The association between increasing levels of gambling harm and emotional health outcomes for individuals who are below the threshold of disordered gambling: A secondary analysis of health data.

Objectives: This paper examines the relationship between increasing gambling harm and emotional wellbeing and mental health amongst individuals below the threshold typically used to define high-risk gambling.

Study design: Combined data from the Health Survey for England (HSE) and Scottish Health Survey (SHeS), covering 2012, 2015, 2016, 2017 (SHeS only), and 2018 (HSE only). 24,898 individuals aged 16+ in private households.

Methods: Mental health and emotional wellbeing were assessed using four self-reported measures: long-term mental health condition (binary), life satisfaction, the General Health Questionnaire (GHQ-12), and the Warwick Edinburgh Mental Health and Wellbeing Scale (WEMWBS). Gambling harm was measured using the Problem Gambling Severity Index (PGSI), only individuals with a PGSI score lower than eight was included in the analysis. The relationship between PGSI and each measure of mental health was explored by plotting risk curves and running regression analysis. The regression models included controls for demographics, gambling participation, and non-lottery gambling in the past 12 months.

Results: The plots and regression results indicated r-shaped risk curves for gambling harms on three of the measures of mental health (WEMWBS, GHQ-12 and life satisfaction) for individuals with PGSI scores lower than eight. Associations persisted after adjusting for gambling participation and demographics. No clear evidence linked PGSI scores to long-term mental health conditions.

Conclusions: While PGSI scores below eight are typically considered low-risk, small increases in scores at the lower end of the risk spectrum correlate with reduced emotional wellbeing. The r-shaped risk curve suggests associated harms increase most sharply at the lowest levels of the PGSI score, between 1 and 3. Evidence of an association between PGSI scores lower than eight and having a long-term mental health condition was inconclusive.