doctor Flora Matheson seated on grey couch before concrete pillar

Photography By Brooke Schaal

Meet the doctor who’s changing our perception of problem gambling

Flora Matheson uncovered a link between homelessness and gambling—and changed how one shelter helps its clients

Jason Smith had a problem with gambling. That might seem surprising, considering he was low on cash and experiencing homelessness at the time. But betting at casinos was a way to escape his troubles, which also included substance addiction. And though he wanted to stop, he just couldn’t. “People think it’s about willpower, like you can just stop [if you have enough willpower],” he says. “People don’t understand when they’re not in that situation.”

That’s why, when the 31-year-old found himself at Toronto’s Good Shepherd Ministries in 2016, he was just looking for a place to stay. Instead, he found a program that would help get his gambling under control—and his life back on track.

Led by Dr. Flora Matheson, a scientist at the Centre for Urban Health Solutions at St. Michael’s Hospital who researches socially marginalized groups, the shelter’s Gambling Addictions Program is one-of-a-kind. The pilot project offers individual counselling, client-centred case management and a life-skills group that focuses on issues related to gambling. For some, the goal is to stop gambling altogether, and for others, it’s to reduce their behaviour and manage their spending.

For Smith, the program worked. He’s now living in a sober living house and has a job. He’s getting his G2 driver’s license in a few weeks, and moving into his own place with his sister in the fall. The Gambling Addictions Program helped him take his life back.

“I pay for my own stuff now; it’s just way better,” he says. “I can go for dinner, I was able to go up to Montreal for a week, and I can take vacations. If I want to do something, I’m able to do it.”

How Matheson first started helping problem gamblers in the shelter system

Stories like Smith’s show Matheson that her research is making an impact. The scientist started working with Good Shepherd Ministries in 2013 when she reached out and asked them about their clients’ relationship with problem gambling. The shelter staff was caught off guard; substance abuse and mental health problems were their focus, not scratch cards, horse betting and casinos.

“I was really interested in working with the community and finding answers and solutions with them.”

The first thing Good Shepherd wanted to know was how common the problem was, says Matheson. “They were afraid they were missing an important support service that they weren’t providing at the moment.”

The question of prevalence was one Matheson didn’t yet have an answer to, but she had a hunch. She’d been studying illicit drug use and homelessness, and reasoned that problem gambling was also connected to precarious housing, since it can have a serious impact on a person’s finances.

“There wasn’t a lot of research done at that point in time, and so I was interested in actually doing a qualitative study,” Matheson says. “I was really interested in working with the community and finding answers and solutions with them.”

Like addiction and mental health issues, problem gambling can be rooted in trauma

Good Shepherd was interested in working with Matheson, too, and together they conducted a study. The shelter—which serves mostly men—surveyed 264 clients who were experiencing homelessness, and found that 35 percent of them also dealt with problem gambling. That’s nine times higher than the general population, Matheson says.

“This is a segment of the population that’s highly vulnerable,” Matheson explains. “For some of the men, it was really about finding a place where they fit in. They had very traumatic upbringings, and like other addictions, trauma is really prevalent among those with problem gambling.”

In 2016, she took her findings and launched the three-year pilot Gambling Addictions Program in partnership with Good Shepherd and funded by the Local Poverty Reduction Fund of the Ministry of Housing. Matheson is one of the first researchers in Canada to study the strong relationship between gambling and homelessness, and by working in a shelter environment, her team can address a problem that’s often overlooked. They’ve even put together a resource guide so shelter workers can better serve their clients.

doctor Flora Matheson seated on grey couch before concrete pillar

The stigma around problem gambling is unfair

“There’s a huge stigmatization of people who have gambling problems because other people think, ‘Just stop.’ They don’t see it as an addiction and a health issue. They see it as a behavioural issue that you should be able to deal with,” Matheson says. “But it doesn’t work like that because it affects the brain the same way that substance use does; you get a high. And once you get a high, you seek that again.”

Much like substance abuse, problem gambling can affect anyone. But Matheson’s research shows that it’s more prevalent among people who are underhoused or experiencing homelessness. “People with low income tend to gamble a larger percentage of their money relative to those with higher income,” Matheson says. “We also know from low-income geographic studies that problem gambling is more clustered in areas with lower average income.”

There’s also an intersection between people who struggle with substance abuse and/or mental health issues, as those populations are more likely to also have an issue with gambling, too, Matheson says. Plus, problem gambling can be a chicken-and-egg situation: sometimes problem gambling leads to homelessness, and sometimes those who are homeless become problem gamblers because it can feel like an escape or a way to solve financial troubles.

While there are resources available to problem gamblers in Ontario, there are no programs outside of Matheson’s specifically developed for people experiencing homelessness. Folks living in a shelter often do not have the financial means to visit a therapist, and they may also feel out of place at an open problem gambling support group.

“If you think about people who have lost everything—their family, their social support, all of their finances, their housing—and they are sitting in a group next to someone who has their family still there, they have their housing, they’re financially still stable even though they’re gambling, it’s a very different picture,” she explains. “It can be uncomfortable for people who have lost everything to be sitting next to someone who hasn’t.”

What’s next for Matheson?

Following the success of her pilot project with Good Shepherd, Matheson hopes the program is expanded into other shelters, but that largely depends on funding. In the meantime, she’s also working on other problem gambling projects, including an arts-based program for women and developing a gambling support app.

“There’s a real lack of awareness of problem gambling in general, and even more so in [the homeless] population,” Matheson says.

Smith agrees. “Gambling is just a symptom of the problem. It’s to get you out of yourself so you don’t really think about the fact that you’re homeless, and the fact that you don’t have any money,” he says. “You’re trying to win money and [gambling] gets you out so you stop thinking about all the shitty stuff that’s going on in your life.”

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