Behavioral Health (Addiction and Mental Health) Care in Schools: Where do you fit in?

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1 Behavioral Health (Addiction and Mental Health) Care in Schools: Where do you fit in? 13 th School Health Interdisciplinary Program (SHIP) Youth and Problem Gambling August, 2013 Presenter Carl E. Robertson, MRE, MDiv.- Prevention Manager Funded by DHMH/ADAA

2 Maryland Center of Excellence on Problem Gambling Partnership of Maryland Council on Problem Gambling and the University of Maryland School of Medicine Funded with a 3 year grant ( ) from State Health Department Purpose: Identify and promote problem gambling treatment resources Provide Maryland based prevention and research initiatives Establish problem gambling lending library resources Conduct Public and Professional Awareness Outreach Campaigns Manage Maryland Problem Gambling Hotline: Funded by DHMH/ADAA

3 If you bet on a horse, that s gambling. If you bet you can make three spades, that s entertainment. If you bet cotton will go up three points, that s business. What s the difference? Gambling is any activity or game where you risk something of value or money on an outcome that is not guaranteed. Funded by DHMH/ADAA

4 Youth and Problem Gambling do not occur in a vacuum Is it normal for youth to gamble? What is the prevalence of gambling among youth Funded by DHMH/ADAA

5 Problem and Pathological Gambling Definitions Problem Gambling is a descriptive term used to define those individuals with problems in their lives due to gambling. Pathological/Compulsive Gambling- is the clinical term for the Impulsive Control Disorder defined in DSM IV (failure to resist the impulse to gamble) Funded by DHMH/ADAA

6 DSM V Leaving- Impulse Control Disorder Joining- Substance Use Disorder section Behavioral Addictions = Gambling Disorder 9 vs 10 Criteria (Illegal activities may be dropped) In functional brain imaging-whether with gamblers or drug addicts-when they are showed video or photograph cues associated with their addiction, the same brain areas are activated. Charles O Brien, M.D. chair of the DSM-5 Work Group on Addictive Disorders

7 What do we know about Adult and Adolescent Problem Gambling? Actually, quite a lot, there is data from sources such as: National Research Council 1999 McGill University 1998/Present National Council on Compulsive Gambling Gambling Prevalence in Maryland: A Baseline Analysis 2010 Johns Hopkins Longitudinal Study

8 Who Are Adult Problem Gamblers based on National Research Council Survey 1999 About 1-3% of the Adult Population of the U.S. has a Gambling Problem Estimated to be over 4-6 million adults in the United States(combination of pathological/problem gamblers) Estimated to be over 128,670 adults in Maryland (based on 2011 census projections)

9 Who Are Adult Problem Gamblers based on Maryland Baseline Survey 2010 Survey indicated 3.4 % of the Adult Population in Maryland are problem/pathological gamblers (1.5% pathological/1.9% are problem gamblers) Estimated to be over 154,400 adults in Maryland(based on Maryland Baseline projections) Range: 128, ,400 Adult Marylanders

10 WHAT DOES THIS REPRESENT? +

11 WHAT DOES + REPRESENT? Capacity 71,008 x 2 = 142,016 Represents less than the 154,400 Adult Gamblers in MD

12 Youth Prevalence Findings 4-8 % Level III, Probable Pathological gambler (NRC, 1999) 1.1 million youth exhibit pathological gambling behavior (NGISC, 1999) 10-15% at-risk for Problem Gambling (Shaffer & Hall, 1996; Winters, Stinchfielf, & Fulkerson, 1991; Wiebe, 1999; Wynne, Smith, & Jacobs, 1996) Youth Gambling 4 to 6 % (problem/pathological) Maryland Youth Estimated: 47,000-50,000 (problem/pathological based on 2011 census projections)

13 Capacity 45,971 to 48,187 If you filled Camden Yards what would that represent?

14 Johns Hopkins survey Study began in 1993 in 27 1 st Grade Classrooms in Baltimore City public schools Data Sources utilized: Teacher ratings Parent ratings Self-reports: 90 minute self-administered computer interview Gambling data collected via age appropriate scales SOGS-RA in 2004, and SOGS Funded by DHMH/ADAA

15 Prevalence of Baltimore Inner-City Youth Found that 11% of African American students have some form of problem gambling. Which is based on the groups studied since 2004 (when gambling questions were added to the 1993 study.)

16 Why do youth gamble? What are the perceived benefits? Money: the possibility of earning extra money is very appealing Excitement: a major motivating factor Enjoyment: this was described as an entertainment value and was more often reported by the girls Social: Again, most often reported by girls. Gambling is viewed as a way to promote relationships with friends and family

17 Gambling (gaming) has become normalized in our society

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19

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21 Reported gambling venues (N=1294) grade 4 grade 6 grade 7 grade 8 grade 9 grade 11 home friend's house school (Derevensky & Gupta, 1997; Gupta & Derevensky, 1998a)

22 With whom adolescents gamble (N=817) grade 7 grade 9 grade 11 alone friends strangers parents siblings relatives total family

23 Percentage of adolescent gamblers regularly* engaging in various gambling activities no problem gambler social gambler some problem gambler probable pathological gambler 0 *(Once a week or more) cards sports sports lottery lottery video poker bingo slots games of skill

24 Involvement in addictive behaviors Total use Weekly use Gr 7 Gr 9 Gr 11 Gr 7 Gr 9 Gr 11 Alcohol 36.8% 62.2% 79.8% 7.4% 14.0% 20.2% Drugs 3.5% 13.4% 26.5% 2.7% 2.1% 9.0% Cigarettes 18.2% 34.5% 48.4% 7.0% 16.1% 31.4% Gambling 79.1% 78.9% 83.4% 30.4% 37.4% 37.1%

25 What we know about the Internet Access is widespread Access is inexpensive Internet is anonymous Internet is convenient Internet is entertaining Internet is used for many purposes

26 Youth Internet Gambling Anybody, Anywhere, Anytime The New Yorker July 5, 1993

27 Internet Gambling Allows individuals to lie about their age Allows underage youth to gamble on prohibited activities Reinforcement schedules are quick Early exposure to practice sites may be priming youth for later gambling behavior Youth are accessing adult gambling sites The Internet provides an accessible venue for an otherwise illegal activity Rise in use as gambling severity increases

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29 National Annenberg Survey of Youth (Romer, 2010) N=835 (2008) N=596 (2010) At least once per month Internet gambling among males rose from 2.7% (2008) to 6.2% (2010) Internet gambling among males rose from 4.4% (2008) to 16.0% (2010) Internet gambling among females rose from 0.5% (2008) to 1.5% (2010) Internet gambling among females rose from 0.0% (2008) to 4.4% (2010)

30 Gambling Prevention No one product can serve as a complete prevention strategy. Prevention should take place, repeatedly, over time, via different mediums and modalities.

31 SMART CHOICES When Does Gambling Become a Problem? Young people develop gambling problems just as adults do. Gambling is a problem when you: - Often find yourself thinking about gambling - Miss school or work in order to gamble - Spend more and more money on gambling activities - Become restless or irritable when trying to cut down or stop gambling - Gamble to escape or forget your problems - Gamble more to win back what you have already lost in gambling - Spend your lunch or carfare money on gambling - Take money from someone you live with, without their knowing, in order to gamble - Steal money from outside the family or shoplifted in order to gamble - Experience problems, arguments, fights etc. with your family or close friends because of your gambling. Funded by: DHMH/ADAA Smart Choices: Youth Problem Gambling Prevention Program A Program to help identify gambling problems and Stop them before they Start Maryland Center of Excellence on Problem Gambling To learn more go to: Problem Gambling Helpline:

32

33 Implications Gambling is one of many activities that carry risk and should be addressed as such in schools, universities and community prevention efforts Gambling behavior should be a topic for parents, teachers, and student services to be talking to students about protective factors related to gambling

34 Resources Carl Robertson / National Council on Problem Gambling National Gambling Awareness Week: March 3-9, McGill University Youth Gambling Problems & High Risk Behaviors Maryland Problem Gambling Helpline

35 Resources Teen Gambling: understanding a growing epidemic. Jeffrey L. Derevensky (2012) National Center for Responsible Gaming (NCRG): see Silvia S. Martins, John Hopkins Study: see Maryland Baseline Study: see

36 Thank you Carl Robertson Funded by DHMH/ADAA

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