• Gamblers have flamboyant, carefree personalities. (Some are, but others are quiet, introverted, and serious minded)
• Gamblers enjoy risks in all areas of their lives. (Some are big risk takers, others are conservative in personal habits and work)
• If you don’t gamble daily, you’re not a problem or compulsive gambler
• You can be addicted to an activity. (Gambling can change one’s mood by affecting the biochemistry of the brain much the same way as alcohol or drugs)
• Gamblers are thieves and criminals.  (Not true, but some gamblers may resort to criminal behaviour in desperation)
• A compulsive gambler will bet on anything. (Problem gamblers generally have preferences and are not tempted by every type of gambling)
• All compulsive gamblers want to lose. (are addicted to the act of gambling –they would rather lose than be out of the action)
• Compulsive gamblers are week-willed, otherwise they would simply stop.

Q: Why talk about gambling and ethno-cultural groups?

A: Problem gambling can affect anyone regardless of ethno-cultural background.

Gambling is an activity that has been present in almost all societies throughout history.  Research tells us that early games of chance took the form of casting lots and dice.  Four-sided gaming sticks dating as far back as 6000 B.C. have been unearthed at archaeological sites in Africa, Asia and North and South America.

At present, research illustrates that the percentage of pathological gamblers is the same for all peoples.

95% of the population are healthy when it comes to gambling but have been involved in gambling.

5% of the population are problem gamblers

1% of the 5% are compulsive/pathological gamblers

“The rate of gambling activity amongst ethno-cultural groups is similar to gambling rates for the general population.” (ARF Study, 1996)

However, we need to emphasize that is not so much the issue of gambling but the lack of access to information and resources that may place individuals from ethno cultural groups at risk of developing a problem with gambling.

CHIEDETEVI:   Ho un problema di gioco d’azzardo?

Sintomi e segnali

Quali sono i sintomi o i segnali?

Ecco alcuni fattori che possono segnalare un problema di gioco in una persona:

• Giocare per lunghi periodi, trascorrendo sempre più tempo nei locali in cui si gioca
• Avere l’ossessione del gioco, pensare costantemente a giocare e a prepararsi a giocare
• Cercare di recuperare le perdite giocando più spesso e puntando di più con la speranza di rivincere i soldi perduti
• Fare assenze frequenti e inspiegabili da casa o dal lavoro e avere segreti
• Giocare per sfuggire ai doveri e agli obblighi della vita quotidiana
• Aumentare i debiti di gioco, mentendo o compiendo atti criminali per finanziare il gioco
• Negare esigenze personali/familiari come nutrizione, sonno, istruzione e benessere generale

Fattori che possono far scattare la dipendenza dal gioco:

Eventi:

• Pubblicità
• Pressione finanziaria
• Tempo disponibile
• Gioco da parte di amici
• Ricchi premi in palio
• Aver saputo di una grossa vincita
• Aver quasi vinto
• Aver giocato e vinto
• Aver perso
• Avere debiti
• Avere troppi debiti
• Essere accusati di giocare d’azzardo

Pensieri:

• Immaginare di vincere
• “È la mia unica possibilità”
• “Questa volta sarò fortunato”
• “Se vinco sarò felice ”
• “Pensiero magico“
• “È il mio destino”
• “Scommetterò solo un po’”
• “Mi merito un po’ di divertimento”
• “Non c’è altro modo per ripagare i miei debiti”
• “Rimetterò i soldi a posto quando vinco”

Sentimenti: 

• Rabbia
• Irritazione
• Noia
• Disperazione
• Scoramento
• Felicità
• Invidia
• Disappunto
• Stanchezza
• Depressione
• Intossicazione
• Solitudine
• Rancore
• Sentirsi “in cima al mondo”

This page is also available in: Inglese, Arabo, Cinese, Somalo

According to the “Provincial Diversity Needs Assessment Report, Centre for Addiction and Mental Health, CAMH, 2004 report, service providers across the province indicated that many clients do not receive the health care they need, this problem is even worse for diverse communities, because of their unique needs and the additional systematic barriers they face in accessing services… most agencies that provide settlement services to new immigrants and refugees do not have the capacity to recognize and deal with clients’ mental health and/or addiction problems.  In addition, service providers often have difficulty referring non-English speaking clients for treatment, because very few facilities provide interpreters and/or programs and services in languages other than English.

In the same report, the shortage of culturally competent health care professionals, as well a general lack of cross-cultural understanding as a significant barrier to accessing services was indicated, participants in focus groups pointed out that there is relatively few primary health care workers and professional trained in regards diversity and cultural differences.  They also stated the need of appropriately trained doctors, nurses and other health care professionals.  Members of ethno-racial and cultural diverse communities indicated that their cultural and linguistic needs are not acknowledged or taken into consideration in the provision of treatment or services.  Most felt the need to express themselves, in their own language and in a culturally appropriate environment, to health professionals who could understand and respond in their language.  Many focus groups viewed racism and homophobia not only as significant barriers to service access but also as major contributors to lack of care, to inappropriate and improper care, and indeed directly to an increase in addiction and mental health problems.  Racism was identified as one of the barriers that prevent members of ethno-racial and cultural diverse populations from accessing mainstream services.

It was also noted in the above mention report by focus group participants, that in communities where casinos operate, there s an increased in mental health and addiction problems, with few new resources to address them.  Participants also noted the lack of community leadership, cohesion and inclusiveness, lack of funding and low policy priority, as well as lack of attention to social determinants of mental health and addiction affecting diverse communities.

To reduce gaps in services, the following are some of the recommendations that most focus groups participants noted were more important:

• Provide culturally and linguistically appropriate programs and services and resources
• Development of  more specific materials that are culturally appropriate, clearly written, removing clinical jargon, and in different languages, to inform diverse community about mental health and addiction education and services
• The use of community radio, videotapes, cable TV, churches and religious institutions, as important routes for education, health promotion and communication.
• Provide alternative approaches to mental health and addition services, such acupuncture, yoga, meditation, etc. vs too westernized and medication-focused existing programs
• Re-train and hire foreign-trained physicians and other professionals
• Share information among service providers that pertains to diversity, including inter-community best practices
• Develop public awareness and media campaigns to reduce stigma in diverse communities.
• Reach out and engage in partnerships with ethno-racial and cultural diverse populations

As A. Blaszczynski, concludes in his article “Gambling Problems in a Multicultural Society”, of a research done in Australia, “In order to achieve better outcomes for ethnic clients, therapists must accommodate cultural differences and specific cultural needs of ethnic clients.  The cultural background of ethnic clients provides hem with a context for actions and interactions with other.  This context will have embedded in it culturally based beliefs, values, attitudes and role requirements.  Awareness of the influence of culture will allow therapists to gain more relevant information from ethnic clients by asking more appropriate questions and allow for more culturally appropriate interventions.”

These practices must include:

• Outreach
• Developing partnerships and/or coalitions
• Prevention and awareness programs
• Counselling in various languages
• Language- specific publications
• Increased collaboration with service agencies working specifically with ethno-cultural groups, especially with Multicultural Centres and/or settlement service agencies. Groups in Ontario

In my successful working experience with members of ethno-cultural communities and their families, I have learned that attitude is more important than knowledge.   Our attitude can open the doors to connect and create a bond with our clients in receiving the message properly and engage in treatment, or it can block communication at both ends.  It is essential to form an essential culturally competent relationship with our clients.  Learn about your individual clients customs such as eye contact, greetings, what is permissible and what it is not, and how is the family decision making process.  Working in partnership and/or very closely with ethno-cultural communities is a key element for developing effective and alternative mental health practices to address the issue of problem gambling.  Building successful and lifetime alliances with ethno-cultural clubs and organizations, Multicultural Centres and other agencies serving newcomers are very important to build trust and be able to engage members of these communities

These are Tips that I used when working with members of ethno-cultural communities

• Have a map of the world
• Learn about your own culture and ethnicity
• Enhance your office space with poster/articles/ornaments from other cultures
• Speak with clear and simple language
• Be aware of your body language
• Be aware of your client’s body language
• Introduce yourself 
• Place special attention to your client name
• Place strong emphasis on confidentiality
• Avoid gambling and/or medical lingo, abbreviations, 
• Be aware about your own biases and fears
• Be respectful always
• Be flexible
• Show patience
• If need be, please allow the presence of another family member in the counselling session, just as a support party, not as an Interpreter

If there is need to use an Interpreter, always look for the Interpreter Services and or Cultural Interpreting Services in your community.  These professionals are highly qualified, abide by a code of ethics, and most likely their particular language is their mother tongue, which will benefit the dynamics of the session.  Their role is to facilitate accurate communication between people of different languages and cultures. Avoid using family members, friends, or people who work in your organization and that have the language but not the training, certification, competence, fidelity, and impartiality as a Certified Interpreter.  This practice can cause confusion, waste of time, and extra stress for the client and service provider.  Place strong  emphasis in the confidentiality of the services.

Please follow the below guidelines when using an Interpreter

• Make sure you have your client’s permission to use and Interpreter
• Meet with Interpreter and/or Cultural Interpreter in advance to clarify roles
• Allow extra time for session
• Speak directly to your client
• Speak clearly and in shot sentences using plain language
• Avoid the use of jargon, Abbreviations or acronyms
• Provide clarification and explanation
• Make sure that the message that you intent to convey is understood
• Try to use alternative, inclusive holistic approaches to treatment
• When using assessment tools, remember that some people may have subjected in the past to interrogation methods, and being questioning may increase stress and fear
• Make sure that client understood time and date of next meeting
• At all times and circumstances be respectful
• Thank your Interpreter and client
• Debrief session with Interpreter after client is gone, if need be
• Evaluate your session
• Evaluate yourself
• Provide professional training and resources focusing in education in cultural competency anti-racism and diversity issues as part of in-service and professional development opportunities.

Qaybaha Ciyaaraha:

Intooda badan ciyaaraha khamaarka kuwa ugu caansan waxa loo qaybin karaa saddex qaybood. Qaybuhu waxay ku salaysan yihiin sida ay natiijada ciyaartu nasiibka u tahay, iyo inta ciyaaryahanku maamuli karo doorashada natiijada.

1. Nasiib ah oo Madaxbannaan (islotis, lootari, laadhuu, ruulet)
   Si nasiib ah loo helo, natiijooyinku ka madaxbannaan ciyaarta xigta
   Lama maamulo natiijada.
2. Nasiib ah oo Tiirsane ah (kaadhadhka, bingo)
   Si nasiib ah loo helo, natiijooyinka inuun waa la saadaalin karaa.
   Natiijada waa la maamulaa.
3. Aan-Nasiib Ahayn oo Tiirsane ah (sharatanka isboortiga)
   Waad garanaysaa waxa aad ku sharatamayso.
   Waxaad si uun u maamushaa natiijada.

Kooxaha Waawayn ee Ciyaaraha:

This page is also available in: English, Arabic, Chinese (Simplified), Italian

This page is also available in: Inglés, Árabe, Chino, Persa, Francés, Hindi, Italiano, Portugués, Ruso, Somalí, Urdu

Ethno-cultural communities are under-represented in gambling treatment. The lack of appropriate culturally sensitive counselling services, as well as the issue of language means that these populations don’t have equal access to services and therefore they may be in a more vulnerable situation.

According to the 2006 Census, (www.statscanadaCanada has welcomed more than 14 million immigrants since 1901, over 1 million arriving in the last 5 years.  The  number and percentage of foreign born in Canada has steadily increased since 1986.  In Toronto 45.7% of the population are foreign born and over 200 different ethnic groups were reported.  The percentage of foreign  born also increased in other cities, in St. Catharines-Niagara 18.3%, London 19.3%, Kitchener 23.1% and Windsor 23.3%, Hamilton 24.4% , Guelph 20.4%, etc. Taking into consideration these demographics, it is important to consider the needs of these communities in regards problem gambling service delivery.

As stated in the 2004, Centre for Addictions and Mental Health, CAMH, “Provincial Diversity Needs Assessment Report”,  “the proportion of diverse ethnocultural/ethnoracial populations in Ontario has increased significantly, culturally and linguistically appropriate services are still few in number.  Diverse ethnocultural/ethnoracial communities often have different beliefs and attitudes toward mental health, mental health problem and substance use, and different opinions about what constitutes an appropriate model of treatment.  Western ideas about mental health problems and addiction are not always applicable to people from other cultural backgrounds.  A participant from the Rwandan community explains, “There is no concept of mental health in our community…. And there is terminology for addiction”.  Focus group participants wanted outreach to diverse ethnocultural/ethnoracial groups… as well as the development of language-specific and culturally sensitive approaches for these populations.”

However, due to the increase in gambling venues in Canada and globally, more research on gambling and ethno-cultural communities is necessary. During the recent years, we have seen a great emphasis regarding problem gambling and members of different ethno-cultural communities and their families.  As of May 2001, the Ontario Problem Gambling Research Centre (OPGRC) has awarded $1.6 million for research focusing on special populations., including ethno-cultural groups. Various organizations such as COSTI Immigrant Services, the Centre for Addiction and Mental Health, CAMH, and the Ontario Problem Gambling Research Centre have conducted research among different ethno-cultural communities.   One can have access to “Addressing Problem Gambling in Toronto and Windsor/Essex County Ethnic communities and Exploration of Cultural Perceptions (gamblingresarch.org) and “Attitudes and Beliefs Regarding Gambling and Problem Gambling in the Hispanic, Polish, Portuguese, Punjabi, Tamil and Vietnamese Communities in the Greater Toronto Area” full reports, by linking the Ontario Problem Gambling Research Centre (gamblingresearch.org)  and or COSTI Immigrant Services (costi.org)

The results of the above mentioned research will be a great help to overcome the information gap regarding ethno-cultural groups and gambling.   More information will hopefully lead to the development of better, culturally and linguistically effective practices for the assessment and treatment of problem gambling for ethno-cultural populations.

According to the “Provincial Diversity Needs Assessment Report, Centre for Addiction and Mental Health, CAMH, 2004 report, service providers across the province indicated that many clients do not receive the health care they need, this problem is even worse for diverse communities, because of their unique needs and the additional systematic barriers they face in accessing services… most agencies that provide settlement services to new immigrants and refugees do not have the capacity to recognize and deal with clients’ mental health and/or addiction problems.  In addition, service providers often have difficulty referring non-English speaking clients for treatment, because very few facilities provide interpreters and/or programs and services in languages other than English.

In the same report, the shortage of culturally competent health care professionals, as well a general lack of cross-cultural understanding as a significant barrier to accessing services was indicated, participants in focus groups pointed out that there is relatively few primary health care workers and professional trained in regards diversity and cultural differences.  They also stated the need of appropriately trained doctors, nurses and other health care professionals.  Members of ethno-racial and cultural diverse communities indicated that their cultural and linguistic needs are not acknowledged or taken into consideration in the provision of treatment or services.  Most felt the need to express themselves, in their own language and in a culturally appropriate environment, to health professionals who could understand and respond in their language.  Many focus groups viewed racism and homophobia not only as significant barriers to service access but also as major contributors to lack of care, to inappropriate and improper care, and indeed directly to an increase in addiction and mental health problems.  Racism was identified as one of the barriers that prevent members of ethno-racial and cultural diverse populations from accessing mainstream services.

It was also noted in the above mention report by focus group participants, that in communities where casinos operate, there s an increased in mental health and addiction problems, with few new resources to address them.  Participants also noted the lack of community leadership, cohesion and inclusiveness, lack of funding and low policy priority, as well as lack of attention to social determinants of mental health and addiction affecting diverse communities.

To reduce gaps in services, the following are some of the recommendations that most focus groups participants noted were more important:

• Provide culturally and linguistically appropriate programs and services and resources
• Development of  more specific materials that are culturally appropriate, clearly written, removing clinical jargon, and in different languages, to inform diverse community about mental health and addiction education and services
• The use of community radio, videotapes, cable TV, churches and religious institutions, as important routes for education, health promotion and communication.
• Provide alternative approaches to mental health and addition services, such acupuncture, yoga, meditation, etc. vs too westernized and medication-focused existing programs
• Re-train and hire foreign-trained physicians and other professionals
• Share information among service providers that pertains to diversity, including inter-community best practices
• Develop public awareness and media campaigns to reduce stigma in diverse communities.
• Reach out and engage in partnerships with ethno-racial and cultural diverse populations

As A. Blaszczynski, concludes in his article “Gambling Problems in a Multicultural Society”, of a research done in Australia, “In order to achieve better outcomes for ethnic clients, therapists must accommodate cultural differences and specific cultural needs of ethnic clients.  The cultural background of ethnic clients provides hem with a context for actions and interactions with other.  This context will have embedded in it culturally based beliefs, values, attitudes and role requirements.  Awareness of the influence of culture will allow therapists to gain more relevant information from ethnic clients by asking more appropriate questions and allow for more culturally appropriate interventions.”

These practices must include:

• Outreach
• Developing partnerships and/or coalitions
• Prevention and awareness programs
• Counselling in various languages
• Language- specific publications
• Increased collaboration with service agencies working specifically with ethno-cultural groups, especially with Multicultural Centres and/or settlement service agencies. Groups in Ontario

In my successful working experience with members of ethno-cultural communities and their families, I have learned that attitude is more important than knowledge.   Our attitude can open the doors to connect and create a bond with our clients in receiving the message properly and engage in treatment, or it can block communication at both ends.  It is essential to form an essential culturally competent relationship with our clients.  Learn about your individual clients customs such as eye contact, greetings, what is permissible and what it is not, and how is the family decision making process.  Working in partnership and/or very closely with ethno-cultural communities is a key element for developing effective and alternative mental health practices to address the issue of problem gambling.  Building successful and lifetime alliances with ethno-cultural clubs and organizations, Multicultural Centres and other agencies serving newcomers are very important to build trust and be able to engage members of these communities

These are Tips that I used when working with members of ethno-cultural communities

• Have a map of the world
• Learn about your own culture and ethnicity
• Enhance your office space with poster/articles/ornaments from other cultures
• Speak with clear and simple language
• Be aware of your body language
• Be aware of your client’s body language
• Introduce yourself 
• Place special attention to your client name
• Place strong emphasis on confidentiality
• Avoid gambling and/or medical lingo, abbreviations, 
• Be aware about your own biases and fears
• Be respectful always
• Be flexible
• Show patience
• If need be, please allow the presence of another family member in the counselling session, just as a support party, not as an Interpreter

If there is need to use an Interpreter, always look for the Interpreter Services and or Cultural Interpreting Services in your community.  These professionals are highly qualified, abide by a code of ethics, and most likely their particular language is their mother tongue, which will benefit the dynamics of the session.  Their role is to facilitate accurate communication between people of different languages and cultures. Avoid using family members, friends, or people who work in your organization and that have the language but not the training, certification, competence, fidelity, and impartiality as a Certified Interpreter.  This practice can cause confusion, waste of time, and extra stress for the client and service provider.  Place strong  emphasis in the confidentiality of the services.

Please follow the below guidelines when using an Interpreter

• Make sure you have your client’s permission to use and Interpreter
• Meet with Interpreter and/or Cultural Interpreter in advance to clarify roles
• Allow extra time for session
• Speak directly to your client
• Speak clearly and in shot sentences using plain language
• Avoid the use of jargon, Abbreviations or acronyms
• Provide clarification and explanation
• Make sure that the message that you intent to convey is understood
• Try to use alternative, inclusive holistic approaches to treatment
• When using assessment tools, remember that some people may have subjected in the past to interrogation methods, and being questioning may increase stress and fear
• Make sure that client understood time and date of next meeting
• At all times and circumstances be respectful
• Thank your Interpreter and client
• Debrief session with Interpreter after client is gone, if need be
• Evaluate your session
• Evaluate yourself
• Provide professional training and resources focusing in education in cultural competency anti-racism and diversity issues as part of in-service and professional development opportunities.

Q: Why talk about gambling and ethno-cultural groups?

A: Problem gambling can affect anyone regardless of ethno-cultural background.

Gambling is an activity that has been present in almost all societies throughout history.  Research tells us that early games of chance took the form of casting lots and dice.  Four-sided gaming sticks dating as far back as 6000 B.C. have been unearthed at archaeological sites in Africa, Asia and North and South America.

At present, research illustrates that the percentage of pathological gamblers is the same for all peoples.

95% of the population are healthy when it comes to gambling but have been involved in gambling.

5% of the population are problem gamblers

1% of the 5% are compulsive/pathological gamblers

“The rate of gambling activity amongst ethno-cultural groups is similar to gambling rates for the general population.” (ARF Study, 1996)

However, we need to emphasize that is not so much the issue of gambling but the lack of access to information and resources that may place individuals from ethno cultural groups at risk of developing a problem with gambling.

Whether people belong to ethno-multicultural communities or the mainstream culture, the reasons for gambling and the problems that can develop by it, are the same.

According to the Centre for Addiction and Mental Health (CAMH), people from different cultural backgrounds gamble:

· To socialize

· To escape problems and isolation

· To socialize with members of cultural groups

· To regain social status

· To celebrate religious festivals

In many ethno-cultural groups gambling is a way to socialize. However, many ethno-cultural communities have unique social and recreational activities as well as preferences for games. In the Italian community for example, card playing is very popular, whether at home or at social clubs. Children of Asian cultural background are taught to play the game Mahjong, or Fan-Tan, which is a traditional and very simple pebble-counting game. “Fan” means “to turn over” an object, which could be a cup or a bowl, and “Tan” means “spread out” the stones.

When talking about gambling and ethno-cultural groups we have to mention the issue of immigration –life in transition- This extra stress on newcomers and refugees may put them in a more vulnerable position to develop a problem with gambling. They may use gambling as an escape from feelings of loneliness, homesickness, sadness and anguish, and the effect that   these issues may have on every family member as well as the whole family as a unit.  It is also important to take into consideration the family roles and behaviours in their own culture and their own family, as well as their attitudes and  beliefs about gambling and luck.

It is also important to note that within the same ethno-cultural communities, many differences exist, mostly due to the following factors:

• Type of Immigration Status
• Time of Immigration
• Level of Acculturation
• Level of Education
• Socio-Economic Status
• Ability to get and feel involved in the :new” community
• Social/Community  support

As cited in the 2006 report “The Human Face of Mental Health and Mental Illness in Canada”, Statistics Canada, (p34), all immigrants face resettlement stress or the challenge of settling in a new country.  Possible stressors include unemployment, poverty, isolation, language barriers, differing societal values, racism, and, in general  knowing how various systems-such as credentialing, employment, workplace, education and health-function.

People from different cultural backgrounds may use gambling to try to regain lost status, to feel part of the new community or part of the crowd and to feel that they belong. However, the social stigma that might be attached to gambling, within their own communities, may prevent gamblers who develop a problem from admitting that there is a problem and seeking professional help. As a result, there is greater stress on family members to deal with this problem and also to provide necessary health, financial and legal care, and what is consider cultural ly appropriate in regards looking for outside help e.g. counselling or t treatment.

The following are a few smart strategies to help family members to cope with issues of gambling and problem gambling

Smart strategies to prevent and protect family members:

• Get Informed
• Don’t Hide the Problem
• Find the Right moment to talk about it
• Support the family member or relative in making positive change
• Find Professional Help and Family Support for yourself
• Remember that change takes time

(Adapted from Within Limits, 2006 publication, Responsible Gambling Council of Ontario)

There may also be the issue of conflict of values between one’s own religious and cultural practices and the modern-western practice of gambling as entertainment, which is very common here in Canada.

Please see COSTI  Immigrant Services  publication “A Reference Manual on Problem Gambling for Newcomers Service Providers”, as an  example of  how perception about gambling, problem gambling and where to seek help are different for members of ethno-cultural groups.

Since gambling is a tourism attraction, many times there may be more opportunities for multilingual people to be employed within the gaming industry (Casinos, Bingo Halls, etc.). However, due to the availability/accessibility of gambling venues, there is also a high incidence of problem gambling within the gaming industry staff.