral changes As many as 1 in 6 on these meds report behavioral changes Increased gambling is one of the most commonly reported problems Drugs used to treat Parkinson's Disease and Restless Leg Syndrome (Mirapex, Requip) may cause behavioral changes As many as 1 in 6 on these meds report behavioral changes Increased gambling is one of the most commonly reported problems

34. Treatment implications for Senior Gamblers More reluctant to seek help Cognitive problems may interfere with ability to make sound decisions Underlying issues of loneliness, lack of socialization must be addressed Financial issues may be more pressing Family should be involved Higher rates of suicide More reluctant to seek help Cognitive problems may interfere with ability to make sound decisions Underlying issues of loneliness, lack of socialization must be addressed Financial issues may be more pressing Family should be involved Higher rates of suicide

35. How We Help Provide outreach to create public awareness

36. Outreach and Prevention through Media

37. Our Billboard Campaign

38. Recruit and provide 30 hours training to licensed clinicians Counselors, social workers and psychologists Quarterly Clinical Supervisions around the state Advanced/Ongoing Continuing Education

39. 24-hour Help-line 1-800-GAMBLER Client follow up Counselor sent information Referral made Data collected Conversational intake completed Crisis intervention Telephone answered by trained clinician

40. All Callers offered free two-hour consult Includes loved ones! Scheduled while on the line Goal is within 30 miles of residence Within 72 hours of call Referred to other support services and information mailed Includes loved ones! Scheduled while on the line Goal is within 30 miles of residence Within 72 hours of call Referred to other support services and information mailed

41. During the Consult Up to 20 sessions of state-funded individual therapy provided Refers to other support services Develops treatment plan Clinician does thorough diagnostic assessment

42. Full range of services Informational mailingOnline ChatFollow-up callsSupport group referralsInitial Diagnostic ConsultIndividual counselingIntensive Out-Patient CounselingWeekend Retreatment SeminarsTelephone Crisis Counseling

43. What does our staff do when the helpline isnt ringing? Pre-appt courtesy call Post-assessment follow-up Treatment pre-certification and utilization review 6-month, one-year and two-year follow-up Compile data Public awareness activities Pre-appt courtesy call Post-assessment follow-up Treatment pre-certification and utilization review 6-month, one-year and two-year follow-up Compile data Public awareness activities

44. Program Highlights First helpline in the nation to offer such aggressive, proactive interventions High appt acceptance and high show up rates Helpline staff and many network counselors are Nationally Certified Gambling Counselors Program driven by data collection and analysis High recovery rates Overwhelmingly positive client satisfaction rates

45. Who is Calling Us for Help?

46. Improving Services with Technology 1800gambler.net Facebook Fan page Electronic forms for counselors Online Chat Service Distance-therapy options coming soon

47. Our Stats