Self-Exclusion Policies and Programmes Sibongile Simelane-Quntana Executive Director The South African Responsible Gambling Foundation NPC

Table of Content Introduction Self Exclusion practices, processes and trends: What we know 2.1. Self-Exclusion process and procedure 3. Distribution of self-exclusion programme (SARGF) 4. Role of venues in creating awareness on and enforcing self-exclusion 5. The effectiveness of the self -exclusion interventions 6. In Conclusion, What more can be done?

Introduction Self-exclusion policies and programmes are widely used harm reduction strategies; aimed at addressing, and preventing problem gambling. However, In a study done in 2002 by Sally Gainsbury she bemoans the fact that there is minimal robust and comprehensive research to evaluate the effectiveness of self-exclusion programmes. This is still a challenge today as there are no in-depth studies on the effectiveness of self- exclusion, organisations that treat people with gambling disorders like the South African Responsible Gambling Foundation can however talks about their experiences of individuals that enrol for self-exclusion and those living with addiction. Kevin Mullally (1995) assert that self-exclusion programmes were first initiated by Canadian operators between 1989 and 2000. Mullaly further states that in the USA self- exclusion was first made popular by the Missouri Gaming Commission in 1995 when it banned ”notorious organised crime figures and placing them on a list of excluded individuals” (Mullally,1995).

Self Exclusion practices, processes and trends: What we know In jurisdictions such as Australia, Singapore, United States, United Kingdom, South Africa and Singapore self-exclusion is a legislated programme, whereas in some African countries such as Ghana and Morocco the process is driven by operators and there is very little evidence of government involvement or oversight, Self-exclusion is meant provide relief to those who believe that their gambling is spinning out of control, however, our experience is that it also serves as an opportunistic intake by individuals with disordered gambling thus defeating the purpose, as many who enrol are often seeking quick fixes. Therapeutic intervention in self-exclusion are different as compared to disordered gambling.

Self Exclusion policies, processes and trends: What we know Self-exclusion largely remains a personal choice in many jurisdictions; The Conundrum: self-exclusion of land based gambling activities vs online based gambling activities, Casino self-exclusion vs all other gambling activities - a large number of SARGF self-exclusion participants are referred by the Casino operators and this accounts for 98% of operator driven exclusions however many a times the intervention comes a little bit too late, the person had already hit rock bottom, We also know that self-exclusion interventions differ from jurisdiction to jurisdiction.

Self-Exclusion: Process and Procedure ( Legislated) Jurisdiction Self-Exclusion Reinstatement Renewal United States Must apply in person Five, ten, life-time or custom ban of at least 5 years Can revoke anytime, but must meet the requirements, else reevaluate after 2 years. Requirements: Complete PG with certified Counsellor, complete educational Courses Exclusion is indefinite, unless request to reinstate is made Australia Telephone of in person 6 months or life time 6-12 months Requirement: Counselling, visitation limits, reinstatement form No process indicated South Africa Must apply in writing (in person, family member) 6mths, 12mnth, 5yrs, life time May apply for reinstatement after 6 months Requirements: Proof of attending Counselling (Privately/SARGF) Singapore Must apply in person, indefinite (life-time ban) May apply for reinstatement after 12 mths Requirements: Participate in counselling, rehabilitation or special education, undergo assessment of harm by trained professional United Kingdom Apply in person 6 mths to 5 years After 6 months reinstatement can be made Requirements: Submit a form and wait for 24 hrs. Jurisdiction Self-Exclusion Reinstatement Renewal United States Must apply in person Five, ten, life-time or custom ban of at least 5 years Can revoke anytime, but must meet the requirements, else reevaluate after 2 years. Requirements: Complete PG with certified Counsellor, complete educational Courses Exclusion is indefinite, unless request to reinstate is made Australia Telephone of in person 6 months or life time 6-12 months Requirement: Counselling, visitation limits, reinstatement form South Africa Singapore

Distribution of Self-Exclusion The graphs below are generated from treatment statistics the SARGF Treatment and Counselling Programmme. They give an overview of who seeks treatment and self-exclusion treatment. The data presented below excludes disordered gamblers. The data is also not conclusive as it only focuses on those gamblers who seek treatment with the SARGF. In the last 5 years our data shows that individuals who seek treatment usually starts at the age of 35 to 44 and these are the same people that are likely to seek help or enrol for self-exclusion.

Age Distribution

Gender Distribution

Employment Distribution

Marital Status Distribution

Role of venues in creating awareness on and enforcing self-exclusion In as far as creating awareness, currently it is standard for most venues advertise self-exclusion programs on their websites and through pamphlets and displays in venues. Individuals wishing to self-exclude can usually register at a venue, sign the agreement and have their photograph taken. It is therefore important that this information is displayed in areas easily accessible to gamblers. Gamblers are then advised that there is help for problem gambling, receive information about the self-exclusion program and the nature of the agreement, including their responsibility to uphold it and may be provided with referral information for further help. In as far as enforcement is concerned, venue security personnel typically enforce self-exclusion policies. A breach is recorded if the person is discovered contravening their agreement. The first time a person is discovered breaching self-exclusion, they are typically asked to leave the venue. In some jurisdictions, this process involves the attendance of a law enforcement officer or representative from the gambling regulator. Someone breaching a self-exclusion agreement can be charged with an offence and/or fined for trespassing. It is not uncommon for excluded persons to evade detection, violate the ban and gamble.

The effectiveness of the self -exclusion interventions The question then is whether self-exclusion is effective in mitigating the impact of problem gambling? As pointed earlier research has been conducted to evaluate the effectiveness of self exclusion programmes. But this is what the available research tells us: Self-exclusion programs seem to help some (but not all) problem gamblers to gamble less often. self-exclusion programs are under-utilised by problem gamblers Self-excluders breach their agreements. They are also not completely effective in preventing individuals from gambling in venues from which they have excluded, or on other forms. Studies by Gainsbury in 2013, generally find that the majority of participants benefit from such programmes including decreased gambling, increased psychological wellbeing and overall functioning, reduction in related psychological difficulties including depression and anxiety and that they feel they have more control of their circumstances. The benefits also include participants reporting improved financial circumstances decreases time spent gambling, reduction in problem gambling severity and negative consequences of gambling.

Data from the treatment unit at SARGF shows that there is a steady growth in the number of patients who once seek self-exclusion and subsequently treatment.

As the graph above indicates, there is definitely a notable increase particularly from 2016. Although we do not have full picture for 2018, currently we are sitting at slightly higher than 50% of the 2017 figures. So in as far as growth in numbers there is evidence that more people are coming through our programme via the self- exclusion. But we also know that most of them become repeat self-excluders; which raises a question on the effectiveness of the programme. However, a key deficit in the gambling exclusion as Gainsbury observed is that the majority of problem gamblers do not enter into these agreements. This is because it is seen as an embarrassing step. As such barriers such as limiting embarrassment in instigating processes are necessary. Also removal of unnecessary complexity in the application and registration. The processes can be deemed long and tedious. The forms the gamblers are expected to fill in are for example long The success of self-exclusion is also partially dependent upon the ability of gaming operators to accurately identify programmes participant in order to detect and report

In Conclusion, What more can be done?

In Conclusion, What more can be done? Access to information is critical. Our data shows that the most relied upon source of information by gamblers is referral by the gambling venue followed by information from staff of gambling venues and then information from the gambling boards Clear information about the self-exclusion program and promotion of programs is important if we are to increase utilisation Improve venue based strategies Programs must offer a range of time periods for exclusion Operators must remove all self-excluded persons from mailing lists and stop offering them incentives during the period of self exclusion Reinstatement process should occur before the self-exclusion individual is permitted re-entry into gaming facilities. The ease with which a self-exclusion maybe reversed is a cause for concern. Operators must have an effective training program for all staff who have a role to enforcing the self- exclusion program including refresher training