Evidence-based Gambling Interventions for People Experiencing Homelessness: A call to Action

Homelessness and problem/disordered gambling (PDG) are social and public health issues that affect a vast number of people globally. PDG prevalence is higher among populations experiencing homelessness than the general population (1.4%), ranging from 11-56%.While we are still untangling the nature of the relationship between homelessness and PDG, we know that historically underserved communities are adversely affected and have an array of associated complex needs that complicate implementation and delivery of effective interventions. The purpose of this commentary is to examine the status of the literature on screening and interventions for PDG, with a specific focus on evidence-based interventions to support recovery from gambling harms, culminating in a call to action to address gaps in research, practice, and policy with respect to gambling-related harms for people experiencing homelessness. Our review of the literature found an almost complete absence of evidence-based interventions to reduce gambling-related harms within homeless communities with only two studies between 1993 and 2023. To move both field and practice forward we will need to embrace implementation science approaches for PDG interventions within the context of homelessness. Cross-sectoral training is key to ensure that providers who intersect with people who experience homelessness in non-traditional gambling service sectors can fully support their clients to reduce gambling harms. Responsible gambling approaches that consider the social determinants of health will be imperative to minimize gambling-related harms among at-risk and under-served communities. Co-design and participatory practices are critical to ensure gambling interventions meet the complex needs of the diverse populations who face homelessness. Lastly, given the burgeoning global online, bricks-and-mortar, and sports gambling market, we need greater commitment to funding for prevention, treatment, and evaluation to support the associated growth in mental health needs among communities who will continue to be adversely affected.