1. Supervisors: A/Prof Samantha Thomas and Dr Priscilla Robinson
Stigma and the involvement of people with gambling problems in peer support and advocacy activities
A qualitative study
Helen Miller
PhD Candidate
Supervisors: A/Prof Samantha Thomas and Dr Priscilla Robinson

2. Declaration of Interests
Helen Miller is an employee of the Victorian Department of Justice and Regulation and during much of this project was an employee of the Victorian Responsible Gambling Foundation.
The authors have no other conflicts to declare.

3. gambling Peer Support and Advocacy In Australia

4. Background
Contact with members of a stigmatised group has been shown to be effective in reducing stigma
Contact may occur through face to face interaction or via mass media
There has been limited research on:
how contact strategies impact on the stigmatised individuals involved
the use of contact strategies to reduce stigma associated with problem gambling

5. Methodology
In depth interviews with 26 people with lived experience of problem gambling on gaming machines
All working in peer support and advocacy
Interviews covered
Experiences with gambling
Norms for gambling behaviour
Public discussions of gambling
Responsible gambling
Community views
Experiences with advocacy and peer support
Consumer consultation to test findings and interpretations

6. Peer environments and Stigma
Participating in peer support activities reduced feelings of self-stigma, and provided a “non-judgemental” environment.
Recognising that they were not alone in experiencing gambling addiction helped some participants to overcome feelings of self-blame.
Participants helped others to moved past feelings of shame by making them feel understood:
You've been there, you've done that. You know what the person has experienced, in general…most people have probably suffered the same sort of feelings I did. Shame and fear and the whole kit and caboodle and so...You know, it's helping them overcome that, too. (Female, PGSI 9)

7. Reducing stigma through advocacy
Advocacy activities aimed to show the “human side” of problem gambling.
Advocates tired to reduce stigma by building understanding in the community, focusing on “telling stories” about the real impacts of gambling:
I've outed myself, and I'll talk about it people…I'll talk to people I don't know. I talk to anyone. And I put my story out there, just in challenging the stigma and the shame that goes with it. It's...some of the impacts, eventually have had some sort of good. (Male, PGSI 5)

8. Impacts of stigma
Some participants feared negative and stigmatising reactions from others as a result of participating in advocacy.
Some felt they had to “live with stigma” as a result of their activities.
Fear of stigma was a significant barrier to participating in both peer support and advocacy activities:
I think there is a big stigma around it…no one spoke about it because they were too afraid of the stigma that they might cop. (Female, PGSI 5)

9. Disclosure
Participants carefully managed the disclosure process, which some described as “coming out”.
Some chose to remain anonymous:
What’s written or what’s told is the absolutely truth…but they cannot put my name to it, it is really sad…I couldn’t let anyone know…I just would have been seen as the village idiot…Like, your mother’s an idiot, you know, she’s gambling. On those stupid frigging machines, what’s wrong with her? (Female, PGSI 7)

10. Self Care
Participants who were involved in these activities needed to exercise “self-care” to manage the impact of stigma on their lives:
Support from others in the community was also needed, which required a reduction in stigma:
If we're going to encourage people to talk up about their issues and their problems…we need to make sure that the care and the support grows with that…So I think we need to have I guess a whole of community adjustment to breaking down stigma… (M, PGSI 5)

11. Implications
Peer support and advocacy activities may be effective ways to reduce stigma associated with gambling problems.
People involved in peer support and advocacy activities need support, particularly through the process of disclosing their gambling problems, and need to be encouraged and supported through self care activities.
Encouraging more people with gambling problems to participate in advocacy may require a reduction in stigma.
Future research on contact strategies should consider the impact of disclosure on stigmatised individuals.