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Transcript of JoCo on the Go podcast 06/09/2020

Theresa Freed [00:00:00] On this week's episode, find out how Johnson County is addressing the issue of gambling and gaming addiction, our mental health experts will share details of a new program to help those affected by this issue. You'll also hear how loved ones of those addicted to gambling and gaming can get the support they need.

Announcer [00:00:17] Whether you live in or just love Johnson County, Kansas, JoCo on the Go has everything Johnson County. Here's what's happening and what's coming up in the community you call home.

Theresa Freed [00:00:30] Thanks for joining us for JoCo on the Go. I'm your host Theresa Freed, a Johnson County resident and employee of Johnson County Government. Gambling and gaming addiction is a serious issue that can lead to some very unfortunate outcomes. But Johnson County Mental Health is here to help. Joining me with more on this is Kelsey Coleman. And Deb Stidham, both with Johnson County Mental Health. Thank you both for being here. All right. So just just start us off with the conversation. What exactly is gambling and gaming addiction?

Deb Stidham [00:00:58] So gambling and gaming addiction is both. They are both recognized by the World Health Organization and in the Diagnostic Statistical Manual as a disorder, a mental health disorder with specific criteria that one can identify for that diagnosis.

Theresa Freed [00:01:16] OK. And can you talk a little bit about what that criteria is?

Deb Stidham [00:01:19] Sure. So this will sound, I think, similar to what you may have heard on alcohol or other drug addiction. So there's questions related to spending more and more time in the activity. Preoccupation with that activity just can't quite not think about it. Right? You're you're just constantly wondering when you can game or gamble next. Moody, irritable, if you can't gamble or participate in that gaming activity. Attempts to cut down those activities are not successful in some cases. A lot of times you can see financial problems as a result of both of these activities. If you're spending your money on those things rather than rent, then you're then you're certainly indicating a problem.

Theresa Freed [00:02:07] OK. And so just us include videogames or are we talking more about sort of electronic games that involve some sort of betting component?

Deb Stidham [00:02:16] It can include all of those things. And even on the gambling side, you can see a wide variety of activities. It might surprise some listeners to know that there are people addicted to buying lottery tickets, for example. Which is not usually something we think of as typical gambling.

Theresa Freed [00:02:32] OK. And so when we talk about like a video game sort of addiction there. Are we talking about, say, for example, a teenager who spends hours on end in front of a television playing a video game and maybe gets sort of irate or seems to overreact to the outcome of that competition? Is that the same thing we're talking about?

Deb Stidham [00:02:53] Right. And again, we're looking for a pattern of behavior over time. We're not just looking for just, you know, a weekend incident or one or two incidences, but something that someone is noticing. Maybe there's a decline in the grades. Maybe they've stopped participating in sporting activities that they used to enjoy.

Theresa Freed [00:03:11] OK. And so we do have a new program here that's available in Johnson County. And really the first of its kind, especially in our area, to address the issue. Can you talk about that?

Kelsey Coleman [00:03:21] Sure. So our new gambling program can provide free services to clients who meet criteria for the mental health center and have concerns about their gambling. The program's paid for by a state grant. So the clients don't have any financial responsibilities when they're working with me. I think the other important piece is that right now we just have outpatient individual counseling for our clients, but we are looking at starting group counseling as well.

Theresa Freed [00:03:50] Just getting back to the actual addiction component there. It may not seem apparent that it's a mental health issue. Can you talk a little bit more in-depth about why it's classified in that way?

Deb Stidham [00:04:01] Well, I think it's classified that way, again, because you see a pattern of behavior that's going to lead to consequences. Again, I have to kind of go back to the alcohol and other drug addiction. We've had that for the millennia. And so that that was classified as a disease by the American Medical Association clear back in the 1950s. So this came along as you see more prevalence of gambling. I mean, honestly, we've had those disorders for, you know, a long time as well. But it wasn't as recognized. And you see this just very similar patterns of behavior, even see it running in families. And so the general public might disagree in some cases about these kinds of addictions being a disease. But, you know, our well-known associations and things have come out and publicly declared it as such. And really what that means is that there is identified treatment. We have plenty of research to base. You know, our theory on and our practice. And so the help that we're providing at Johnson County Mental Health is based on that research.

Theresa Freed [00:05:07] OK. And you mentioned the family component. So can you also talk about sort of the age range in which in what that looks like four different maybe different ages or maybe it's the same for all ages? I don't know.

Deb Stidham [00:05:19] Well, what you see is that there are certain groups of folks that are more at risk. So on the gambling side, what we know is that youth are particularly at risk. And again, it's like the alcohol and drug addiction, that developing brain, that prefrontal cortex isn't quite where we'd like it to be sometimes. And so they're very susceptible to that pattern of conditioning, that constant exposure to gaming and gambling can have on that brain. The the other group that we're very concerned about is the older adults, some assisted living places and the like are loading buses of of the elderly into casinos and the like for that social activity. And there is a concern there because some some of them are spending, you know, the only money that they have left maybe for their care, they're spending the inheritances that they had intended to leave for their children. The other group that's a high risk is the military. There's been a significant increase in the number of military individuals having a gambling problem. I've talked to people in the military and it's a little bit like the elderly. That's one of the things that there is to do on the base is go and they have these gambling activities. It's kind of sanctioned. And so you are seeing an increase of that probably again, due to some of the stressors of being in the military. Maybe they've been in war. They may have a co-occurring post-traumatic stress disorder. I mean, it's hard to know all the factors, but we do know that there is kind of that comorbidity of mental health problems could be depression and the like and these kinds of behaviors.

Theresa Freed [00:06:55] OK. And you did talk some about the the repetitive behavior. So what are the signs? Say, for example, I'm a parent and I've got a teenager who is spending a lot of time in his room playing video games. At what point should I be concerned about that?

Deb Stidham [00:07:11] Well, one of the resources that that I did want to let folks know about is a Web site that's offered by the state of Kansas, ksgamblinghelp.com. So just again, like in alcohol and Alcoholics Anonymous. We have Al-Anon for parents and families. We have Gam-Anon for families, concerned others of people with these problems. If you go on that Web site, there is actually a list of 20 questions to look at to kind of say, does my person have a problem? There's even a list of 20 questions for the person, the concerned other, how it's affecting them. If I answer yes to a whole bunch of these questions of how it's affecting me, likely there's an issue and I should also seek my own support for this problem.

Theresa Freed [00:07:58] OK. And so what are some of those worst case scenarios that you hear about or what are the things that that can actually result from from what seems like maybe just a fairly innocent habit?

Kelsey Coleman [00:08:11] So I do have some statistics on that. One of the big things that I talk about with my gambling clients is the concern for suicide. So studies show us that problem gamblers are at least 10 times more likely to attempt suicide due to the comorbid mental health, substance use and the extreme debt that they get themselves into. The other thing that's pretty significant is the legal involvement that people can get involved in. And the data from the state of Kansas shows us that 30 percent of our problem gamblers have committed illegal acts.

Theresa Freed [00:08:48] Wow. And so what does that look like?

Kelsey Coleman [00:08:51] A lot of times it could be stealing. It could be, you know, with the substance use, it could be drug related. A lot of people use substances at the casino. So we're looking at DUIs at that point as well.

Theresa Freed [00:09:03] OK. All right. And so you mentioned that there are screening tools for individuals who may feel they have a problem. They're also screening tools available at the state level for family members to get that help. Can you talk more specifically here in Johnson County? What do we offer for family members?

Kelsey Coleman [00:09:22] So we can meet with the concerned other and that is included in the grant that would apply to the client's treatment as well. But we also might encourage that person to get their own assistance if they have experienced some significant consequences of their loved ones behaviors, problem gambling impacts everybody in the household. When you're thinking about the finances and they might spend hours away at the casino, so you're looking at attachment abandonment. All that stuff's included. And if that person qualifies for services through Johnson County Mental Health, they could be assigned to one of our providers as well.

Theresa Freed [00:10:00] You know, we talk about alcoholics and, you know, people with other kinds of addictions. Is this is this gonna be a lifelong battle for somebody or can somebody reach a point, say I'm done with that?

Kelsey Coleman [00:10:12] I think that when we think of recovery, we think of lifelong because the changes in the lifestyle that they're going to make and they're going to learn in treatment, it's we encourage them to sustain those lifestyle changes. So some clients do well with harm reduction. They might continue to go to the casino. But we teach and they implement self-management, self-regulation skills or we set them up with some sort of financial assistance to prevent them from spending all their money. We can do some of those harm reduction techniques. But when it comes to restoring relationships and addressing mental health associated with this, you know, we encourage those lifelong changes.

Theresa Freed [00:10:50] And is that a quick process or is that something that takes a lot of time when you talk about rebuilding relationships and things like that?

Kelsey Coleman [00:10:57] I think that it depends on the damage of the relationship. A lot of our gambling clients have lied about the extent of the damage is that they've done. And so I think it just kind of depends too, what's the other person's perception of it? Do they have the ability to overcome that? And I think that it's promising, but it does take work from both people.

Theresa Freed [00:11:17] OK. And when you talk specifically about the program at Johnson County, can you kind of walk us through what that looks like?

Kelsey Coleman [00:11:25] We offer outpatient services. So I have clients who meet up to two times a week right now, one or two times. And we do have a state-approved curriculum they can work through. Some clients choose that. Some clients choose to do cognitive behavioral therapy techniques. Other clients choose to really hone in on those harm reduction skills. How can I still go to the casino but keep my job and keep my wife and keep my family safe?

Theresa Freed [00:11:49] So you talked about the techniques that you're helping them with so that they can they can kind of get their life back. Can you talk more specifically about what those are?

Kelsey Coleman [00:11:59] In terms of the cognitive behavioral techniques we look at what are your high risk situations? What are your high-risk thoughts? And how do we replace those with something more low risk? So if someone tends to gamble more when they're upset, what can they do instead to calm themselves down? I like to look at my clients patterns of behavior. Do you spend more time in the casino when you're upset versus when you're going in just to win a few dollars? And if that's the case, I look at replacement skills for what to do when you're upset, if it's the case that they really just can't manage their money. I look at ways to reduce their access to money. Can we hand it over to mom? Can we trust someone in the family with your money? Can we develop a plan that you check in with yourself and say, I'm here for 30 minutes and then I'm out? And then I help them reinforce that throughout the way.

Theresa Freed [00:12:51] OK. And just may seem like sort of an obvious question, but we have a program for this. So what is the extent of the issue here in Johnson County or is this a problem here?

Kelsey Coleman [00:13:01] Yes, I think that the program has been open. I started my first client in November, I think. We are consistently getting referrals from probation, the help line, family members. I think what's tricky for them to get linked up to me is that they have to meet criteria for both the mental health center and the gambling. If they don't meet criteria for the mental health center, I can't work with them, I have to refer them out. And that usually means they're going to Kansas City or Lawrence and sometimes that's just not feasible for some of the clients.

Theresa Freed [00:13:31] OK. So a lot of demand for this service, but you mentioned the service is free to those who are involved and in the mental health center. And how do people access the service?

Kelsey Coleman [00:13:42] The clients can reach out, whether they're already clients of the mental health center or they're not yet clients. And if they are clients already. I can just meet with them and start the intake process. If they are not current clients, they have to come through our open access and complete an intake and then they will be assigned to me.

Theresa Freed [00:14:00] How has the pandemic impacted those with gambling and gaming addictions, especially with casinos being closed and then recently reopened and with increased time at home and access to online gaming?

Kelsey Coleman [00:14:11] I think that pandemic definitely has impacted the gambling and gaming addiction with the casinos being closed. A lot of my clients have had a really good opportunity to work hard on their treatment goal. While some of my other clients have shown an increase in an alcohol and drug use since they don't have access to casinos or they're finding other ways to gamble, such as online or using apps. In terms of gaming, I'm definitely getting a lot of reports from parents with schools being closed during the pandemic. They have seen a lot of decreasing structure and increasing gaming with the kids.

Theresa Freed [00:14:52] And how does your office serve clients differently during the pandemic?

Kelsey Coleman [00:14:56] Across the mental health center since the pandemic has started, we have been serving clients differently. We have been seeing clients by phone or by Zoom. And most of the clients that I'm working with on the gambling side of things have found this pretty effective because it's more convenient. They don't have to drive to the appointments or take time off work. So that has given me an opportunity to have more appointments with them and help them work on a very specific plan on how we're going to manage gambling behavior when the casinos reopen.

Theresa Freed [00:15:30] And just lastly, hear any messages for for those who might be dealing with this situation?

Deb Stidham [00:15:37] Well, I think there's always hope. I mean, where where you have resources available and certainly the knowledge that is already out there about the kinds of symptoms that we would look for. You know, one of the things that I wanted to also mention is that the state of Kansas offers what's called a voluntary exclusion program. So if a person is concerned, even in any way about their access to the casinos, they can talk to the state of Kansas, this is all on that ksgamblinghelp.com website. Talk to the state and put themselves on a voluntary exclusion list for a period of time. And I think this gives kind of the time out that some people need to to get their life back on track.

Theresa Freed [00:16:22] OK. What exactly does that mean if they're on this list?

Deb Stidham [00:16:26] It means that they are banned from going into the casino. If they slip in in some way and they win something, they win money. They won't be able to retain those winnings. So it's just it's it's a well-known strategy. It's used all over the country by casinos to help these folks, you know, do what they need to do to to regulate themselves. The other thing I wanted to mention was also that sports betting is gaining a lot of traction. So this is kind of gaming and gambling. You know, this is where we're kind of intermixing the two and and being able to do sports betting on your phone increases access. Where you increase access, you have increased prevalence. And so these are things that we all just need to be aware of and mindful of. But I think the main thing is for people to just understand that there is resources out there and there is hope. There's a lot of information on the Internet that can be very, very helpful. Other states have developed extensive documents and things just for free for people to access as well.

Theresa Freed [00:17:36] OK. So if somebody doesn't know where to begin, though, they can always reach out to you. And how do they do that?

Deb Stidham [00:17:41] Well, they can get a hold of Kelsey at the Mental Health Center, 913-826-4100. And be happy to answer any questions and go from there.

Theresa Freed [00:17:52] All right. Well, thank you both for being here today.

Announcer [00:17:55] You just heard JoCo on the go. Join us next time for more everything Johnson County. Have a topic you want to discuss? We want to hear from you. Follow us on Facebook and Twitter at JoCoGov. For more on this podcast, visit jocogov.org/podcast. Thanks for listening.