Gambling Harms in Justice Settings
Mark Conway
Consultancy for Gambling Harms, Lived Experience Advocate ** All comments solely represent my own opinion **
A few weeks ago I was fortunate enough to be invited to give a presentation on my experiences and thoughts on gambling harms as they relate to justice settings in Scotland. This was at a virtual seminar hosted jointly by Community Justice Glasgow and the Scottish Public Health Network (ScotPHN), and formed part of an initiative currently underway in Glasgow to create a community wide framework for tackling all aspects of disordered gambling and gambling related harms. The ultimate hope is that the work in Glasgow will act as a pilot for creating and successfully implementing a national strategy to enable the future prevention and treatment of Gambling Harms in Scotland to be brought within the wider remit of Public Health provision. I have decided to post the script of my presentation here in the hope that it may prove useful to others sharing an interest in Justice, Public Health and Gambling Harms. It is a bit of a long read, for which I apologise in advance.
Mark Conway [Author]
#gamblingharm #gamblingaddiction #problemgambling #criminaljustice #criminaljusticereform
Good morning everyone.
I am here today to share my story of problem and disordered gambling leading to gambling harm, and also my experiences within the Scottish Criminal Justice System as they relate to disordered gambling, the widespread prevalence of such amongst the prison population, and a desperate lack of meaningful screening, or intervention, being in place that might otherwise help prevent gambling from becoming a repeated gateway cause for crime and future recidivism.
Those of you here today with first or second-hand experience of extreme addictions, no matter how they manifest, will doubtless appreciate just how controlling they can become to someone once they start to lose themselves to that addiction. Severe addiction driven behaviour can lead people to do things that previously they would never have contemplated, or even believed themselves capable of doing. Please believe me, I know. I was one of those people. But following a descent into disordered and compulsive gambling, which controlled my life for almost a decade, I found myself having to admit to defrauding my employer out of over one million pounds, and then being sentenced to over five years in prison as a consequence.
But, before continuing with my own story, I think it might be useful to briefly explain why gambling can become such a focus for disordered, harmful and addictive behaviours, and why humans are so susceptible to partaking in gambling activities.
At a basic level the concept of gambling revolves around taking risks. And what sets humans apart from other animals is our ability to view risk taking as a positive learning experience, and as a driver for continuing innovation. Technology, scientific progress, and the complex societies we live in, are all the result of generations of people having taken risks. As a race, humans have become accustomed to associating risk with reward and, as such, rather than being wary of taking risks, most of us accept risk as being a normal part of life. So much so that many of us actively seek out risk related activities such as rock climbing, motor sports and white water rafting as leisure pursuits because, quite simply, taking unnecessary risks provides us with thrills. But of course risks are, by definition, risky.
The vast majority of us are conscious of, and are able to manage, the level of risk attaching to anything we do, but as individuals we can sometimes become distracted and lose focus on the dangers associated to our own actions. Activities such as gambling, drinking alcohol, or taking mood enhancing drugs, can all be seen as presenting minimal risks at low levels of use, such as those that most of us encounter when first experiencing these activities. This allows our brains to make an association between doing these things and deriving pleasure from them. But that connection can become dangerous when events or circumstances in our lives arise which leave us feeling vulnerable, unhappy, unsure, or even desperate, and in need of help that doesn’t seem to be there for us. Our brains instinctively react to such negative emotions by seeking ways to make us feel better, to divert our attention away from an unpleasant current situation in favour of activities which have previously brought us happiness. Not at all unlike the way that a parent might try to comfort a child showing signs of distress by offering them hugs or treats.
However, if due to our life circumstances, we find ourselves repeatedly facing difficult situations, or if we encounter one particularly traumatic event, or apparently unresolvable problem, then the delaying, or distracting activity that we tend to resort to can become an absorbing and automatic displacement activity. So much so that the weighing up process that compares the benefits we have come to associate with it, when set against the possible negative impacts it may cause, can become skewed, or break down altogether.
Such a loss of balance can lead to addiction, and the triggers leading us there can include a wide range of social, psychological and emotional factors. Financial hardship, physical and mental abuse, loss of a loved one, loss of employment, illness, social deprivation, relationship problems. These can all act to tip the balance from coping mechanism to addiction. Gambling addiction can often be found in conjunction with other addictive behaviours such as alcohol dependency and excessive drug use, but while these other activities can only ever be seen as a mechanism for avoiding facing up to the underlying issues in the individual’s life, gambling can unfortunately be seen by some as offering a potential way to resolve them. Winning money through gambling may sometimes appear to be the only foreseeable way out of severe and chronic financial problems to those who are desperate enough. And when gambling proves not to be the solution, as invariably will be the case in the long run, and indeed after gambling has merely left individuals in an even worse financial position that they were in to start with, then some will be left feeling that turning to crime is their only remaining alternative.
In my own case, I can trace the root of my problems to an emotional trauma that occurred later in my life, and which I was simply not equipped to deal with on a psychological and emotional level. While I can now identify this trigger point, and the underlying weakness that it exposed, this is only from much reflection, and with the benefit of hindsight. At the time that it was happening I was in no position to make that connection. I knew that I felt unhappy, and I even knew why I felt unhappy. My first serious long-term relationship was in a state of crisis. Not because of anything that either of us had or hadn’t done, but simply because people evolve over time, and so do their priorities and aspirations. We simply found ourselves wanting different things from life. Eventually we both recognised this and agreed amicably to go our separate ways. However, that did not stop me from feeling a sense of loss and grief. And, of course, self-pity. To some extent I found myself in a classic, if slightly premature, mid-life crisis.
Up to that point I had led a pretty sheltered and fortunate life, with no significant setbacks or challenges needing to be overcome. Seemingly perfect, as far as it went, but it had left me bereft of the tools needed to overcome adversity when I did finally encounter it. I had never had to struggle in my life so, when things stated to go pear shaped, I did struggle to cope. Which is where gambling became a problem for me.
I had been introduced to gambling several years previously, initially through colleagues at work. A few of us were interested in football, and as a fun challenge would try and predict results for the coming weekend. Initially just for office bragging rights, but then someone suggested combining our predictions and putting a small bet on the agreed results. It was small stakes and most years we did quite well, but it did mean someone having to go down the bookies each week with the coupon. When it was my turn, I would pick up an extra coupon, and put my own predictions on. Still relatively small stakes, a tenner a week. It was gambling, but carried out in a controlled and ordered manner. A seemingly fun leisure activity. But, as with the root of many addictions, my brain built up a connection between taking part in that particular activity and the enjoyment that I experienced from it.
By any current form of measurement I would have come out as having a low risk of developing problem or disordered gambling. But the emotional turmoil in my personal life changed that.
Because I found it uncomfortable facing up to the problems in my relationship, I started avoiding situations where I was forced to confront, or even acknowledge those issues. It meant that I ended up spending more time on my own. Feeling unhappy and sorry for myself. Due to the association that my brain had established between betting and enjoyment I found myself spending more and more time online using gambling websites. But my relationship with gambling had altered. Where once I had made considered opinions based on observations and knowledge to inform the placing of a select few bets, once or twice a week, I found myself betting each day on whatever events were happening in real time. Football also became horse racing, and then even greyhounds too. Events which took increasingly less time to complete, and which also occurred far more frequently. They were also events which I knew absolutely nothing about. But immersing myself in online gambling distracted me from thinking about more important, real-life matters.
After my relationship ended I was still psychologically and emotionally vulnerable. Instead of picking my life up and looking for new, positive futures, I wallowed in a sense of loss. Gambling was still the crutch that I found myself leaning on to distract me, and circumvent the need to sit back and take proper stock of where I was. And without having someone else there to moderate my online time my disordered way of gambling only got worse. Gambling became my go-to displacement activity, it became the thing that I did when I wasn’t at work. And then, later, even when I was.
Some health professionals categorise gambling addiction as being an activity addiction [1], which I feel is quite a good description, as, once it has reached an advanced stage, it is the activity of gambling rather than any possible outcomes resulting from it that stimulate the addictive parts of the brain. Yes, winning is nice, losing not so nice, but the truly addicted gambler merely views winning as a means of funding their continued gambling, and losing as an obstacle to be overcome so that they can resume gambling. And that was how I came to view it. The money I wagered was no longer a stake, it was an admission fee for losing myself in the mindset of addiction.
Initially money hadn’t been a problem, but it soon became one. Gambling had expanded to fill the void in my life and the thing about gambling is it takes money to participate. I was gambling online so it was easy to justify it internally as not being real money. It was just numbers on a screen. There was a disconnect between the virtual and the real. I would think nothing about betting hundreds of pounds on some horse that I had never seen or heard of, but would balk at physically handing over a pound more than I thought it was worth for a cup of coffee.
Most of the time I was funding my addiction through credit. I started maxing out my credit cards, all deposited on gambling websites, with the upshot that I would end up with large monthly credit bills and no way of paying them. Three times I re-mortgaged just to clear unmanageable credit debts. But still I gambled, and still the credit balances would max out. Eventually I reached the point of having massive personal debt and no equity left to borrow against. For some people that might have been the crisis point that forced them to confront their addiction and to seek help, as it should have been for me. But when you’re that deep in addiction the addicted part of your mind will do anything it can to keep you addicted.
Which is where my introduction to crime appeared. Part of my job involved enabling the transfers of huge amounts of money. Up to millions a day. And all electronic. Numbers on screens. Not unlike the smaller numbers that I transferred daily to my gambling accounts. And all just as insubstantial. As unreal. I was at my wits end and could see no viable way out of the money problems I had caused myself through reckless and disordered gambling. The clock was ticking towards the day when I would have to default on all those debts, and I was stressed out about it. Stressed about having to admit to my family, my loved ones, the lenders, and even my employers, about the terrible situation I had brought upon myself. So, I did what I had never thought myself capable of. I stole from my employer. It was a minor technical change to what I did legitimately on a daily basis, but a major change on a psychological level. I crossed a moral line that could never be uncrossed. I self-rationalised it in various ways. Thanks to my addiction I had become used to lying to myself. It wasn’t stealing, it was borrowing. It was only to cover a short-term need. I would pay it back. But, of course, I never did.
From that point on my moral certainty was fatally compromised, and my self-esteem collapsed. The guilt that I had suppressed over my addiction became dwarfed by the guilt that I felt over my betrayal of everything I had previously thought right, and of everyone who still trusted me. My only escape was within gambling itself and I became locked into a cycle of despair, which in many ways suited the addicted part of my mind just fine. As with all addictions that are left unchecked, the problem only ever got worse. I was gambling harder and longer. I was also stealing more often and to a greater value. My feeling of helplessness made me ever more reckless. Every time I stole more money I knew I was increasing the risk of being found out, and every time I did so I allowed myself to gamble it all away so that I would be forced to do it all over again. It was a toxic situation.
From speaking to many people, since, who also committed crime to fund gambling addictions, and who also ran up huge criminal losses for innocent victims, this "locked in" cycle is a common occurrence. Particularly, amongst those who previously had never considered themselves to be criminals, and who were previously "of good character". Once the law is broken, it remains broken, and fear of the consequences of owning up to it is leveraged by the addicted mindset to dissuade those affected from seeking to stop their behaviour at an early stage. What tends then to happen then is that criminal behaviour only ever increases. Stopping no longer is an option as even if one did stop, and even if no-one ever discovered the crime, the person themselves would still harbour the guilt over their own actions. Even winning enough money to pay back all which had been stolen no longer seems a viable solution as the guilt would still exist, and the fear over the effects on those close to them of the disordered gambler admitting to the crimes still acts as a significant barrier. Relatively low criminal losses often become seriously large criminal losses simply because there appears no "soft" way of stopping and admitting to the crime which reinforces the cycle of theft, gambling, and despair.
In my own case, eventually the inevitable happened. I took one too many risks, pushed the boundary just too far in favour of being discovered, and at long last I was. I had absolutely no idea how much my addiction had caused me to steal. I had once tried totting it up but my brain couldn’t cope with acknowledging the truth, and so I had stopped after adding up just one year’s worth.
Which leads me to my introduction to the Criminal Justice System. When the Police arrested me and told me the final figure, over one million pounds, I was shocked, and yet unsurprised. The actual amount seemed somehow irrelevant. I knew it was too much for me to ever be able to repay and I knew that I would be going to prison.
After admitting my guilt and being charged, one of the arresting officers had suggested to me that I would probably be glad that it was now all over. At the time this seemed an incredulous suggestion. Prior to that morning I had not known for sure whether I would be charged and prosecuted. Now that I did know for sure, I was preoccupied with thoughts of having to tell my new partner and our families just what I had been up to, and had hidden from them for so long.
But in many ways that police officer was right. The burden of guilt and deceit that had engulfed my waking days for so many years would soon be out there for everyone to see, and it would no longer represent a reason for me to continue in my relationship with disordered gambling. Having had sight of the sheer numbers and frequency of my gambling behaviour from his investigations, this officer had some appreciation of how out of control it had caused my life to become. Which was the first and sadly the last time that I encountered such empathic understanding of the harms caused by disordered gambling in any of my interactions with individuals involved in the Scottish Criminal Justice System.
While I am not doubting that there are many informed and enlightened individuals working in criminal justice who do know and understand gambling harms, the truth is that this understanding is not reflected in either the system processes, or the practices that routinely take place.
The day after my Police arrest I finally plucked up the courage to go to my local GP practice and admit that I had a gambling problem and needed help. I was referred to the mental health practitioner. This was in 2017, and at the time there was no provision for treating problem gambling within the NHS. Sadly, this is still the case in Scotland, and one of the reasons why the work being done here in Glasgow involving the Scottish Public Health Network is so important on a national level. I was lucky though, the mental health practitioner was able to put me in contact with a local charity, a partner of the RCA Trust, and through them I was able to access counselling to address my addiction. It was a post code lottery, however, and if I had been living in a different area I might not have been so lucky. But, fortunately, I did receive support, and I did manage to finally break the addiction that gambling had held over me. It meant that by the time I went to prison, I was free from any form of gambling compulsion.
Which was just as well for me, as it was only then that I started to realise just how overlooked problem and disordered gambling is within the current criminal justice system. At my sentencing hearing my defence made it clear to the judge that gambling addiction had been the one and only driving factor behind my criminality. Everything that I had stolen had been spent gambling. Just as everything I had owned prior to starting down my offending pathway had also been spent gambling. It was also put to the judge that the gambling operators, who had benefitted from receiving the illegal proceeds of my criminal actions, had done much to encourage me to continue gambling, even though it would have been obvious to them that my pattern, scale, and frequency of gambling were indicative of extreme disordered gambling, and unaffordable for any but the wealthiest of lawfully funded individuals. And yet the direct causal link between my criminality and my underlying gambling addiction was considered irrelevant when determining my culpability, and the sentence that should be deemed appropriate.
I now know that this judicial detachment is not unique to addictions founded just upon disordered gambling. No addictions, whether substance or alcohol related, are currently allowed to be regarded as mitigatory factors in Scottish criminal courts. Courts do however have the powers to make orders for treatment with regards to drugs and alcohol, and to refer individuals for diversion from prosecution where it is deemed appropriate to do so. This is something that simply does not happen in any significant way in relation to gambling related offending. To illustrate this, the Criminal Justice Social Work Statistics for Scotland Report reveals that in 2018/19 there were 128 diversion from prosecution cases approved involving referrals to drug and alcohol treatment programmes [2]. Over the same period there were also 595 drug treatment and testing orders issued as part of Community Payback Orders in Scotland [3]. There were no recorded cases involving referral to gambling treatments, which is hardly surprising as gambling addiction does not feature in any of the nine requirements that a CPO can contain [4]. This is despite research showing that between four and nine percent of all crime is gambling related, and is committed by individuals experiencing problem gambling.
Which is where we encounter one of the big problems that Criminal Justice in Scotland faces when confronting the relationship between gambling and crime. There is no framework for consistent identification and recording of gambling associated criminality, or for the assessment of individuals to see if they are affected by disordered gambling.
Despite gambling being readily identified as the prime causal motivation behind my criminality there was no plan put in place to either screen me for gambling addiction, to quantify my current level of gambling addiction, or to prescribe a course of treatment to address my gambling addiction. Either before my committal to prison, or during my incarceration in prison. Put bluntly, the prison authorities had no knowledge at all of whether I was still suffering from disordered and problematic gambling. Nor did they, or anyone with input into my casework, seem to care. There is no universal or even widespread access to treatment specific to tackling gambling harms and addictions while in prison. There is also no universal or even widespread adoption of screening to identify potential and actual exposure to gambling related harms for individuals prior to criminal charge, conviction or sentencing. Prisons, Courts and Criminal Justice Social Work are letting thousands of individuals down, each and every year, through lack of structured engagement over these issues.
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Worse still, even where gambling is identified as a causal or contributory factor prior to incarceration, perhaps by Criminal Justice Social Work in pre-sentence and background reporting for courts, it is deemed acceptable that treatment can be put on hold until such a time as the prisoner finishes serving their custodial sentence, and once again becomes the duty of community based social work services. Criminal Justice Social Work for longer term prisoners is meant to be a throughcare service, but instead it has a tendency to stop at the prison door, and only picks up again once preparing the prisoner for release. Two assumptions repeatedly seem to come in to play with regards to prisoners with gambling disorders. The first being that no treatment or improvement is expected while the prisoner is incarcerated, and the other that the prisoner’s time in prison can be largely discounted as they will not be able to gamble while they are in prison. Both of these assumptions are so flawed as to beggar belief.
Gambling is rife in prison. After drug use, it is undoubtedly the largest negative impact activity affecting the prison population. Gambling exists between prisoners through cards, pool, sports events and other in prison activities. It is the second largest cause of in-prison indebtedness, and leads to prisoner-on-prisoner violence, and a locking in of an individual to continued criminality on release, due to obligations entered into as agreed payback, or to involvement of outside family members in smuggling activities to wipe a prisoner’s debt slate clean. Gambling through regulated and lawful channels also occurs unfettered in prison through use of family members acting as proxies for placing bets. Prison pay phones are used daily to direct and arrange bets with regulated bookmakers, and especially so at weekends.
International research has identified that prisoners are up to nineteen times [5] more likely than the general population to be involved in problem level gambling. I know from my experience in prison just how many other prisoners either admitted to, or exhibited overt signs of, problematic levels of gambling, and gambling related harms. For some, particularly those involved in street level drug dealing, gambling, and being seen frequently participating in shop based gambling, was part of their cover for explaining away being in possession of large quantities of cash should they ever be questioned. It became clear to me that to many of these individuals gambling was so fundamentally a part of their concept of what was, to them, normal life that there was effectively no separation or differentiation between their gambling and criminal activities in their personal ideologies. Both were normalised behaviours which invariably fed off each other to the extent that cause and effect were interchangeable. By reinforcing dependence on each other they created a significant barrier to any hope of engaging successfully in future rehabilitation.
And yet, individuals, whether accused or convicted, are not routinely screened for problem gambling at any stage in the criminal justice process. As a consequence, there is no recognition or understanding of the extent to which gambling disorders may contribute to criminal ideation within individuals and affect crime figures on a national level. There are some pilot projects being carried out in England, with the support of organisations such as GamCare and the Beacon Trust, with a view to introducing screening to custody and prison settings, as well as providing information and support options to those experiencing gambling harms within specific criminal justice settings, but nothing like that currently exists in Scotland. A 2016 study into Gambling Harm and Crime [6] found that prisoners in Scotland were almost one and a half times more likely to be suffering from medium and problem level gambling harms than their counterparts in English prisons.
While my own case received publicity, due to the large sums involved, the overwhelming majority of cases involving problem gamblers who are driven to crime to fund their addiction remain unreported as they involve relatively low levels of money. Tens, hundreds and even thousands of pounds at a time, but they can be having just as devastating an effect upon the living circumstances of those involved as cases involving hundreds of thousands, and even millions. The lowest income earners spend the highest proportion of their income on gambling [7], and also suffer the highest incidence rates of problem gambling, which is why gambling harms cannot, and should not, be defined purely by the amount involved in each case.
However, where crimes occur involving smaller amounts it can be easy to overlook the significance of the role that gambling had in the commissioning of those crimes. Instead, other potential comorbidities such as alcoholism, drug addiction and simple poverty will often suffice to provide a plausible explanation, even when these were all influenced or caused by the pre-existence of a gambling problem. Thus, the underlying gambling problem will neither be flagged up as being significant, nor will it be addressed.
Recidivism amongst those who are convicted of crime and who have associated gambling disorders is considerably higher than amongst similar convicted individuals who do not have gambling issues [8]. It has been estimated, from research, that over a lifetime, fifty percent of individuals suffering from problem or disordered gambling will go on to commit a crime [9]. And not necessarily for direct financial gain. Problem gambling has been shown to lead to increases in propensity for violent and destructive behaviours such as assault, arson, vandalism, possession of weapons, and even driving offences such as speeding and uninsured driving.
If this is not enough on its own to persuade those vested with the power and capabilities to bring about change, to act, and to act now, then I would like to leave you with a few facts and figures relating to problem gambling and how it harms not only the affected individuals but also directly impacts upon us all through resulting societal, criminal and economic consequences.
36,000 adults in Scotland are currently experiencing problem levels of gambling [10,11].
18,000 of these are likely to commit a crime (50%) [9,10,11].
160,000 additional adults are at risk of developing problem levels of gambling [10,11].
2% of boys aged 11 – 16 are already classified as being "problem" gamblers, which is more than double the adult incidence rate [12].
£190 million – upper projected cost at GB level of incarcerating individuals experiencing GRH [13].
£120 million – projected annual cost to Scotland’s public purse from gambling related harms [14,15].
46.7% of the prison population are estimated to have suffered Gambling Harms in their lifetimes [16].
31% of the Scottish prison population are estimated to have suffered significant Gambling Harms in the 12 months immediately prior to incarceration [16].
Citations/References
1.???????Mentalhelp.net. Activity Addictions (Behavioural Addictions)?https://www.mentalhelp.net/addiction/behavioral/activity/ (accessed 09/02/2021)
2.??????Scottish Government. Criminal Justice Social Work Statistics in Scotland 2018-2019, Table 4 – Diversion from Prosecution, https://www.gov.scot/publications/criminal-justice-social-work-statistics-scotland-2018-19/pages/16/ (accessed 09/02/2021)
3.??????Scottish Government. Criminal Justice Social Work Statistics in Scotland 2018-2019, Table 2 – Social Work Orders, https://www.gov.scot/publications/criminal-justice-social-work-statistics-scotland-2018-19/pages/14/ (accessed 09/02/2021) [49 for Glasgow City Council]
4.??????Scottish Government, Community Payback Order: Practice Guidance, https://www.gov.scot/publications/community-payback-order-practice-guidance/pages/11/ (accessed 09/02/2021)
5.??????Walters GD. The effect of a gambling lifestyle group intervention on subsequent disciplinary adjustment in male prisoners. Addictive Disorders & Their Treatment. 2005.
6.??????May-Chahal, C., Humphreys, L., Clifton, A.?et al.?Gambling Harm and Crime Careers.?J Gambl Stud?33,?65–84 (2017), Table 4 – PGSI Scores for Prisoners Scotland v England, https://doi.org/10.1007/s10899-016-9612-z (accessed 09/02/2021)
7.??????Barnes, G.M., et al. Effects of Neighborhood Disadvantage on Problem Gambling and Alcohol Abuse. Journal of Behavioral Addictions, 2013. 2(2): p. 82-89.
8.??????Lloyd CD, Chadwick N, Serin RC. Associations between gambling, substance misuse and recidivism among Canadian offenders: a multifaceted exploration of poor impulse control traits and behaviours. International Gambling Studies. 2014;14(2):279-300.
9.??????Zorland J, Mooss A, Perkins A. Gambling and offending: An examination of the literature. Georgia State University Gambling Project 2008.
10.??Scottish Government. Scottish Health Survey 2017 (0.8% adult population report as problem gamblers, 3.6% at risk)
11.??National Records of Scotland. Population Statistics 2019. (5.5M mid-year population, 83% are 16+, 4.48M adults x 0.8% PG rate = 35.8k problem gamblers)
12.??Gambling Commission. Young People and Gambling 2018, https://www.gamblingcommission.gov.uk/PDF/survey-data/Young-People-and-Gambling-2018-Report.pdf [based on DSM-IV-MR-J screen]
13.??Thorley C,Stirling A,Huynh E. Institute for Public Policy Research. Cards on the table: The cost to Government associated with people who are problem gamblers. 2016.
14.??National Audit Office. Population Estimates for the UK: mid-2019 (65.9 M GB - i.e UK excl. NI)
15.??National Audit Office. Gambling Regulation: Problem Gambling and Protecting Vulnerable People. 2020. (£1.16bn upper extra cost to GB public services from problem gambling, pro-rata with Scottish population (5.5/65.9) and weighted for rate of PG in Scotland (0.8% cf 0.7% GB rate)
16.??Patel K. TalkGen: Gambling Harm and Crime. Prevalence of lifetime problem gambling amongst prison populations. Combined results of 8 international studies. 2020.