By Kelly O’Brien

In his two decades working at Good Shepherd Ministries, a homeless shelter in Toronto, Aklilu Wendaferew had seen many clients with a history of problem gambling. But it was not until a comprehensive study of those clients was done that he realized the full scope of the problem.

The study at the Centre for Urban Health Solutions of St. Michael’s Hospital — formerly the Centre for Research on Inner City Health — found that more than one-third of people living in homeless shelters have a history of problem gambling. That is nine times higher than the general population.

“We were not fully aware it was that bad,” said Wendaferew. “It was a big shock. We realized we needed to do something about this.”

That led to a collaboration between St. Michael’s, Good Shepherd Ministries and the Problem Gambling Institute of Ontario at the Centre for Addiction and Mental Health. The result – a new guide for service providers to help people struggling with poverty and homelessness.

Dr. Flora Matheson conducted the original study and led a followup study to develop the content of the guide. She said it was designed to help service providers at homeless shelters adapt the skills they already have to the issue of gambling.

“They were concerned that they didn’t have the knowledge, the education or the training to provide that service to their clients,” said Dr. Matheson, who has a PhD in sociology. “The idea behind this guide is, you already talk to your clients about substance use, you can have the same type of conversation with your clients about gambling.”

As the guide explains, many of the same strategies used to help clients with substance use issues can also be applied to problem gambling, which is considered a behavioural addiction that has much in common with substance abuse and other addictions. Studies have shown that gambling can increase levels in the brain of Dopamine, the neurotransmitter responsible for feelings of pleasure and reward.

Another benefit of the guide, said co-author Beth Murray of the Problem Gambling Institute of Ontario, is that clients already being treated for other addiction or mental illness issues can get help for their problem gambling at the same time.

“Many clients do not want to access these services at another agency,” said Murray. “This guide will help them start the conversation about gambling concerns. The handbook provides information about signs of problem gambling, and tips on how to support people to reduce harms, cut down or quit. It is important for service providers to make it part of their routine practice to ask clients about gambling and make it part of their assessment and screening.”

For front line service providers like Wendaferew, the guide is a valuable tool to help his clients get their lives back on track.

“It helps to build capacity for us to respond to this very serious problem,” said Wendaferew. “It has tools that help us make a greater impact working with a homeless population that requires a lot of support to get off the street.”

The development of Problem Gambling: A Guide for Helping People Experiencing Povertywas funded by Gambling Research Exchange Ontario.

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To order copies of the handbook email:
This paper is an example of how St. Michael’s Hospital is making Ontario Healthier, Wealthier, Smarter.

About St. Michael’s Hospital

St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in more than 29 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, and care of the homeless are among the Hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Center, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael’s Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.

About the Centre For Addiction And Mental Health

The Centre for Addiction and Mental Health (CAMH) is Canada’s largest mental health and addiction teaching hospital, as well as one of the world’s leading research centres in the area of addiction and mental health. CAMH combines clinical care, research, education, policy development and health promotion to help transform the lives of people affected by mental health and addiction issues. CAMH is fully affiliated with the University of Toronto, and is a Pan American Health Organization/World Health Organization Collaborating Centre. For more information, please visit or follow us on twitter @CAMHnews.

About the Good Shepherd Ministries

Good Shepherd Ministries is a registered charity located in downtown Toronto. Founded in 1963, Good Shepherd Ministries operates Toronto’s largest free meal program as well as providing shelter, clothing, medical care, and other vital services for people struggling with homelessness and poverty. For more information, please visit or follow us on Twitter @goodshepherd_to.