Abstract
BackgroundProblem gambling and homelessness are recognized as important public health concerns that significantly impact individuals, their friends and families, communities and broader society. We aimed to explore the experiences with health and social services of men who had histories of problem gambling and housing instability in Toronto, Ontario.MethodsWe used a community-based participatory approach with a multi-service agency serving low-income individuals. We conducted qualitative interviews with men (n = 30) who had experienced problem gambling and housing instability. Our interviews employed open-ended questions to elicit men’s perceptions of services related to housing instability, problem gambling and other comorbid conditions (e.g., mental illness, substance use). We reviewed relevant themes related to experiences with services (e.g., Use of and feedback on: health and social services, housing services, justice/legal aid services, substance use services, gambling services; stigma; goals; triggers; physical health; coping strategies; finances; relationships; barriers to services and recommendations for services).ResultsThe concept of person-centred engagement was identified as a main overarching theme, and seemed to be lacking in most of the men’s experiences of services. Person-centred engagement for these men entailed empowerment and autonomy; empathy, compassion and sincerity; respectful communication; and tailored and holistic life plans. While there was a strong emphasis placed on independence, the men identified the importance of positive therapeutic relationships as being critical aspects of the recovery process. Based on our analyses, several recommendations were identified: 1) Increasing general awareness of services for problem gambling; 2) Delivering integrated services in a one-stop-shop; 3) Addressing mental health with psychotherapy and pharmacotherapy; 4) Providing timely access to prevention and recovery services; and 5) Enhancing life skills with peer support.ConclusionsOur study highlighted that most of the men we interviewed were not having their health and social needs met. Services need to address the intersection of problem gambling, housing instability, and other comorbidities. Ensuring services are grounded in person-centred engagement appears to be critical for optimal service delivery.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-016-1583-3) contains supplementary material, which is available to authorized users.
Highlights
Problem gambling and homelessness are recognized as important public health concerns that significantly impact individuals, their friends and families, communities and broader society
This paper describes the health and social services experiences of men who have a history of gambling problems and housing instability
We explored the experiences with health and social services of men who had a history of problem gambling, and housing instability in an urban centre
Summary
Problem gambling and homelessness are recognized as important public health concerns that significantly impact individuals, their friends and families, communities and broader society. We aimed to explore the experiences with health and social services of men who had histories of problem gambling and housing instability in Toronto, Ontario. In 2002, 1.2 million Canadians (5 %) had the potential to be or were problem gamblers [15] For these vulnerable individuals, gambling may lead to persistent problematic behavior causing significant interpersonal problems with family and friends, educational or employment challenges, criminal or legal problems, health problems, as well as financial hardships and homelessness/housing instability [2, 16]. Persons who experience persistent financial instability are at high risk for both substance abuse and problem gambling [1, 19,20,21,22,23,24,25]
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