Social service workers should ask about gambling addiction, NICE says

A new guideline advises healthcare professionals, social service workers, and mental health professionals to ask about gambling in various situations.

The recommendation is included in the National Institute for Health and Care Excellence (NICE) first clinical guideline on gambling-related harms: identification, assessment and management, published today (Tuesday, 28 January).

The new guideline advises mental health professionals and social service workers to ask about gambling in situations such as appointments related to depression, anxiety, self-harm, suicidal thoughts, or potential addictions such as alcohol or drug dependence.

NICE says that these groups may be at higher risk of gambling-related harm and recommends identifying these risks as early as possible.

The guidance also advises that healthcare professionals should consider asking people about gambling when speaking to them about smoking and alcohol consumption during a health check or GP appointment.

Research has found that people may also be at increased risk of gambling-related harm for several other reasons, including if they are suffering from post-traumatic stress disorder (PTSD), personality disorder, or attention deficit hyperactivity disorder (ADHD). Taking medication that may affect impulse control, experiencing safeguarding issues or violence or a family history of gambling that harms could also increase a person’s level of risk.

The health watchdog says people should be encouraged to assess the severity of their gambling-related harms by completing a questionnaire available on the NHS website. This is based on the Problem Gambling Severity Index (PGSI), a standardised measure for at-risk behaviour. A score of 8 or above indicates that they should seek support and treatment from a specialist gambling treatment service, while those with lower scores may also benefit from available support.

Healthcare professionals and social care practitioners must recognise and take action to ensure that stigma, shame, and fear of disclosure does not prevent people experiencing gambling-related harms from seeking and accessing support and treatment, NICE said.

It recommends using a tailored approach to meet the needs of each person, which could include providing them with access to vocation-specific services, such as veterans’ groups, or that take account of their ethnic background and religion. Treatments for gambling-related harms should also be provided in separate locations from services for alcohol or substance dependence.

The guidance recommends healthcare professionals consider involving a partner, family member or other person close to the person experiencing gambling-related harms in their treatment, if that is what they both want.

“Gambling related harm has a devastating impact on those who experience it, and the people close to them,” Professor Jonathan Benger, NICE’s Chief Medical Officer, said. “Our useful and usable guideline will help healthcare professionals and others to identify those needing help earlier and ensure they get the treatment and support they need.”

The Gambling Survey for Great Britain (2023), which collects data from 20,000 respondents each year, reported that 2.5% of the population aged 18 years and older living in Great Britain participate in ‘problem gambling’ (defined as a PGSI score of 8 or more), with an additional 12% of the survey population participating in gambling with an elevated risk of harm (PGSI score 1 to 7). Overall, 2.8% of participants who had gambled in the past 12 months reported experiencing at least one severe consequence, such as the breakdown of a relationship. Rates were higher among male participants and were also higher among younger adults (those aged 18 to 34) than older adults (those aged 55 and over).

NHS England has also opened 15 gambling clinics across the country since 2019 – seven of which opened in 2024. These clinics are expected to see 3,000 people a year.

“We welcome this guidance from NICE on identifying, assessing, and managing gambling-related harms, which will support those experiencing harmful gambling to get access to the right support,” Minister for Gambling Baroness Twycross said.

“We know that clinical treatment is not necessarily right for everyone, but it is important that there is a full spectrum of support as we strengthen treatment options.