Chicken and egg

‘But it’s often impossible to determine which one comes first when it comes to gambling and mental health issues,’ says Vicky Northe, senior social worker at the Alfred. ‘It’s the chicken and the egg. The stress from gambling losses co-exists with several mental health disorders. Some clients say that gambling provides an escape even from psychosis.’

Vicky is the leader of a clinical assessment team made up of a social researcher, family therapist, clinical psychologist, occupational therapist, consultant psychiatrist and psychiatric registrar.

Working across Victoria, the team supports frontline services such as Gambler’s Help with complex case discussions, diagnostic clarification and treatment planning of clients with co-morbid mental health and problem gambling disorders.

They also strengthen inter-service links, building the capacity of Gambler’s Help services to deal with mental health issues, and mental health services to deal with gambling issues. Clients may manage severe psychotic symptoms, such as auditory hallucinations, outside a residential mental health facility, for example, but out in the community their issues with gambling remain. Bridges between the specialist services are therefore vital.

Working in collaboration

The team was established in 2010 in response to research conducted at The Alfred that found 17.6% of patients presenting to Emergency services with a mental health issue had a history of gambling problems.

They’re a wholly collaborative, short-term service only activated by, and working alongside, services that offer longer term assistance.

It’s a partnership of great benefit to the clients referred by Gambler’s Help Southern counsellor Gretta Daley.

‘I’m really proud of the work we do, but it can be very heavy,’ says Gretta, who has a caseload of 40 clients, many with past trauma. ‘We work with people with very complex lives and this team approach with the Alfred often brings greater clarity and improved outcomes.’

‘They come to know our clients’ histories and issues, so their second opinion and psychiatric insight is invaluable. Hospitals are often strict about their criteria for access to public mental health services, but the Alfred team’s psychiatrists have supported our clients to access those important services that are just beginning to acknowledge gambling harm.’

Vicky agrees that the team plays an important role in advocacy, putting gambling harm front-of-mind when it comes to assessing mental health disorders.

The insights gained from The Alfred team’s neuropsychology assessments are also integrated into long-term counselling by Gambler’s Help.

An estimated 90 per cent of clients are referred to the Alfred team through Gambler’s Help while others come through mental health, drug, alcohol, housing and hospital inpatient services, general practitioners and psychiatrists.

‘We’re flexible and adaptable with what works for services and clients,’ says Vicky. ‘Gambler’s Help provides an amazing service, taking their clients along an often long road to recovery.

‘We’re proud to play our part alongside them.’