On stigma and how we can tackle it

by Linley Kensitt

Paul Fung was addicted to gambling for 15 years, and last week told an audience at Melbourne’s Wheeler Centre about his first meeting with others in the same situation. ‘I walked in the doors and thought, “Look at this bunch of losers”. And I sat down and thought, “I don't belong here, this isn't right. I'm not as bad as these people”’.

Paul was setting the scene for a panel discussion about stigma at the launch of Gambling Harm Awareness Week 2019. The theme of the week was ‘Talk. Share. Support.’. Paul says when he was in the grip of his addiction, ‘there was no talking, definitely no sharing … and I didn’t feel I needed to be supported’.

Many misconceptions feed the stigma of gambling harm. Research shows 96 per cent of Victorians believe gambling is addictive, just over half think the addiction is diagnosable, and around a third see it as a mental health condition. Yet many also consider people who experience harm from their gambling to be impulsive, foolish or greedy.1

‘I sat down and thought, “I don't belong here, this isn't right. I'm not as bad as these people.”’ - Paul Fung

It’s no surprise more than 80 per cent of Victorians experiencing harm from gambling keep it secret, including from loved ones, due to shame and fear of rejection and being judged.1 Stigma can also make it difficult for someone to recognise they’re experiencing harm, because they don’t fit the stereotype of a ‘problem gambler’.

Gambling Harm Awareness Week is all about having open conversations, so it was fitting to start the week by staring down stigma. Discussing stigma in their fields were Dr Michelle Blanchard, deputy CEO of SANE Australia, Chris Raine, founder and CEO of Hello Sunday Morning, and Ina Tan, Gambler’s Help counsellor at EACH. Journalist Sally Warhaft chaired the panel.

In supporting people with complex mental illness, Michelle sees stigma operate on multiple levels. ‘There’s self-stigma, which is the stigma we might feel towards ourselves if we have an issue that may be stigmatised. There’s public stigma, which is how the public feel about a particular issue. There’s perceived stigma, which is how we think other people think about the issue. And then there’s this whole idea of institutionalised or structural stigma.’

Self-stigma is particularly strong in mental illness, says Michelle. Recent data from Beyond Blue shows public stigma around anxiety has fallen to virtually nil, but self-stigma is still significantly high. ‘The more we can help people see there are others experiencing similar challenges and shame and vulnerability, the more likely we are to be able to address that challenge.’

‘[Stigma] can either hurt you or help you.' - Ina Tan, Gambler’s Help counsellor at EACH

As a Gambler’s Help counsellor, Ina believes stigma 'can either hurt you or help you'. She sees many clients from Chinese and Asian communities and says family shame is often more potent than personal shame and can deter people from seeking help. However, it can also act as a ‘change agent’. She has seen stigma push someone from denial to acknowledging a problem and taking the first steps to recovery.

As founder of the largest online movement for alcohol change in the world, Chris has seen conversations about alcohol and stigma evolve over the past decade. Since Hello Sunday Morning started in 2010, the dialogue has moved away from negative words like ‘problem’, ‘addiction’ and ‘alcoholic’ to a more nuanced language acknowledging our relationship with alcohol is much less definitive and changes over time. ‘And that shift means people are more able to talk about it with their families and friends and organisations like my own to get help earlier,’ he says.

‘[Storytelling] creates this sense of a common humanity, that everyone’s been through something similar.’ - Dr Michelle Blanchard, deputy CEO of SANE Australia

While progress has also been made in the past decade in reducing stigma around episodic mental illnesses like depression and anxiety, Michelle says ‘the public conversation is still incredibly negative’ for illnesses like schizophrenia. She believes one of the most effective ways to reduce public stigma is social contact. ‘Bringing people in touch with people who have a lived experience, whether it’s of gambling harm, of mental health issues or other stigmatised issues, seems to be the most powerful thing we can do.’

SANE works with the media on how mental illness is reported, equipping journalists to tell responsible stories that focus on positives, not just extreme cases. This includes establishing and enforcing the Mindframe guidelines. ‘It becomes much more of a conversation about inclusion and participation,’ she says. ‘An issue like gambling harm is one where … supporting the media to change that public conversation, I think would be really effective.’

A 2016 Foundation-funded study compared anti-stigma initiatives for gambling harm with those for issues like mental illness. The researchers found public awareness campaigns for mental illness were the most effective, using personal stories and emphasising the impact of stigma and discrimination. In encouraging help-seeking and individual actions and controls, gambling harm campaigns were found to reinforce personal responsibility, alongside industry and government messages framing the issue in terms of ‘responsible gambling’.2

‘[When it comes to addiction] such a small amount is the individual’s fault, but the culpability is placed squarely at their feet.’ - Chris Raine, founder and CEO of Hello Sunday Morning

Acknowledging the term is not popular, Ina asserts ‘responsible gambling’ is a shared responsibility, not an individual one, with services, industry and government also accountable.

Chris says when it comes to addiction, ‘such a small amount is the individual’s fault, but the culpability is placed squarely at their feet’. He believes systemic change is needed to address the imbalance, involving greater responsibility, regulation and taxes attached to licences to sell addictive products. He cites B Corporations, where companies achieve certification for social and environment performance, as a good example of the way forward.

Storytelling was a recurring theme for the panel, suggesting it is perhaps our greatest weapon against stigma. ‘It creates this sense of a common humanity,’ says Michelle, ‘that everyone’s been through something similar’.

After a dubious start, when Paul Fung attended that first meeting, he sat down and started hearing stories. ‘And something clicked. I connected. I was thinking, “I can breathe”’. For the next two and a half years, he was there every Monday night. ‘We all have issues, we all have problems, but when we share our vulnerabilities, we connect to each other on a deeper level.’

Read Paul’s story: Sharing stories on the path to recovery

Download the infographic:

Overcoming the stigma of gambling harm

¹ Hing, N, Russell, A, Nuske, E & Gainsbury, S 2015, The stigma of problem gambling: Causes, characteristics and consequences, Victorian Responsible Gambling Foundation, Melbourne.

² Thomas, SL, Bestman, A, Pitt, H, David, J & Thomas, S 2016, Lessons for the development of initiatives to tackle the stigma associated with problem gambling, Victorian Responsible Gambling Foundation, Melbourne.