Who gambles how often and how much? Myths and the Reality of Austrian Gamblers after National Regulation

Transcription

1 Who gambles how often and how much? Myths and the Reality of Austrian Gamblers after National Regulation Oliver Scheibenbogen Ute Andorfer Anton Proksch Institute Vienna Director: Michael Musalek

2 Contents 1. Short overview of the treatment concept of the Anton Proksch Institute 2. Data on gambling and gambling addiction in Austria 3. Development of the Responsible Gaming Approach and the Gaming Act (GSpG) 4. Curriculum for prevention officers 5. Responsible Gambling from the perspective of therapists 2

3 The Anton Proksch Institute 3

4 Patients treated between Inpatient treatment patients hospital days > 82,000 > 4,060,000 Outpatient treatment patients patient contacts > 270,000 > 1,750,000 4

5 Inpatient treatment unit for gambling dependent patients 10 beds for men and 2 beds for women Average length of hospitalisation: 8 to 12 weeks Total: 300 beds (34 for illegal drugs) 80% alcohol dependent patients 10% pathological gamblers 10% prescription drugs patients 5

6 Orpheus Modules Strengthening and extending existing resources Finding and creating new resources Rediscovering buried resources 6

7 Concepts on which Orpheus modules are based Resilience research (Block) Hardiness (Kobasa) Coping (Lazarus) Self-efficacy expectation (Bandura) Euthyme methods Salutogenesis (Antonovsky) Meaning in life (Frankl) 7

8 Basic treatment Addiction specific interventions Comorbidity specific interventions Social and professional (re)integration Sports, movement and relaxation therapies Orpheus Modules One-to-one session Relapse prevention group Eating disorder group Care by social workers Active awakening Body awareness Small groups Smoking cessation group Anxiety group Learning centre Gym Learning to enjoy Large groups Group for pathological gamblers Social skills training Skills training and measures to raise the level of general skills Nordic Walking Clinical gardening Care by nurses Group for prescription drug users Stabilisation group for PTSD patients Outplacement Movement therapy Cooking in groups Treatment by internal specialists Memory training Progressive muscle relaxation Music, choir and band projects Activation and mobilisation group QI-GONG Creativity centre Spinal gymnastics Yoga Creative workshop Physiotherapy Running Excursions and cultural trips Biofeedback therapy Painting and art therapy Philosophy and the art of life Cinema therapy Reading group Group ball games

9 Psychiatric comorbidities for alcohol addicted inpatients at the Anton Proksch Institute 60% 56% 50% 40% 33% 30% 20% 10% 0% 10% 15% 23% 6% 6% 19% 16% 12% 10% 12% 12% 6% 10% 8% 4% 0% 10% 8% men women (Zadro-Jaeger, Scheibenbogen, Zoghlami & Musalek, 2007) 9

10 Comorbidity in Pathological Gambling Relevant comorbid mental disorders in pathological gambling: 1. Personality disorders up to 93% (Baszczynski, 1993; Ibanes et al., 2001; Slutzke et al., 2001) 2. Substance-related disorders up to 80% (Lesieur & Blume, 1991; Bondolphi et al., 2002; Hodgins et al., 2005) 3. Depressive disorders up to 75% (Taber et al., 1987; Rahmann, 2000; Petry et al., 2005) 4. Anxiety disorders up to 38% (Specker et al., 1996) 10

11 We are all hopeless cases with a very bad prognosis, since all of us will have to die sooner or later, however, as long as there is still some life in us, we are also healthy to a certain degree. (Antonovsky, 1987) 11

12 Epidemiology of Gambling Addiction in Austria 12

13 Data on Gambling Addiction I Representative Study for Austria: Kalke et al. (2010; 2015) Gambling Activity 2009 Gambling Activity months 30 days 12 months 30 days Lotto 6 aus % 18.6 % 33.0 % 20.3 % Euro Millions 9.0 % 3.9 % 13.2 % 8.2 % Scratch cards 7.8 % 3.4 % 8.7 % 4.1 % Joker 10.9 % 6.2 % 14.3 % 9.1 % Other lottery games 1.5 % 0.7 % 1.6 % 1.0 % Sports betting (including horse and doc racing) Classic casino games (roulette etc.) Slot machines outside casinos 2.8 % 1.7 % 3.8 % 2.6 % 4.9 % 1.6 % 4.0 % 0.9 % 1.2 % 0.4 % 1.0 % 0.6 % Slot machines in casinos 0.6 % 0.1 % 0.5 % 0.2 % Other games 0.9 % 0.4 % 0.4 % 0.3 % N (weighted)

14 Data on Gambling Addiction II Representative Study for Austria: Kalke et al. (2010; 2015) Unproblematic or risky gambling Problem gambling Pathological gambling Point Estimate % Confidence Interval 2009 lower value upper value Point Estimate % Confidence Interval 2009 lower value upper value Extrapolation to the 14 to 65-year-olds living in Austria lower value upper value 98.9 % % % 98.9 % % % % 0.27 % 0.59 % 0.5 % 0.34 % 0.60 % % 0.46 % 0.86 % 0.6 % 0.47 % 0.77 % *) According to figures from STATISTIK AUSTRIA there were 5,959,952 people between the ages of 14 and 65 living in Austria in

15 Data on Gambling Addiction III Prevalence of problematic and pathological gambling (3-4 or 5-10 DSM-IV criteria) by type of game in 2015 (multiple responses possible) 30% 25% 20% 15% 10% 5% 0% Lotteries Scratch cards Sports betting Classic casino games Slot machines in casino Slot machines outside casino problematic pathological 15

16 Austrian Gaming Act Amendment

17 European Legal Framework and Gambling (Monopoly) The EU insists on: Freedom of services Monopolies restrict this fundamental freedom In A: Gambling monopoly - state licences have to be granted European Court: only permits state monopolies for overriding reasons of public interest Public interest with regard to gambling: Consumer protection Fraud prevention Combating gambling addiction 17

18 Definitions: The Austrian Gaming Act How do we define gambling 1 Section 1 of the Gaming Act contains basic definitions: A game in which the decision on the outcome of the game depends solely or predominantly on chance. Article 1 Section 2 of the Gaming Act provides examples: Roulette, Black Jack, Two Aces, Bingo, Keno, Baccarat, Chemin de fer (under powers granted to the Ministry of Finance to issue secondary legislation to designate additional games as games of chance); Exceptions Poker - Constitutional Court: G 26/2013: reversed for procedural reasons - legislators needed to repair the law Sports Betting (Not Games of Chance within the Meaning of the Gaming Act) 18

19 Legislation Governing Protection of Players in Casinos, 25 Gaming Act; 1/3 Now also applies to licensees in the provinces (gambling on slot machines) Article 25 Section 1: Admission only for those who have reached the age of 18 (official photo ID must be presented) Licensee must record and store the data on the player s ID for 5 years Article 25 Section 2: Licensee can ban a player from visiting the casino without stating reasons = ban Compulsory staff training scope defined by provincial law (K) and requirements can be made in the conditions of the licence 19

20 Legislation Governing Protection of Players in Casinos, 25 Gaming Act; 2/3 Article 25 Section 3: Player protection clause; phased approach, 2 possibilities Prerequisite: Suspicion that a player is at risk of falling below the breadline (frequency and intensity of play) 1st option obtain credit rating > 1. if the suspicion is confirmed: Counselling interview in which trained staff advise the player of the risks of gambling and provide information on counselling organisations 2. if despite counselling, the player refuses to engage with the counselling or continues to play with the same frequency and intensity: management is obliged to ban the player from gambling for either a specific period or permanently 20

21 Legislation Governing Protection of Players in Casinos, 25 Gaming Act; 3/3 2nd option: If it is not possible to obtain an independent credit rating or if this does not provide meaningful information 1. Counselling interview/credit rating by specially trained staff who advise the player of the risks of gambling and provide information on counselling organisations 2. following that: The player is questioned about their financial situation and income and whether their gambling puts them at risk of falling below the breadline 3. If these suspicions that the player is at risk are confirmed: management is obliged to ban the player from gambling for either a specific period or permanently 21

22 Legislation Governing Protection of Players and Slot Machine Gambling Slot machine arcades: 5, 25 (3) Gaming Act Maximum stake 10 euros per game Maximum win per game 10,000 euros Each game lasts for at least 1 second Ban on automatic start buttons Set payout ratio (at least 85%) Entrance only with an official ID (CHILD PROTECTION) Obligation to warn players with conspicuous gambling behaviour and to provide compensation in the event of failure to warn No parallel games and multiplication over the maximum stake No jackpots Cooling off phase (after two hours of continuous play) Terms and conditions must be available in German Mandatory training concept for staff Mandatory cooperation with gambling welfare organisations Single Slot Machines: 5 Gaming Act Maximum stake 1 euro per game Maximum win per game 1,000 euros Each game lasts for at least 2 seconds Ban on automatic start buttons Set range for the odds of winning (lower than in slot machine arcades) Special admission ticket with ID function No parallel games and multiplication over the maximum stake No jackpots Maximum 3 hours of continuous play in a 24-hour period Terms and conditions must be available 22

23 Development of the Responsible Gaming Approach Cooperation Novomatic Anton Proksch Institute 23

24 Personality Leisure behaviour, changing values and lifestyle Gambling as a Drug Form and type of stake Use Abuse Dependency psychological/physical Environment Technical development and dealing with mass media Growing number of products 24

25 Compatibility of Cooperation? 25

26 Treatment and Prevention Goals = Business Goals Enjoyable Gambling Problem Gambling Pathological Gambling Reduce Gambling Controlled Gambling Moderate Gambling Total Abstinence Under the Austrian Gaming Act this person must be banned 26

27 Training as a Prevention Advisor Drug counselling Do take a lot! 27

28 Balance? Prevention Advisor Staff Member Casino Manager Betting Shop Staff Member 28

29 Chance! Staff Member Casino Manager Betting Shop Staff Member Prevention Advisor 29

30 Tools & Method 30

31 Tell me and I ll forget. Show me and I ll remember perhaps. Involve me and I ll understand. Chinese Proverb 31

32 Training for Prevention Advisor Basic training 8 hours for staff members Advanced week for future prevention advisors 33 hours Supervision Refresher course each year 32

33 09:00-09:50 09:50-10:40 10:40-11:00 11:00-11:50 11:50-12:50 Monday Tuesday Wednesday Thursday Friday Welcome Experiential Structural and First steps RG Role plays psychodynamic education characteristics of different types of games Aetiology theories Aetiology theories Guidance Experiential education Break (20 min) Structural and psychodynamic characteristics of different types of games Operational RG & critical processes in guest interviews Appraisal of the experiences gained during the week 12:50-13:50 13:50-14:40 14:40-15:30 15:30-15:50 15:50-17:00 Lunch Break (60 min) Patient interviews Case studies Emotion regulation and resource management for prevention Treating gambling addiction Case studies Break (20 min) officers Emotion regulation and resource management for prevention officers RG interview content & preparation Practical examples Practical examples & role plays. 14:00 End 33

34 At the of things! Patient interviews Communication training Role plays Video training 34

35 Communication Channels At-risk players Prevention advisor Member of Staff 35

36 Dealing with defensive behaviours Aggressive behaviour: I don t have to put up with this from you; that is nothing but slander! Behaviour that seeks to win sympathy: My problems are of a personal nature. I have to struggle a great deal... Indifferent behaviour: I don t care if you think... Blackmailing behaviour: If you pile on the pressure too, then I ll give up! Shows understanding but with no willingness to seek professional help: You re right, I have to change, but just not today! 36

37 Player Protection Measures from the Therapist s Perspective 37

38 Framework for Player Protection Measures 1. Uniform regulation across provincial and national borders 2. Uniform regulation for online and offline games 3. Raise awareness: Player protection is a service provided by the operator 4. Evidence based vs eminence based RG 5. Instead of static limits logarithm-based dynamic limits 38

39 Uniform regulation across provincial and national borders In each province differing duration of: Total ban in a number of provinces Cooling off phase Maximum duration of play per day Example: Player from Vienna Needs approx. 20 mins to Lower Austria If I reach the daily maximum duration of play in Upper Austria of 3 hours, I can drive to Lower Austria (gambler s nomadism) If I am banned in Austria, I can be in Hungary or Slovakia in 45 minutes 39

40 Uniform Regulation of Online and Offline Games From a player s perspective it makes no difference whether his existence is threatened by online or offline games Very good evidence available of the efficiency of warning signs in online games Only the total of (almost) all gambling activities is a valid measure for assessing a risk 40

41 Raise Awareness: Player protection is a service provided by the operator Player Protection = Insurance Comparison High-Risk Sports: Scuba diving (Padi-System) Indoor skydiving The staff of the operator act as an instructor/ buddy/ guide

42 Evidence Based instead of Eminence Based RG Many of the thresholds defined in Austria are based on expert recommendations but are rarely based on systematic research Example: There is very little research on whether a cooling off phase should last 15, 30 or 60 minutes and on how effective this measure is Does it really make sense to leave a player alone after an intensive gambling phase? Or: Would it not make more sense to give feedback with specific individualised information? Independent applied research is needed!

43 Instead of Static Limits Logarithm-Based Dynamic Limits Tracking the player longitudinally and not cross-sectionally! If one takes this idea further, different strategies have different effects depending on the game and dynamics. Personal limits are always relative: Yet in player protection we currently act as if all limits were the same for everyone! Example/Comparison: Driver assistance system only intervenes in dangerous situations, is otherwise not noticeable and adapts to the different road conditions!

44 Thank you for your attention! (nature.com)