The Integrated Approach

1
The Integrated Approach aka More Ways than one
to skin a (fat) cat Presenter Adrianne
Transom - Regional Manager, Problem Gambling
Foundation of New Zealand
2
(No Transcript)
3
(No Transcript)
4
Problem Gambling Foundation of New Zealand

• National organisation
• Over 60 clinics throughout NZ
• Counselling, health promotion and policy advice
• Asian services

5
(No Transcript)
6
Gambling in New Zealand

• 1988 Pokies introduced into NZ
• Rapid increase in the number of people seeking
  help
• 2003 Gambling Act introduced
• Gambling is regulated by
• Dept of Internal Affairs
• Territorial Authorities (73)

7
Gambling in New Zealand

• Problem gambling is recognised as a significant
  public health issue in New Zealand
• The prevalence of problem gambling in New Zealand
  is about 1.2 of adult population aged over 15
  years and over
• Men a women present equally to treatment agencies

8
Gambling harm is a complex issue

• Requires multi-pronged approach
• Requires a multi-level approach
• Requires resourcefulness and resilience
• Requires a thick skin

9
Complex!

• Gaming societies own machines and operate
  independently from each other 64 public
  societies 375 clubs
• Some aspects of gambling are regulated by local
  authorities 73 of them
• The government receives million from the same
  industry it is supposed to regulate
• Gambling is an authorized activity as long as
  money goes back to the community
• Community groups have become dependant on that
  money
• Its a hidden problem
• Its a multi-million industry

10
Integrated Public Health Approach To Problem
Gambling

• Public Health Interventions and Capacity Building
  Strategies within the Problem Gambling Continuum

Individual Approach
Population Approach
Individual Approach
Screening, individual risk assessment
Health education and skill development
Social marketing, Health information, Health
promotion
Community action
Settings supportive environments
Capacity Building Counsellor
Health promoter
11
Unpinning Principals

• Health Promotion Ottawa Charter principles
• Health Protection regulatory measures such as
  Gambling Act and TLA policies,
• Advocacy community, media, political,
  organisational
• Collaboration building partnerships at
  national-regional-local
• Workforce Development Research training
  development

12
Key Features of Integrated Approach

• Develop mix of interventions (individual and
  population strategies)
• Build capacity for internal and external
  workforce by delivering workforce development
  training
• Develop Leadership skills
• Effective partnerships inter and intra agency
  partnerships
• Involvement of broad range of sectors
  (non-governmental, governmental, PHC, schools,
  workplaces)
• Support organisational development
• Strengthen systems
• Build sustainable models

13
Putting our money where our mouth is

• So what does all this mean in practice??

14

• Action Groups
• Consumer Voices
• Gamble Free Day
• POW Pokies
• Option 4
• Prison work
• Conferences
• Research
• Fact Sheets

15
Integrated Public Health Approach To Problem
Gambling

• Public Health Interventions and Capacity Building
  Strategies within the Problem Gambling Continuum

Individual Approach
Population Approach
Individual Approach
Screening, individual risk assessment
Health education and skill development
Social marketing, Health information, Health
promotion
Community action
Settings supportive environments
Capacity Building Counsellor
Health promoter
16
Fact Sheets

• Provide consistent messages
• Cheap to produce
• Professional and believable
• Provide referencing for further reading
• Easily distributed
• Wide range of applications
• Effective for myth-busting

17
Fact Sheets
18
Integrated Public Health Approach To Problem
Gambling

• Public Health Interventions and Capacity Building
  Strategies within the Problem Gambling Continuum

Individual Approach
Population Approach
Individual Approach
Screening, individual risk assessment
Health education and skill development
Social marketing, Health information, Health
promotion
Community action
Settings supportive environments
Capacity Building Counsellor
Health promoter
19
Working in Prisons

• The number of people seeking counselling
  following the commission of a gambling-related
  crime has risen from one every two weeks to one a
  day.
• Australian Productivity Commission 1999

20
Working in Prisons

• Individuals are being criminalized.
• Communities are paying the cost
• The gambling industry keeps the proceeds
• One third of inmates meet the criteria for
  problem or pathological gambling1
• Approximately 50 of crime committed by this
  group was to support gambling1
• RJ Wlliams et al 2005

21
Working in Prisons

• NO GOING BACK
• Working towards lasting change in people affected
  by problem gambling
• A programme for delivering an intervention and
  rehabilitation programme within the criminal
  justice system for people impacted by problem
  gambling.

22
Working in Prisons a seamless approach

• Pre-sentence reports
• Counselling and group while in prison
• Preparation for release
• Working with family/whanau
• Support upon release

23
Integrated Public Health Approach To Problem
Gambling

• Public Health Interventions and Capacity Building
  Strategies within the Problem Gambling Continuum

Individual Approach
Population Approach
Individual Approach
Screening, individual risk assessment
Health education and skill development
Social marketing, Health information, Health
promotion
Community action
Settings supportive environments
Capacity Building Counsellor
Health promoter
24
Never doubt that a small group of thoughtful,
committed citizens can change the world. Indeed,
it is the only thing that ever has. - Margaret
Mead
25

• Option 4

26
Christchurch City Council Gambling Venue Policy

• March 2004 Council Policy was set at a
  moratorium It is the Committees view, having
  considered the issues, that a moratorium is the
  only option for the Council that fulfils the
  requirements of the legislation. Christchurch
  City Council, 2004
• May 2005 resolution that Council staff report
  back to the Council on its Gambling Policy
  (adopted in March 2004)

27
CCC Gambling Venue Policy cont.

• 21 July 2005 staff recommendation to Council
• Insufficient evidence to review gambling policy
  at that time
• Consider reviewing 2004 Gambling Policy in or
  about 2007 as per legislation
• 31 May 2006 CCC announcement of intention to
  review Gambling Policy
• Preferred policy option places no restrictions
  on
• Number of venues in city
• Location of venues in city

28
Option 4 The Campaign

• PGFNZ initiated a campaign aimed at ensuring that
  the Christchurch City Council (CCC) kept its
  current policy
• Referred to as Option 4
• The precedent that a change by CCC may have set
  for other Councils
• PGF developed a campaign which led to over 2060
  submissions to the Council and the eventual
  decision by the Council to keep the moratorium in
  place

29
Process / Factors of Success

• Leadership - PGFNZ took the leadership
  roleLeaders dont force people to follow they
  invite them on a journey (Charles S. Lauer)
• Formed a campaign group
• Who were our closest allies
• What skills were needed
• Define the goalsGoals need to be defined at the
  start, in a way that can launch an effort, draw
  people into it, and sustain it over time
  (Democracy Centre, 2005)
• Long term and short term goals
• Content goals policy change
• Process goals to generate 1000 written and 50
  oral submissions

30
(No Transcript)
31
(No Transcript)
32
Outcomes

• 2060 written and 136 oral submissions
• 3 days of hearings at Council
• Decision was to continue with Option 4 a
  sinking-lid moratorium

33
Consequences

• Empowered clients Consumer Voices Group
• Huge reverberations throughout TLAs and Industry
• Major reinforcement of an integrated Public
  Health approach to the issue

34
Integrated Public Health Approach To Problem
Gambling

• Public Health Interventions and Capacity Building
  Strategies within the Problem Gambling Continuum

Individual Approach
Population Approach
Individual Approach
Screening, individual risk assessment
Health education and skill development
Social marketing, Health information, Health
promotion
Community action
Settings supportive environments
Capacity Building Counsellor
Health promoter
35
(No Transcript)
36
Problem Gambling A sexy social issue???!!!

• Putting problem gambling on to peoples agendas
• Making it an important social issue
• Targeting a population group that is influential
  and active
• Developing a key marketing concept

37
(No Transcript)
38
POW Pokies Project

• Developed by young local designers
• Aimed at the 25-35 year old age grou
• Covered by local media
• Released on Gamble Free Day 2007
• Sold over 140 in the first release
• High public profile
• Available in a target retail store

39

• An advertisement gets read once or twice, and
  costs around 200, t-shirt gets worn for two to
  three years and costs around 18. . . .
• Thats great exposure!!

40

• Resourceful, resilient, thick skinned!

41

• Having fun along the way

42
Celebrate successes Look after each other Beware
of the wolves in sheeps clothing Never, never,
never give up
43
2008 International Gambling ConferenceLooking
Forward New Directions in Research and
Minimising Public Harm

• 21-23 February 2008 Crowne Plaza Hotel,
  Auckland, New Zealand