Jeremy Wampler, LCSW, LADC, NCGC-II Director, DMHAS Problem Gambling Services Fiorigio (Fred) Fetta, LPC, NCGC-II Clinical Director, DMHAS Problem Gambling Services

1. Identifying Areas or Populations of Concern 2. Finding Champions and Key Stakeholders 3. Be Creative

Disordered Gambling Integration (DiGIn)

A group of providers came together in the Spring of 2009 to seek to better understand why gambling services are underutilized in greater Bridgeport and to develop a plan to address it.

Conclusions made from Bridgeport  Gambling at first mention is not seen as problematic Problem Gambling is often seen as relational to negative outcomes, not addiction  When pressed addiction/ gambling are seen as having similarities.  The fact that gambling is legal, government sponsored and embedded in a variety of cultures (religion, ethnic) increasing belief that it is a safe, acceptable form of entertainment.  Help is known (back of lotto tickets, 211) but not viewed as accessible – nor is the need to get help

Lifetime Co-morbidity Kessler et al., 2008 (National Comoribidty Survey Replication) Although nearly half (49%) of those with lifetime pathological gambling received treatment for mental health or substance abuse problems, none reported treatment for gambling problems

DiGIn Mission To increase the capacity of substance use disorder and mental health treatment programs to address gambling and problem gambling through enhanced screening, assessment, awareness, intervention, recovery and health promotion strategies. To make gambling problems and behaviors a relevant topic of conversation within the broader substance use and mental health disorder treatment communities.

 Bettor Choice Gambling Treatment Programs  Different Substance Abuse and Mental Health Programs across the five regions of CT  12 Programs  Fund the Champions to get staff training on gambling

 Integrating gambling into program milieu  Integrating Gambling into program paperwork, including interventions.  Agency mission statements, policies and procedures that address problem gambling and gambling.  Identify Key Staff who will participate in the DiGIn program (at least three per each agency or program participating in DiGIn).  All staff completes Problem Gambling Awareness and Readiness Survey  Complete Problem Gambling Capability site visit evaluation.

Key to Assessing:  Ask more than once!  What do you like to do for fun?  Ever win anything?  Certain times of the year  Superbowl – pools, money on the game, etc.  Big horse races (Kentucky Derby, Belmont, Preakness)  When the lottery prize gets very high  NCAA Basketball Tournament (March Madness)  Fantasy leagues (Especially football)  What impact has gambling had on your recovery?  What impact has gambling had on your relationship/s?  What impact has gambling had on your finances?  How long have you been gambling?  Integrate gambling into substance use questions. Don’t be afraid to talk about money!!!

 A majority of clients treated in Bettor Choice Gambling Treatment Programs are Caucasian.  Research suggests disenfranchised communities and people of color have higher rates of disordered gambling.  Find the “First Line of Defense” in the disenfranchised communities – Faith Based Ministries and Community Programs

 Regional Action Councils  Peer Counselor  Priest, working in an agency providing services for Substance Abuse and Mental Health

 Integrate gambling with other topics  CAP trains individuals in faith-based organizations and addiction professionals on the following: mental health, substance abuse, gambling, inhalants, suicide, and local resources.  6 hour or 8 hour trainings with food

Be Creative CAP Annual Conference Continues to Grow Last year almost 100 people This year over 100 people already

CAP Research – 2014 and 2015 Report  268 participants31% African American 14.9% Latino  Top 3 topics participants learned the most about (6 hour trainings) – Gambling, Suicide, Substance Abuse  Overall, participants were moderately to very informed on all topics after the trainings

 Research suggests cultures of Asian decent have higher rates of disordered gambling.  Currently, we do not have the culturally appropriate capacity to treat Asian Pacific American (APA) clients through our Bettor Choice programs.  Stigma and culture reduce APA ethnic groups to reach out for help outside the community.

 Asian Pacific American Affairs Commission  Connecticut Council on Problem Gambling  Regional Action Councils  Asian Pacific American Ambassadors (Laos, Vietnamese, Japanese)

 Reimburse Ambassadors for their work  25 hours of gambling specific training  Ambassador meetings with Steering Committee  Community Conversation Presentations (Evidenced Based Prevention Program)  Prep Time for Community Conversations  Translation services (if necessary)  Mileage  Supplies  Prevention Showcase at the National Conference on Problem Gambling

Community Conversations  Instructions – Welcome / Why we’re here  How gambling impacts our communities.  Making Connections  Building relationships; thoughts on gambling  Discussing Challenges  Challenges in educating people on facts of gambling  Understanding Problem Gambling  Myths vs. Facts about Problem Gambling

Community Conversations  Opportunities to Talk about Our Challenges  Recognizing warning signs  How Are We Responding to the Challenges  Strengths / weaknesses to help individuals affected  How to Support People Who Have gambling Problems  Ideas to take action  Next Steps / Closing  Future projects with the group

 Raise awareness within the general population about gambling.  Students are hearing about alcohol, tobacco and other drugs in schools, but very little to nothing about gambling.  Research suggests that youth have a higher prevalence rate of problem gambling than the general population.

 Regional Action Councils (RAC)  Partnership with all 15 RACs on gambling awareness initiatives  2011 – One lead RAC per region facilitates a Gambling Awareness Team  Lead RACs meet bi-monthly to review progress and share initiatives

Ct Statewide Prevention Model Moving towards Problem Gambling Informed Prevention, Intervention & Treatment across the Continuum of Care & across the Lifespan. Five Regional Problem Gambling Prevention Teams, coordinated by designated DMHAS Regional Action Councils (RACs): Quarterly Forum Meetings: Prev, Tx, Community Cadre of Identified Trainees (prevention, treatment professional, recovery supports providers, community partners, etc.) Gambling Awareness Certificate of Competency

Special projects supported through this Initiative include:  Gambling Awareness integration in schools and youth programs  Financial Literacy with Older Adults, Women, People in Recovery and Youth  Business community awareness  Program evaluation and regional data collection  Problem Gambling Awareness Month events  Fantasy Sports Awareness  Legislative Events

Thank You