The Massachusetts Council on Gaming and Health is a private, non-profit health agency that was founded in 1983. It provides information, promotes public awareness, and offers community education, professional training, advocacy and referral services for problem gamblers, their loved ones, and the greater community. [1]
The Massachusetts Council on Compulsive Gambling was founded in 1983 by Thomas N. Cummings and a small group of others affected by gambling problems. Together, they identified a need for statewide problem-gambling services. Tom served as Executive Director until his passing in January 1998. Today, there is a greater awareness of problem gambling in Massachusetts. The Massachusetts Council provides problem gambling education, trainings and events. There is also access to statewide Department of Public Health problem-gambling treatment facilities throughout Massachusetts. Services provided by the Council include information and public awareness, education and training, advocacy, referral and helpline and prevention programs.
The council works to raise awareness about problem gambling and the programs and services available to help people affected by the disorder. It provides a variety of informative material, from brochures and DVDs to websites, free to the public. [2]
Representatives from the Council offer presentations at schools, businesses, non-profits, and consult on problem gambling policy development and review. They also lead an annual conference, regional trainings, and online trainings. Trainings aim to increase current substance abuse and mental health clinicians’ skills in clinical interventions, addictions treatment, and case management for people experiencing gambling disorders.
The council works towards responsible public policy guidelines for responsible state-supported gambling. It advocates for services for problem gamblers, their families, and the greater community. It started with the 1987 legislation that provided funding for the council. In 1987 there was only 1 treatment site available for those affected by problem gambling, as of 2012, there were 14 sites. The Council formed the Massachusetts Partnership for Responsible Gambling in 2010. It also worked with the National Council on Problem Gambling to advocate for the Comprehensive Problem Gambling Act of 2009 [3] with federal legislative offices and key Massachusetts stakeholders.
Set up in 1987, the helpline has provided free, live, confidential and anonymous caller responses 24 hours a day, 7 days a week. [4] Council staff members are equipped to offer information and referrals for self-help, treatment providers and other community resources to people experiencing problems with gambling. They are free and are offered in English, Chinese, Vietnamese, Khmer, and Spanish. [5]
The Council increased its focus on prevention initiatives in 2007, bringing together community, faith, and educational institutions to strengthen the prevention of problem gambling efforts in at-risk communities. The council has developed special prevention programs for African American, Latino American and Asian Americans, older adults, youth and college students.
The council has advocated for treatment for problem gamblers that has resulted in a progression of treatment availability in Massachusetts and the development and implementation of a plan that integrates gambling treatment throughout the substance abuse delivery system. [6]
Since 1987 the council has answered over 37,000 calls and referred more than 32,000 people to treatment services. [7] Since 1983, the council has generated and contributed to more than 1,950 media stories on problem gambling.
Research has estimated the number of U.S citizens who gamble as well as the number who experience pathological and sub-clinical pathological gambling:
Bipolar I disorder is a type of bipolar spectrum disorder characterized by the occurrence of at least one manic episode, with or without mixed or psychotic features. Most people also, at other times, have one or more depressive episodes, and all experience a hypomanic stage before progressing to full mania.
A mood disorder, also known as an affective disorder, is any of a group of conditions of mental and behavioral disorder where a disturbance in the person's mood is the main underlying feature. The classification is in the Diagnostic and Statistical Manual of Mental Disorders (DSM) and International Classification of Diseases (ICD).
Narcissistic personality disorder (NPD) is a personality disorder characterized by a life-long pattern of exaggerated feelings of self-importance, an excessive need for admiration and a delusional sense of status, diminished ability or unwillingness to empathize with others' feelings, and interpersonally exploitative behavior. Narcissistic personality disorder is one of the sub-types of the broader category known as personality disorders. It is often comorbid with other mental disorders and associated with significant functional impairment and psychosocial disability.
Antisocial personality disorder is a personality disorder characterized by a limited capacity for empathy as well as a difficulty sustaining long-term relationships. A long-term pattern of disregard or violation of the rights of others and a contemptuous or vindictive attitude are often apparent, as well as a history of rule-breaking that can sometimes include law-breaking, manipulation, compulsive lying for amusement or personal gain, a tendency towards chronic boredom and substance abuse, and impulsive and aggressive behavior. Antisocial behaviors often have their onset before the age of 8, and in nearly 80% of ASPD cases, the subject will develop their first symptoms by age 11. The prevalence of ASPD peaks in people age 24 to 44 years old, and often decreases in people age 45 to 64 years. In the United States, the rate of antisocial personality disorder in the general population is estimated between 0.5 and 3.5 percent. In a study, a random sampling of 320 newly incarcerated offenders found ASPD was present in over 35 percent of those surveyed. One out of 17 (6%) of divorces involves a person affected by ASPD.
Obsessive–compulsive personality disorder (OCPD) is a cluster C personality disorder marked by a spectrum of obsessions with rules, lists, schedules, and order, among other things. Symptoms are usually present by the time a person reaches adulthood, and are visible in a variety of situations. The cause of OCPD is thought to involve a combination of genetic and environmental factors, namely problems with attachment.
Generalized anxiety disorder (GAD) is a mental and behavioral disorder, specifically an anxiety disorder characterized by excessive, uncontrollable and often irrational worry about events or activities. Worry often interferes with daily functioning, and individuals with GAD are often overly concerned about everyday matters such as health, finances, death, family, relationship concerns, or work difficulties. Symptoms may include excessive worry, restlessness, trouble sleeping, exhaustion, irritability, sweating, and trembling.
Problem gambling or ludomania is repetitive gambling behavior despite harm and negative consequences. Problem gambling may be diagnosed as a mental disorder according to DSM-5 if certain diagnostic criteria are met. Pathological gambling is a common disorder associated with social and family costs.
Intermittent explosive disorder is a behavioral disorder characterized by explosive outbursts of anger and/or violence, often to the point of rage, that are disproportionate to the situation at hand. Impulsive aggression is not premeditated, and is defined by a disproportionate reaction to any provocation, real or perceived. Some individuals have reported affective changes prior to an outburst, such as tension, mood changes, energy changes, etc.
Impulse-control disorder (ICD) is a class of psychiatric disorders characterized by impulsivity – failure to resist a temptation, an urge, or an impulse; or having the inability to not speak on a thought. Many psychiatric disorders feature impulsivity, including substance-related disorders, behavioral addictions, attention deficit hyperactivity disorder, fetal alcohol spectrum disorders, antisocial personality disorder, borderline personality disorder, conduct disorder and some mood disorders.
Oppositional defiant disorder (ODD) is listed in the DSM-5 under Disruptive, impulse-control, and conduct disorders and defined as "a pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness". This behavior is usually targeted toward peers, parents, teachers, and other authority figures. Unlike conduct disorder (CD), those with ODD do not show patterns of aggression towards people or animals, destruction of property, theft, or deceit. One half of children with ODD also fulfill the diagnostic criteria for ADHD.
The National Comorbidity Survey: Baseline (NCS-1) was the first large-scale field survey of mental health in the United States. Conducted from 1990–1992, disorders were assessed based on the diagnostic criteria of the then-most current DSM manual, the DSM-III-R. The study has had large-scale implications on mental health research in the United States, as no widespread data on the prevalence of mental illness was previously available.
Dual diagnosis is the condition of having a mental illness and a comorbid substance use disorder. There is considerable debate surrounding the appropriateness of using a single category for a heterogeneous group of individuals with complex needs and a varied range of problems. The concept can be used broadly, for example depression and alcohol use disorder, or it can be restricted to specify severe mental illness and substance use disorder, or a person who has a milder mental illness and a drug dependency, such as panic disorder or generalized anxiety disorder and is dependent on opioids. Diagnosing a primary psychiatric illness in people who use substances is challenging as substance use disorder itself often induces psychiatric symptoms, thus making it necessary to differentiate between substance induced and pre-existing mental illness.
Ronald C. Kessler is an American professor at Harvard Medical School. His research focuses on the precision treatment of mental illness to determine the appropriate intervention for specific patients. He ranks among the most highly cited researchers in the world, with an h-index of 316 as of March 2023.
The prevalence of mental disorders has been studied around the world, providing estimates on how common mental disorders are. Different criteria or thresholds of severity have sometimes been used.
Personality disorders (PD) are a class of mental disorders characterized by enduring maladaptive patterns of behavior, cognition, and inner experience, exhibited across many contexts and deviating from those accepted by the individual's culture. These patterns develop early, are inflexible, and are associated with significant distress or disability. The definitions vary by source and remain a matter of controversy. Official criteria for diagnosing personality disorders are listed in the sixth chapter of the International Classification of Diseases (ICD) and in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM).
The World Health Organization Composite International Diagnostic Interview (CIDI) is a structured interview for psychiatric disorders. As the interview is designed for epidemiological studies, it can be administered by those who are not clinically trained and can be completed in a short amount of time. Versions of the CIDI were used in two important studies, the National Comorbidity Survey (NCS) and National Comorbidity Survey Replication (NCS-R) which are often used as a reference for estimates of the rates of psychiatric illness in the USA. The first version of the CIDI was published in 1988, and has been periodically updated to reflect the changing diagnostic criteria of DSM and ICD.
The epidemiology of depression has been studied across the world. Depression is a major cause of morbidity worldwide, as the epidemiology has shown. Lifetime prevalence estimates vary widely, from 3% in Japan to 17% in India. Epidemiological data shows higher rates of depression in the Middle East, North Africa, South Asia and U.S.A than in other regions and countries. Among the 10 countries studied, the number of people who would experience depression during their lives falls within an 8–12% range in most of them.
Patricia A. Berglund is a researcher at the University of Michigan's Institute for Social Research. She was included in the 2014, 2015 and 2016 Clarivate Analytics lists of "highly cited researchers" in the fields of psychiatry and psychology.
Hans-Ulrich Wittchen is a clinical psychologist, psychotherapist and epidemiologist. He has been a head of the Institute of Clinical Psychology and Psychotherapy and the Center of Clinical Epidemiology and Longitudinal Studies (CELOS) at the Technische Universität Dresden. Since 2018, he is leading the research group "Clinical Psychology and Psychotherapy Research" at the Psychiatric Clinic of Ludwig-Maximilians-Universität München and directs the IAP-TU Dresden GmbH in Dresden.
Nancy M. Petry was a psychologist known for her research on behavioral treatments for addictive disorders, behavioral pharmacology, impulsivity and compulsive gambling. She was Professor of Medicine at the University of Connecticut Health Center. Petry served as a member of the American Psychiatric Association Workgroup on Substance Use Disorders for the DSM-5 and chaired the Subcommittee on Non-Substance Behavioral Addictions. The latter category includes Internet addiction disorder and problem gambling. She also served as a member of the Board of Advisors of Children and Screens: Institute of Digital Media and Child Development.