Nearly two years after Pennsylvania's casinos began opening, compulsive gamblers seeking treatment are able to begin receiving services paid for by the state.
The state Department of Health posted a listing on its Web site last week of 13 different individual or agency providers, including several in southwestern Pennsylvania, authorized to be reimbursed for treating gamblers. Officials say at least two dozen more providers are likely to be approved soon, making them eligible to be reimbursed for up to 20 therapy sessions for gambling addicts or their family members.
The state will pay $65 per session if those individuals have no other way to pay, which is often the case with pathological gamblers since they typically wait until a financial crisis occurs before seeking help.
Hundreds of clinicians around the state have attended training sessions over the past two years to learn issues that set gambling addicts apart from the drug and alcohol users they've more commonly treated.
Therapists who have been through the training say there's no sign yet that Pennsylvania's legalization of slot machine parlors, with seven now in place, has created a flood of new addicts. They expect the numbers seeking help to increase, however, as the casinos are open longer and more people become aware of the state-funded services that were unavailable before.
"This is going to give them a whole new world to get help," said Brent Olean, a licensed social worker who sees clients with various addictions in Cranberry and McKees Rocks. "I predict it will grow by leaps and bounds once they see there's funding."
Mr. Olean said relatives of problem gamblers may end up pursuing more services than the addicts themselves. That's one of the differences from drug and alcohol clients -- gamblers can have a more devastating effect on their families from the financial upheaval they create.
Also, addictions to gambling are usually hidden far longer than is the case with substance abusers, since there are no obvious physical signs. And it can be harder for gamblers who obtain treatment to avoid relapsing, because access to various forms of wagering is so prevalent in society, from office pools to club raffles to ubiquitous lottery machines.
"People forget gambling has been around for a long period of time," said Jana Harrison, executive director of Recovery Revolution Inc., an approved gambling treatment service in Northampton County. "Obviously, they're opening these large places [for slots], but go to any local club, and they're already in there gambling any way they can."
Though estimates of compulsive gamblers can vary, researchers have estimated about 1 percent of adults are pathological and unable to control themselves. Another 2 percent to 4 percent of the population are sometimes put into a "problem gambling" category, meaning they gamble more than they should at times and are at risk to become pathological.
Up to now, with most private insurers refusing to pay for gambling therapy, treatment has most typically been provided to drug and alcohol abusers for whom gambling is a secondary issue. The providers could bill insurers or government for substance abuse treatment while also counseling those individuals on gambling issues.
Most of those with gambling as their primary disorder had to rely on Gamblers Anonymous meetings to try to overcome the problem. The new reimbursement system opens the door to professional help, though it's unclear how many will walk through it.
"From everything we know from research in other states, they don't beat your doors down," said Robin Rothermel, director of the health department's Bureau of Drug and Alcohol Programs. "The challenge is we don't know what the demand will be, but I'd rather be in the position to have too much [treatment available] than not enough."
The health department has reserved nearly $2 million for treatment and expects to receive at least $1.5 million more this fall from the state's share of casino revenues, she said. The department has no plans, however, for any extensive advertising of the new services.
Past research has suggested that the closer people live to casinos, the more likely they are to have gambling problems, though a new study in Quebec found no significant difference once the casinos have been in place for a decade or so.
Proximity to the slots could be a big issue next year, once The Meadows Racetrack & Casino completes a major expansion and Pittsburgh's North Shore casino opens.
Even though the ARC Manor treatment center in Armstrong County is presently treating no one for a gambling disorder, and has seldom done so in the past, it sent a staff member for special training and obtained state approval for future reimbursement, said Executive Director Cindy McCrea.
"We did it not because there's an immediate market, but because we're foreseeing there will be more of a market for it," she said.
Even in Washington, Pa., just a few miles from The Meadows, the number of people reporting gambling problems at the Turning Point II counseling center isn't large.
It has increased, however, to where program director Lisbeth Mihok said she is treating at least six individuals for gambling as part of their problems.
That's more than for most therapists around the state, though only about half of those clients have gambling problems connected to The Meadows, Ms. Mihok said. She speculated that she's seeing more gamblers than other therapists partly because her agency has increased its screening of new clients for possible gambling problems, and because she's been more widely advertised as a nationally certified gambling counselor with special training.
Other area providers authorized by the state include Jody Bechtold and Sabrina Heller, a pair of social workers who have separate, part-time clinical practices in Mt. Lebanon; the Fayette County Drug & Alcohol Commission; and The Open Door in Indiana, Pa.
In addition to the health department Web site, www.health.state.pa.us/gambling, information on providers can be obtained from the state's problem gambling hot line, 1-877-565-2112, or through the 1-800-GAMBLER services of the Pennsylvania Council on Compulsive Gambling.
Gary Rotstein can be reached at firstname.lastname@example.org or 412-263-1255.