Understanding and Addressing Gambling-related Harms

Baroness Clare GeradaClare Gerada has spent her career asking uncomfortable questions about the people medicine tends to overlook. As a GP, addiction specialist, and one of the most influential voices in British healthcare, she has consistently turned her attention towards those who suffer in silence - patients whose conditions are stigmatised, whose needs fall between services, and whose stories are rarely told. Gambling disorder is, in many ways, the defining hidden harm of our time, and it was the recognition of that gap - between the scale of suffering and the inadequacy of the clinical response - that led her to found the NHS Primary Care Gambling Service.A former Chair and President of the Royal College of General Practitioners, and Co-Chair of the NHS Assembly, she has shaped national policy across addiction, mental health, and physician wellbeing. Her earlier work establishing the NHS Practitioner Health Service - a service for doctors whose mental health or addiction needs had been left unaddressed - reflects the same conviction that runs through this book: that people in difficulty deserve compassionate, expert care, and that embedding that care in the fabric of the NHS is both possible and necessary.Dr Emma RyanEmma Ryan is a GP in South East London, and the experience of working in one of the most deprived and complex urban communities in England has shaped everything she brings to this subject. She sees, in her daily practice, how gambling harm hides behind other presentations - the patient who comes in about sleep, the young man whose anxiety does not quite fit any obvious cause, the partner who attends alone and is clearly carrying something she cannot name. Learning to recognise those patterns, and knowing what to do with them, became a clinical preoccupation that grew into a vocation.As Deputy Medical Director of the NHS Primary Care Gambling Service and RCGP Clinical Champion for Gambling Harms, she has led the development of the Primary Care Gambling Competency Framework and the RCGP Gambling Harms e-learning programme - resources designed to give clinicians the knowledge and confidence to have conversations they might otherwise avoid. This book grows directly from that work, and from the conviction that the consultation room is one of the most powerful places in which gambling harm can be identified and addressed.Ruby WiltshireRuby Wiltshire came to this subject through a different door. Her background in psychology and positive psychology - the study not only of what damages human flourishing but of what enables it - brings a distinctive perspective to a field that can easily become focused solely on harm and deficit. Throughout this book, she has worked to ensure that the evidence is rendered accessibly and honestly, that the voices of those with lived experience are present alongside the clinical data, and that the question of recovery - what it looks like, what enables it, and what stands in its way - receives the attention it deserves.Together, the authors bring complementary perspectives shaped by decades of clinical practice, service development, research, and personal commitment to this field. They hope that this book will help reduce stigma, support earlier identification, and improve the care available to everyone affected by gambling-related harm - whether they are sitting in a consulting room, staffing a helpline, or trying to understand what has happened to someone they love.

• 1. Gambling and Gambling Disorder 2. Gambling Harms 3. Treatment 4. Specific Treatments for Gambling Disorder 5. Different Groups Affected by Gambling 6. Policy and Public Health 7. New Frontiers in Gambling Harm