Suicide Risk in Problem Gamblers: An Introduction for Criminal Justice and Mental Health ProfessionalsPosted September 30, 2017 | By Tony Salvatore and Jerrod Brown
Problem gambling is seldom identified among leading suicide risk factors, but it should be. This repetitive behavior negatively affects a diverse array of risk factors for suicidal behavior including personal and family life, school or job obligations, financial well-being, and physical and mental health. In turn, compulsive gambling may precipitate or aggravate conditions conducive to suicide. For example, suicidal thoughts and attempts have a relatively high incidence in problem gamblers. In light of these concerns, forensic professionals must give more attention to problem gambling.
Who Is a Problem Gambler?
A problem gambler is preoccupied with gambling and finds stopping intolerable. Problem gambling may grow out of social or recreational gambling, which for some may be a source of gratification or a means of relieving stress. Online gambling appears to be a common venue for the onset of problem gambling. Further, the individual is often compelled to bet larger amounts of money at a higher frequency. As a result, hiding or lying about losses and experiencing financial problems related to gambling are common. Problem gamblers will cash out every available personal financial resource and try to draw on those of relatives and close friends. Ultimately, they may turn to sources that may make them liable for charges and incarceration. As such, most problem gamblers will have criminal justice contact at some point.
Legal Consequences of Problem Gambling
Problem gambling can lead to ongoing criminal activity to compensate for losses. A large proportion of problem gamblers commit crimes to pay off gambling debts. Criminal activity increases with the severity of the gambling problem. Although criminal offenses are usually non-violent in nature (e.g., theft, fraud, embezzlement, forgery, and selling drugs), domestic violence and abuse may occur too. The link between problem gambling and criminal behavior is supported by the high rate of problem gambling that is commonly found in surveys of prisoners. Desperations to escape debt and punishment in the criminal justice system are both strong, inter-related risk factors for suicide.
Suicidal Behaviors and Problem Gambling
Three forms of suicidal behavior may arise among problem gamblers: suicidal ideation, suicide attempts, and completed suicides. The estimated incidence of these behaviors, though wide ranging, appears higher in problem gamblers than in the general population. Studies show that nearly half of Gamblers Anonymous participants have contemplated suicide. Further, problem gambling is a behavior associated with suicide attempts and many other serious risk factors for suicide completion. Nonetheless, suicide mortality among problem gamblers has not been well-researched, and estimates of completed suicide rates are unavailable. One potential expression of suicidal behavior in individuals with problem gambling may be homicide-suicide and suicide-by-cop incidents. The deleterious effect of problem gambling on domestic relationships may result in familicide of an intimate partner followed by suicide in some cases. Alternatively, a suicide-by-cop scenario may arise when someone overwhelmed by the seemingly inescapable consequences of problem gambling fixes on a suicide plan assuring a high degree of lethality.
Suicidal Pathway in Problem Gamblers
Gamblers may come to see suicide as a “way out” of the ever-mounting financial problems and family-related stress generated by their behavior. Shame, loss of control, and entrapment are common among problem gamblers. Suicidal behavior may occur when high expectations, particularly those that are extremely unrealistic, lead to severe disappointment and frustration. For example, suicidal behavior may follow the unsuccessful pursuit of a “big win” that had the potential to resolve severe personal difficulties. When the hope of “big money” evaporates, the only apparent option to “getting out from under” debts may appear to be suicide. This is especially likely when desperation is high, lies can no longer conceal losses, family bailouts are not feasible, and criminal acts become more frequent and risky. In such situations, problem gamblers may develop a profound sense of being disconnected from or feeling burdensome to their social support system. This can result in perceptions that death is the only way out. Such beliefs raise suicide risk.
Problem gamblers experience serious financial, job-related, interpersonal relationship, and legal stress. At the same time, mental illness and substance abuse issues are common. These stressors coupled with the sense of entrapment brought on by problem gambling may increase the risk of suicidal ideation, attempts, and completions. Nonetheless, problem gambling itself is a modifiable or treatable risk factor for suicide. Given the high level of contact that problem gamblers have with the criminal justice system, forensic professionals are well-positioned to identify individuals at potential risk and refer them to appropriate sources for help. Further, greater awareness of the suicide risk among individuals detained for problem gambling-related offenses has the potential to assure safety and lessen exposure to liability.
Tony Salvatore, M.A., manages suicide prevention and postvention at Montgomery County Emergency Service, a psychiatric crisis response service and hospital in Norristown, Pennsylvania. He has organized and led suicide prevention task forces at the county level in Pennsylvania and served on both the state youth and adult/elder suicide prevention task forces. He has written articles and developed training and suicide prevention and postvention resources for police officers and emergency medical services (EMS) staff on suicide crisis intervention and providing support after a suicide. He is an advocate for increasing suicide prevention efforts on behalf of older adults, persons with serious mental illness, and individuals with developmental disabilities.
Jerrod Brown, Ph.D., M.A., M.S., M.S., M.S., is the Treatment Director for Pathways Counseling Center, Inc. Pathways provides programs and services benefiting individuals impacted by mental illness and addictions. Jerrod is the lead developer of an online graduate degree program in Human Services with an emphasis in Forensic Behavioral Health from Concordia University, St. Paul, Minnesota. Jerrod is the founder and CEO of the American Institute for the Advancement of Forensic Studies (AIAFS), and the Editor-in-Chief of Forensic Scholars Today (FST) and the Journal of Special Populations (JSP). He has completed four separate master’s degree programs and holds graduate certificates in Autism Spectrum Disorder (ASD), Other Health Disabilities (OHD), and Traumatic-Brain Injuries (TBI).