Supporting Gambling Awareness Program Leadership in FNGAP

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Authors: Kerry Arabena and Natalie Wood Managing Editor: Jane Yule Suggested citation: Arabena, K. & Wood, N. 2023, Supporting Gambling Awareness Leadership in FNGAP: Refreshed Guidelines, Performance Measures and Templates, Victorian Responsible Gambling Foundation, Melbourne.

Professional disclosure statement: Karabena Consulting prepared this document in good faith based on the research and information available to us at the date of publication without any independent verification. We do not guarantee the accuracy, completeness or currency of the information. Karabena Consulting does not accept any liability if this document is used for an alternative purpose, nor to any third party in respect of this document.

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Acknowledgment: We acknowledge the Traditional Owners of the lands on which we live, work and play. We acknowledge Elders past and present, and give thanks to all who have kept the home fires burning and culture strong for our families and communities. We are also indebted to the staff and funders of the FNGAP program for your time, insights and your engagement with the project.

This report provides an overview of the recommendations and key findings from works commissioned by the Victorian Responsible Gambling Foundation for interventions with Aboriginal and Torres Strait Islander people residing in Victoria. Through Indigenous methodologies and in partnership with the First Nations Gambling Awareness Program (FNGAP) deliverers, including staff in Aboriginal Community Controlled Organisations in Victoria, the report highlights the need to provide balanced information on the benefits and risks of gambling. In pre-colonial times, gambling was a feature of First Nations societies. To this day, gambling can be a fun experience, if done with mindfulness and people are provided opportunities to say no to others, pressuring them to increase their gambling amount and frequency. When gambling is done in our own community contexts, we have seen people and projects be supported through raffles and games that provide the opportunity to ‘win big’. On the flip side of our in-community experiences of gambling, and particularly in a post COVID economic climate, many companies target First Nations people for ‘easy money’, as evidenced by targeted campaigns that create the environment for mobile phone gambling.

Therefore, it is important to work up a strategy to destigmatise harmful gambling for Aboriginal and Torres Strait Islander people. These approaches require collaborative efforts from government, service providers and community members. By increasing awareness, involving communities, developing and delivering services through a ‘cultural lens’ it is possible to address the root causes of harmful gambling, reduce the impact of harmful gambling and prevent harmful gambling overall.

The FNGAP, in partnership with the Foundation, needs to discuss how to implement recommendations made in this report, particularly those focused on achieving positive outcomes and addressing emerging trends and issues in communities. Critical in this work will be delivering policies, programs and services that support and coach people toward achieving their financial aspirations, particularly as families receive reparations, and in these Treaty times. As such, the report focuses on areas such as training, funding, reporting and access to support services that acknowledge culture as the protective factor for our families. The report also emphasises the importance of confidentiality, incorporating place-based cultural knowledge and values, taking a multigenerational and trauma informed approach; of building capacity, engaging in campaigns and promoting community ownership. Also critical is the need to evaluate the outcomes of program delivery to ensure the realisation of the Victorian Responsible Gambling Foundation’s commitment to effective and sensitive interventions.

This project recommends the adoption of strengths based approach to programming and promoting gendered and multigenerational programs, aligning with Victoria’s commitment to gender equality and responding to the realities of intergenerational transmission of harmful gambling behaviours. The outcomes of these interventions will address adult gambling and protect children and Elders from the direct and indirect impacts of gambling harm. To aid in this work, we recommend the uptake of a life course approach to understand the negative impacts of gambling harm across a person’s life. A combination of education and prevention strategies could address Elder abuse, the need for adults to receive counselling and support services, and protect children by diverting their attention away from targeted gambling advertising to more culture based activities.

Additionally, we advocate for a broadening of access to financial planning services, particularly in Treaty times. There will be a trajectory of investment and inputs to support this work from financial counselling, financial aspirations, realising financial goals and developing programs which support parents to change their behaviour, manage their money, avoid financial hardship and reduce their children’s exposure to harmful gambling.

Even as we note that gambling has a place in societies, we recognise that the negative harm from gambling can be real (sustained financial loss, e.g. cannot pay rent), anticipated (poor mental health, e.g. worry and rumination about money issues), or perceived (reputational risk, e.g. feeling of shame or guilt). It is important to review the Foundation’s harm framework from a First Nation’s perspective, particularly the concept of shame. Further, the report incorporates culturally appropriate prevention and intervention programs that involve Elders and community members in traditional healing practices and the need to understand the impact of historical trauma and systemic issues, in order to address gambling related problems in Aboriginal and Torres Strait Islander communities. Wherever possible, a trauma informed lens should be incorporated into prevention and intervention efforts.

Whilst more fully described in the appropriate section of the report, the recommendations from this project include that the Foundation with FNGAP:

1. Review of the Foundations Harm Framework with a First Nations and cultural lens emphasising real, anticipated and perceived impacts of harmful gambling.
2. Adopt principles and program guidelines detailed in this work for use in implementing strengths based and cultural solutions in support of families and communities financial aspirations in Treaty times.
3. Considers encouraging and promoting gendered and multigenerational programming opportunities to address and prevent the negative impacts of harmful gambling.
4. Develop specific campaigns that support Aboriginal and Torres Strait Islander people access culturally safe and supportive mainstream services.
5. Implement specific interventions to address harmful levels of adult gambling and protect children, including education and awareness raising, access to counselling and support services, young people focused interventions to mitigate against targeted advertising campaigns, and protect children from their parent’s harmful gambling.
6. Implement specific advocacy strategies to enhance regulatory and policy measures in the state of Victoria, aligning to the Treaty Framework, the aspirations for self-determination and access to coaching, Elder’s wisdom, traditional healing practices and the opportunities inherent in upcoming events such as the Commonwealth Games being delivered in regional Victoria.
7. Recognise the impact of historical trauma and systemic issues on First Nations communities and incorporate a trauma informed lens in prevention and intervention efforts.
8. Increase community awareness and education through balanced information on the benefits and risks of gambling including the implementation of cultural dosing strategies, promoting support services and addressing emerging issues in communities as they arise.
9. Fund and support the implementation of financial literacy programs for Aboriginal and Torres Strait Islander communities, building on existing initiatives.
10. Enhance reporting processes by adopting a joint reporting approach involving regular meetings across all implementation sites, incorporating feedback from workers and the community.

11. Develop clear performance measurement frameworks, key performance indicators and targets to monitor programs and evaluate outcomes.
12. Provide training opportunities for Aboriginal Health Workers, FNGAP staff and other service providers on identifying harmful gambling behaviour, behavioural change strategies and culturally sensitive care, including specific resources including in this report that detail cultural dosing strategies, life course approaches and celebrate multigenerational interventions. A strategy that also has merit is to provide education and training on engaging and preparing communities for Treaty, recognising the importance of self-determination.
13. Research funding: Support research initiatives to further understand the relationship between gambling, violence, and other emerging issues in the community. Emphasise strengths and culture led initiatives, and implement financial literacy programs, as they have proven effective in preventing and minimising harmful gambling among participants.

By working together and aligning their efforts, the FNGAP, the Foundation, Indigenous businesses and the Aboriginal Community Controlled Organisations implementing the First Nations Gambling Awareness Program can create a powerful force for positive change in addressing gambling harm. This collaboration will not only enhance the effectiveness of interventions but also foster a sense of community ownership and investment in the process. Through a strengths-based approach, the FNGAP and Foundation can empower First Nations communities to overcome the challenges posed by harmful gambling and work towards a future of financial resilience and wellbeing as Victoria moves toward a Treaty.

This project aims to deliver the Victorian Responsible Gambling Foundation’s (VRGF or the Foundation) refreshed First Nations Gambling Awareness Program Guidelines (Guidelines), the new performance and outcome measures, and further planning and reporting templates for use within the First Nations Gambling Awareness Program (FNGAP). FNGAP encompasses work delivered by five First Nations organisations and the VRGF to reduce harm from gambling in First Nations communities. Price Waterhouse Coopers (PWC) Indigenous Consulting was appointed to evaluate the FNGAP program in October 2022, and identified four key findings:

1. Gambling Awareness Programs (GAPs) have the flexibility to respond to the local context: a. the benefit of this flexibility is that GAPs can tailor the program to meet the needs and aspirations of the communities with which they work and deliver culturally specific, safe and appropriate programs b. it is acknowledged that this can be inconsistent and inefficient when similar programs evolve separately.
2. FNGAP is available across the traditional Country of First Nations Victorians, particularly those areas with the largest populations experiencing socioeconomic disadvantage, a high number of electronic gaming machines (EGMs) and high EGM spending. However, the reach, effectiveness and long-term viability of the program are at risk because: a. most parts of Victoria do not have a GAP b. GAP staff, particularly managers, work on the program as only one aspect of their role, which can be compromised when urgent priorities emerge.
3. Three GAPs prioritise raising awareness of gambling-related harm, but are less focused on treatment for this harm. The evaluator anticipated that this may need to change with time.
4. GAPs have mixed views about their role in building the capacity of the wider gambling sector to be more culturally safe. However, all agreed that more could be done to make mainstream services competent in supporting First Nations people.

Response to evaluation recommendations

In addition to these findings, PWC Indigenous Consulting made 10 recommendations that the FNGAP and the Foundation are actioning. These following four draft recommendations and FNGAP’s responses to them were essential to developing the framework for this project. Recommendation 7: The Foundation should support further connections between program managers in different services. The program managers should consider regular touchpoints and the value of face-to-face and virtual contact.

Response: The Foundation accepts this recommendation and will provide six-monthly online briefing meetings for program managers to ensure they can connect directly. The Foundation will continue to encourage program managers and team leaders to attend the regular network meeting as an opportunity to meet with each other face-to-face.

Recommendation 8: The Foundation should support revising and updating the FNGAP Program Guidelines.

Response: The Foundation accepted this recommendation and has contracted Professor Kerry Arabena of Karabena Consulting to undertake this work in the first six months of 2023.

Recommendation 9: The Foundation should consider developing concrete performance measures through a co-design process undertaken by First Nations Consultants with the Aboriginal Community Controlled Organisations (ACCOs) and Strong Brothers Strong Sisters (SBSS) so that ACCOs can be evident when meeting the mark. These should be flexible enough to suit different ACCOs but must be concrete and reportable. Output and outcome measures should be considered.

Response: The Foundation accepted this recommendation and contracted Professor Kerry Arabena of Karabena Consulting to undertake this work in the first six months of 2023.

Recommendation 10: The Foundation should review and revise reporting requirements through a co-design process undertaken by First Nations Consultants with the ACCOs and SBSS to align measures developed as part of Recommendation 9. Consideration should be given to improving the use of technology, and to quantitative rather than narrative reporting.

Response: The Foundation accepted this recommendation and contracted Professor Kerry Arabena of Karabena Consulting to undertake this work in the first six months of 2023. However, it is noted that if the agencies and the Foundation decide to pursue a database for client data collection, this will exceed the scope of the Karabena Consulting work and will be managed by the Foundation.

Finally, PWC Indigenous Consulting developed a program logic through the co-design process, which assumes that the evaluation recommendations are accepted. It has been provided to the consulting team as the model to use in developing new guidelines, measures and templates.

As noted in the revised program logic, five critical strategies for preventing and reducing gambling-related harm among First Nations communities have been identified:

1. Raise awareness of gambling-related harm using a culturally safe and responsive approach.
2. Build protective factors against gambling harm.
3. Provide First Nations communities with positive alternatives to gambling.
4. Provide effective counselling/referrals for people experiencing gambling-related harm.
5. Engage with ACCOs and other organisations to provide more culturally safe gambling-related harm services.

Each new instrument relates to these strategies and the program logic included in the evaluation report.

Methodology

In support of FNGAP meeting the requirements of its response to these recommendations, Karabena Consulting implemented a phased co-design process that included project planning, a desktop review and facilitating stakeholder consultations to redevelop FNGAP’s guidelines, measures and templates. Together with FNGAP staff, funders and program advocates, we facilitated a co-design approach where First Nations organisations, the Foundation and Karabena Consulting worked together to design the consultation plan and question guides, the strategies used in online consultations, to provide oversight to findings and recommendations and in the drafting of proposals. These strategies align with the Foundation’s commitment to self-determination. The co-design process was crafted to recognise that FNGAP is a small program with high staff turnover resulting in a mix of highly experienced practitioners and relatively new staff. The lines of enquiry included workshops with FNGAP staff, consultations with case studies of signature activities, and interviews with staff from each organisation.

The past few years has been one of consolidation and of new milestones within the First Nations Gambling Awareness Program, particularly as it relates to the health and wellbeing of Aboriginal and Torres Strait Islander Australians. As a result of the evaluation undertaken by PWC Indigenous Consulting, the implementation of the program so far has been mixed, but occurring in relation to priority areas. However, progress against specific targets is less evident despite these targets being the critical measure by which the success of the FNGAP will be assessed. There was a need to engage agencies delivering the programs to agree to coherent approaches across their work, which will lead to measurable improvements in the lives of Aboriginal and Torres Strait Islander families, FNGAP staff and broader communities.

Since 2019 and the COVID 19 pandemic, and with the change of federal government, the context of Indigenous affairs has changed rapidly. There are now more Aboriginal and Torres Strait Islander people in politics, in professions, on boards and in executive roles in both corporate and not-for-profit organisations than at any other time since colonisation. Many Aboriginal and Torres Strait Islander Australians are reactivating their ancestral trade routes through entrepreneurship and revitalising the language, culture, ceremonies and connections that empower them to be influential. This influence is also occurring in mainstream institutions where allies are leaning into the opportunity to recognise the past, to heal and to move forward as a reconciled country.

The first Treaty (SWALSC 2022) in Australia, having been reached in 2017, has catalysed all States and Territories in their Treaty negotiations. In June 2022, Treaty legislation passed in Victoria (Victorian Government 2022). A central tenet of the Treaty in Victoria is to establish equal footing between Traditional Owners and the State, and to negotiate future wealth and prosperity for all Aboriginal and Torres Strait Islander people living in Victoria. The First Nations’ Assembly has been established, and a self-determination fund is being set up to support Aboriginal and Torres Strait Islander people achieve their wealth and prosperity goals, in perpetuity. This will be the first ’Treaty generation’ in Australia and in Victoria (Arabena 2016). To maximise the promise of Treaty for individuals, families and communities, Aboriginal and Torres Strait Islander people will need to assess their relationship with money, understand and value their finances, and consider the aspirations held by individuals, families and communities.

At the same time as Treaty consultations were happening at a State level, in 2022 the Uluru Statement from the Heart moved to the centre of the Australian political debate (Uluru Statement 2017). While the Statement also calls for a truth-telling and healing process and a Makarrata or agreement-making, the focus has been on its call for a national Voice to Parliament (Australian Government 2022). In addition, Aboriginal and Torres Strait Islander health and wellbeing services have identified the need for greater investments to engage the Close the Gap campaign (Coalition of the Peaks 2020), for ACCOs to work in partnership to address preventable and curable health issues, for an increased focus on the social and cultural determinants of health and wellbeing (Centre for Healthcare Knowledge and Innovation 2021), and for a greater understanding of the circumstances of people attending FNGAP and their need for financial, clinical and other forms of care.

Despite all this effort, on 13 February 2023, the Prime Minister Anthony Albanese stated the health gap was not closing fast enough (Morris-Grant 2023). Nationally, the Labor government released a second Commonwealth Closing the Gap Implementation Plan (NIAA 2023) that identified four new priority areas:

Aboriginal and Torres Strait Islander women and girls Elders and aged care people with disability people in remote Australia.

This second Implementation Plan marks a milestone in integrating suicide prevention (as one of three priority areas), and social emotional and mental health into a planning space that has traditionally been focused on physical health. While mental health strategies are still needed, the Plan’s integrated approach better reflects Aboriginal and Torres Strait Islander holistic conceptions of health as including body, mind, family, community, culture, Country and spirituality (AIHW 2018). This broader policy and programming landscape provides for a rich, once in a generation opportunity for FNGAP to create lasting and meaningful change, by incorporating all elements of health and wellbeing into the scope of its practice. This includes prevention and early intervention work, the social and cultural determinants of health and wellbeing and, through co-design, investing in Indigenous leadership, self-determination and truth telling. There are many more potentially transformative opportunities for FNGAP to leave a legacy that establishes strong financial foundations for Treaty-based wealth and prosperity, for working with cultural determinants of health and wellbeing, and for creating intergenerational wealth, rather than intergenerational trauma. FNGAP has a central role to play in education, awareness raising and breaking through intergenerational cycles of harmful gambling in communities. Whilst much FNGAP work is community-based and preventative, this report is premised on several assumptions (by the authors):

Aboriginal and Torres Strait Islander people in Victoria are responsible for maximising the opportunities that will be provided by Treaty and reparations relating to Treaty. This will be a fundamental shift in the current position of Aboriginal and Torres Strait Islander people being described and supported as disadvantaged and impoverished communities in Victoria. Families and communities are obliged to create their own wealth and prosperity, but to achieve this, families need the opportunity to identify their aspirations, and have their aspirations recognised and supported. Aboriginal and Torres Strait Islander people are provided with opportunities to consider the value of money and understand what it means to be wealthy and prosperous.

For this reason, despite FNGAP’s work being primarily focused on crisis work and targeting harmful gambling, this report, and many of the new products related to the program, will focus on strengths, promote the value of money, and engage multiple generations in the development of financial aspirations that will progress the promise inherent in the Victorian Treaty.

The FNGAP logic identifies ‘why we do what we do’ and refers to the program’s drivers in transforming gambling-related harm. To de-stigmatise the narratives about this harm, the principles of the program have been developed to promote positivity about being in financial control, while still relating to each of the ‘why’ statements developed through the evaluation. Research shows that using positive language and descriptions can overcome stigmatisation by challenging negative stereotypes about Aboriginal and Torres Strait Islander people and behaviours, and promoting a more accurate and respectful understanding of our cultures, histories and gambling behaviours. Research has also shown that negative stereotypes and stigmatising language can have harmful effects on the wellbeing and self-esteem of Indigenous peoples, as does the perpetuation of discrimination and exclusion (Paradies et al. 2015; Reilly et al. 2018). By contrast, positive language and descriptions that celebrate culture and achievements can promote a sense of pride and empowerment among Aboriginal and Torres Strait Islander peoples and challenge negative stereotypes (Roberts et al. 2017). Similarly, initiatives that promote the use of Indigenous languages and positive representations of Aboriginal cultures, such as the Indigenous Literacy Foundation, have been found to have positive impacts on the wellbeing and education outcomes of Indigenous children (Wigglesworth, Simpson & Loakes 2019). Overall, using positive language and descriptions can be a powerful tool for challenging stigma towards, and promoting understanding and respect of, Aboriginal and Torres Strait Islander Australians. We have used positive language in this report and strategy to de-stigmatise all gambling behaviours.

Gambling offers individuals ‘a promise of winning, excitement, a distraction from worries and problems, and creates meaningful opportunities to socialise with family and other community members’ (Maltzahn et al. 2018, Hing et al. 2014). Aboriginal and Torres Strait Islander societies have adapted, changed and been transformed because of colonisation, with gambling participation one of the legacies of this transformation. The legalisation and availability of many forms of gambling, mainly commercial gambling (table games, electronic and online), has broadened opportunities for everyone, including Aboriginal and Torres Strait Islander people, to participate in gambling (McMillen & Donnelly 2008; Hing et al. 2014, Hing et al. 2022, Breen & Gainsbury 2013). Gambling activities are influenced by cultural, familial and social patterns, and are experienced across and between generations at different times of life. For many people, gambling has been a source of social engagement and acceptance, reduced isolation, pleasure, physical comfort, an opportunity to win money and, for some, reduced alcohol consumption (Hing & Breen 2014, Hing et al. 2014). However, families experiencing entrenched financial vulnerability more often report the negative impacts of gambling, including poverty and debt, debilitating stress, depression, and feelings of guilt and shame all of which contribute to poor health outcomes for individuals, families and communities (Ryu & Fan 2023, Hing et al. 2020). Several social, economic and cultural factors contribute to the high rates of harmful gambling among First Nations people in Australia. One significant factor is the historical and ongoing marginalisation and discrimination experienced by many First Nations people, which has resulted in social and economic disadvantages that include poverty, unemployment and poor health outcomes (Breen, Gainsbury & Armstrong 2017). These factors are associated with higher levels of gambling participation and greater vulnerability to gambling-related harm (Hing et al. 2014).

People will come [when they are] in crisis because they’re not able to pay their rent or their bills because of gambling losses, their pay cheque has gone down on that. Or we get a referral through the doctor because somebody’s anxiety is heightened because they’re experiencing financial stress. So, we get that warm referral through to us and then we uncover these issues... Pokies are everywhere here, but also younger women at bingo, I think, are emerging a lot more... Like on my Snapchat with all my cousins and stuff, I’ll notice that there’s four or five of them catching up at bingo. So it’s not just for the older age group anymore. It’s now young people getting into bingo as well…

Cultural factors are also crucial in understanding the high gambling rates among First Nations people in Australia. Traditional forms of gambling have been an integral part of First Nations culture for centuries, with gambling used as a form of social and cultural exchange and an essential part of community life (Breen, Gainsbury & Armstrong 2017). However, introducing modern forms of gambling, such as EGMs, has disrupted traditional gambling practices and resulted in higher levels of harm. Harmful gambling in Aboriginal communities must also be understood against a background of dispossession, marginalisation and discrimination, all of which significantly impact people’s health and wellbeing (AIHW 2022). With the forcible removal of Indigenous children from their families and communities, First Nations Australians have suffered long-term, ongoing inter-generational trauma, which has fundamentally impacted their experience of disadvantage and negatively affected their physical and mental health (Menzies 2008).

You know, our mob does have issues from generational trauma and right down through domestic violence to grief and loss. And sometimes, you know, our Aboriginal community does need some major healing in that way because of all the teachings and everything else that comes with our spirit because that’s what it’s all based on, the spirit…

The inequality experienced by Indigenous peoples in Australia and globally is maintained through social and political systems that preserve these disparities (see, for example, ANU 2020; Paradies 2016; Paradies & Cunningham 2012). To remedy this situation, Indigenous peoples have advocated for interventions based on healing, empowerment, inclusion and cultural concepts of health and wellbeing. Additionally, Indigenous leaders have pushed for Aboriginal and Torres Strait Islander people to have ownership of the solutions needed to address social injustice and disadvantage (Dudgeon et al. 2020). Despite the concerns about most aspects of contemporary Indigenous gambling, there is little insight into gambling as a sociocultural activity (Wynne 2011), or into commercial gambling forms. In Victoria, there are ‘saturation levels’ of targeted gambling advertising campaigns, with free to air TV showing more than 900 gambling advertisements per day.

In terms of trends, we know that younger people are getting caught up with sports betting and online betting. Some older women [go to the] pokies, [which] are just a venue people go… to meet each other, not just because they’re feeling isolated. We know that that’s a constant issue. With the young generation today, who love sitting there watching sport, especially cricket, netball, basketball, whatever they’re doing, on Foxtel it’s just getting smashed [with gambling ads].

Promoting smartphone-accessible gambling (Hing et al. 2022) and activities such as bingo were once considered safe. However, harms still exist – namely, exhausting the family budget, causing family conflict, and pressuring people to commence other forms of gambling (Maltzahn et al. 2018).

No, [bingo] here is alive. Daytime, night-time, different sessions, different, you know, rolling jackpot things, and we’ve got the PETs [Personal Electronic Tablets] nearly everywhere here in Melbourne now, which is the electronic bingo, so they can play up to, I feel like it’s like 10 to 12 games on that and then they can play their own normal book as well. So, they could be playing, you know, 15–16 books every night, which gets expensive…

Additionally, there is a greater need to recognise and respond to the different patterns of gambling among men and women, and the implications of these gendered approaches to the health and wellbeing of Aboriginal and Torres Strait Islander, including providing support to those women and children experiencing domestic violence (Freytag et al. 2020)

Gendered approaches to harmful gambling

Gender differences play a significant role in the development and maintenance of gambling behaviours. Men and women tend to have different reasons for gambling, and they also differ in the types of gambling activities in which they engage. For example, a study by Hing et al. (2014) found that women were more likely than men to gamble as a way of coping with stress or negative emotions, which can lead to problem gambling behaviour. This is consistent with other research that has found that women are more likely than men to develop gambling problems because of stress or traumatic life events (Petry, Stinson & Grant 2006). Moreover, studies have shown that gambling can have a significant impact on family health and wellbeing, particularly when it becomes problematic. For example, a study by Dowling et al. (2015a) found that problem gambling was associated with a range of negative outcomes, including financial stress, relationship breakdown and mental health problems. These negative outcomes can have a particularly significant impact on women and children, who may experience financial hardship, social isolation, and increased risk of domestic violence because of problem gambling within the family (Hing et al. 2016a). Therefore, it is important to develop tailored interventions that address the specific needs of women and children affected by problem gambling, as well as increasing awareness of the potential risks associated with gambling among vulnerable populations.

Adult harmful gambling behaviour: Impacts on children

Harmful gambling can have serious negative impacts on the children in a family. In Australia, the prevalence of gambling-related harm is estimated to be around 0.7% of the population, with children being among the most vulnerable groups (Productivity Commission 2010). Research shows that children who grow up in families where harmful gambling occurs are at a higher risk of experiencing a range of adverse outcomes, such as emotional and behavioural problems, poor academic performance and social isolation (Delfabbro, Lahn & Grabosky 2006). These negative effects can be attributed to several factors, including parental neglect and financial strain, which can lead to conflict and tension within the family environment.

The impact of harmful gambling on children in families can be both direct and indirect. Direct impacts may include first-hand exposure to the negative consequences of gambling, such as witnessing arguments, and experiencing financial difficulties and emotional distress. Indirect impacts may include the effects of parental stress, anxiety and depression, which can all have a significant impact on children’s mental health and wellbeing. Suomi et al. (2022) undertook a study to understand the harm experienced by children that can be attributed to their parents’ gambling behaviours. Through surveys and interviews, adult respondents recollected their childhood experiences of parental gambling. The study then investigated several areas, such as determining the areas of child wellbeing that are affected by harmful parental gambling, the extent to which its severity predicts the degree of harm to children, and the ways in which exposure to gambling harm in childhood relate to health and wellbeing outcomes later in life. The study found that parents reported lower incidents of harm, usually focusing on financial impacts. Children, however, reported higher incidents of harm based mainly on the psychosocial impacts of their parents’ gambling habit. It also found that ‘adult children exposed to parental gambling reported more current mental health problems compared to participants who had not been exposed to parental gambling… particularly verbal and physical abuse, and child welfare calls’. More positively, the results also suggested that ‘being exposed to severe psychosocial consequences of parental gambling may act as a deterrent against harmful gambling behaviours in later life’ (Suomi 2022). Adult harmful gambling behaviours can have severe impacts on children, and it is important to address this issue through education, prevention and better service coordination. Early intervention is also critical in reducing the negative impacts of gambling harm. Parents and caregivers need to be encouraged to seek help and support, and resources made available to help families cope with the impacts on their children of harmful gambling.

Specific interventions that can be used to address adult gambling and protect children include:

1. Education and awareness-raising: Adults need to be informed about the negative impacts of gambling on children and the risks associated with harmful gambling. This can be achieved through public awareness campaigns, community education and school-based prevention programs.
2. Counselling and support services: Adults who are struggling with harmful gambling should be encouraged to seek help from a qualified counsellor or support service. This can include individual counselling, group therapy or self-help programs.
3. Financial counselling: Harmful gambling can lead to financial problems and debt, which can have a significant impact on children in a family. Adults may benefit from financial counselling services to help them manage their money and avoid financial hardship.
4. Parenting support: Children who are exposed to harm from gambling may need additional support from their parents or caregivers. Parenting programs can help adults develop skills and strategies to support their children and promote their wellbeing.
5. Regulation and policy: Governments can introduce regulations and policies that restrict gambling advertising and promote responsible gambling practices. This can include measures such as mandatory warning messages on gambling products, restrictions on the promotion of gambling to children and limits on the availability of gambling products.

Harmful gambling: real, anticipated and perceived impacts

These negative impacts can be real (sustained financial loss, e.g. cannot pay rent), anticipated (poor mental health, e.g. worry and rumination about money issues), or perceived (reputational risk, e.g. feeling of shame or guilt). The burden of these impacts is often higher among lower income households due to poor job security and low-level support options (Hamilton et al. 2019). Additionally, individuals with similar income levels can have different consumption values, spending habits and demands on income such as food, childcare, transport and housing (Huang et al. 2009; Prawitz et al. 2006). For some Aboriginal and Torres Strait Islander people, there are also strong cultural expectations of individuals gambling and sharing their winnings with relatives, which affects whole communities across every age group. Several studies demonstrate that perceived financial hardship was more important than accurate measures of debt on self-reported health or mental health outcomes, such as depression and anxiety (Bridges & Disney 2010; Drentea 2000; Drentea & Lavrakas 2000; Drentea & Reynolds 2012; Hamilton et al. 2019). The current literature shows the importance of focusing on the perception of one’s financial hardship and its relationship with psychological distress, as well as the realities of losing while gambling.

So whether it was poor mental health from carers or parents, which is related, then in some circumstances we’re saying people turned to drugs and alcohol [and the] ripple effects sort of flow from there, which [exposes] those children and young people to certain circumstances in the households. For us, it was around being able to provide support for carers or the poor parents to be able to get back on track. But then also creating a safe and supportive house for them for those young people together…

This approach is consistent with Aboriginal and Torres Strait Islander people’s concept of health and wellbeing as holistic – not just physical but also social, emotional, environmental and cultural (NAHSWP 1989).

Prevalence and patterns of gambling among First Nations people in Australia

Studies have consistently found that First Nations people in Australia are slightly more likely to gamble than non-Indigenous Australians, with electronic gaming machines and lotteries the most popular forms of gambling (Breen, Gainsbury & Armstrong 2017; Hing et al. 2014). In their 2014 study, Hing and colleagues found that 73% of First Nations adults in Queensland had participated in some form of gambling in the previous 12 months, compared with 51% of non- Indigenous adults. Similarly, a study conducted in 2017 by Breen, Gainsbury and Armstrong found that 81% of First Nations adults in the Northern Territory had gambled in the previous year, compared with 63% of non-Indigenous adults. In addition to higher levels of participation, First Nations people in Australia also experience higher levels of harm associated with gambling than non-Indigenous Australians, including greater debt, relationship problems and psychological distress (Breen, Gainsbury & Armstrong 2017; Hing et al. 2014).

In their 2014 study, for example, Hing and colleagues found that 21% of First Nations adults in Queensland were classified as problem gamblers or at-risk gamblers, compared with 13% of non-Indigenous adults. Gambling is a social norm (bingo, card games), and is one of the reasons that harmful gambling recognition is low (Hing & Breen 2014). Thus, gambling programs that only focus on financial issues are less useful in their effects on individuals’ health and wellbeing outcomes than those interventions that also support people dealing with the cultural elements of resource sharing, and the anticipated and perceived stressors that shape gambling behaviours (Prawitz et al. 2006).

Intergenerational transfer of harmful gambling culture

Of significant concern is the intergenerational transmission of a harmful gambling culture in Aboriginal and Torres Strait Islander communities, one that is maintained by normalising gambling activities in everyday life.

Most of the senior leaders [are] down the pub gambling now, so one of the learnings from the community was you just got to get people to relax and talk about it. And then if they trust, when they trust you, they’ll talk [about gambling].

Normalisation activities include exposure to gambling at a young age, the lack of access to other forms of entertainment, high levels of exposure to gambling advertising, high gambling expenditure, and the drinking of alcohol and using drugs while gambling.

NDIS and Indigenous gambling

The National Disability Insurance Scheme (NDIS) was introduced to improve the lives of people with disability by empowering them with their own funds to purchase the services they need. The NDIS funds a range of supports and services to help participants achieve their goals and enable social and economic participation, but gambling addiction can put this support at risk (Pitt et al. 2021). Research has shown that people with disabilities are at a higher risk of developing gambling addiction due to factors such as social isolation, lack of employment opportunities and experiencing financial difficulties. A study completed by the Victorian Responsible Gambling Foundation found people with disability are twice as likely to experience gambling harm compared to the general population (Pitt et al. 2021). The NDIS has recognised the issue of gambling addiction among its participants and has taken steps to address it. The NDIS Code of Conduct, which outlines the ethical and professional standards for NDIS providers, includes a provision that requires providers to support participants in managing their financial affairs, including their gambling activities. However, some NDIS carers working with First Nations clients are actually enabling their gambling, according to one disability advocate:

The NDIS carers are taking their clients to the pokies with their daily spend of $20 and let them sit in front of a machine playing one cent, single line games. They are there on their phones. After they finish playing, they get dropped off back home. This happens a lot in places where there are no shopping centres to go to…

Thus, the NDIS has partnered with gambling support services to provide education and awareness programs for both participants and providers. For example, it has worked with the VRGF to develop a training program for NDIS providers on how to identify and respond to gambling-related harm.

Protective factors that reduce harmful gambling

FNGAP has been funded to implement protective factors that can help prevent harmful gambling behaviour among First Nations people. One such crucial factor is having a strong sense of cultural identity and connection to community. Studies have found that First Nations people who are more connected to their cultural heritage and participate in cultural activities are less likely to experience problem gambling (Breen, Gainsbury & Armstrong 2017; Hing et al. 2016b). A culturally safe and responsive approach to addressing gambling harm in First Nations communities involves understanding and respecting the cultural values, beliefs and practices of these communities. This approach recognises the importance both of community-led initiatives and of culturally appropriate services that are responsive to the unique needs and experiences of First Nations people.

Traditional healing practices

One effective way to address gambling harm in First Nations communities is through the implementation of culturally appropriate prevention and intervention programs that incorporate traditional healing practices involving Elders and community members. For example, the Ngallu Wal Aboriginal Child and Family Centre in New South Wales has developed a program that combines traditional healing practices, such as yarning circles and bush tucker gatherings, with evidence-based interventions to address gambling harm (Blaszczynski, Ladouceur & Shaffer 2004).

Recognising historical and systemic issues

In addition to community-led initiatives, it is important to recognise the impact of historical trauma and systemic issues on First Nations communities as these can contribute to the development of gambling-related problems. A culturally safe and responsive approach acknowledges this context and incorporates a trauma-informed lens into prevention and intervention efforts. Overall, a culturally safe and responsive approach to addressing gambling harm in First Nations communities involves recognising the unique experiences and needs of these communities and working collaboratively with Elders and community members to develop and implement effective prevention and intervention strategies.

School-based education programs

Research has shown that education and prevention initiatives are effective in reducing gambling-related harm in First Nations communities (Hing et al. 2014). One example of a successful school-based approach is the Gambling Awareness Program developed by the Victorian Aboriginal Health Service (VAHS) in Australia. This program takes a holistic approach to educate First Nations youth on the risks and consequences of gambling and provides strategies to resist gambling-related harms. Evaluation of the program found that it was effective in increasing knowledge and awareness of gambling-related harms among participants (Calado et al. 2020).

Another example is the Talking About Gambling program, developed by New South Wales Aboriginal Safe Gambling Services and the Australian National University. Funded by the NSW Government, this program provides education and resources to teachers and parents to help them recognise signs of gambling harm in young people and ways to support them (NSW Aboriginal Safe Gambling Services & ANU 2021). Overall, school-based presentations on the risks and consequences of gambling, and strategies to resist gambling-related harms, can help reduce the prevalence of harmful gambling in First Nations communities.

Appropriate support services

Another protective factor is having access to appropriate support services. This includes access to counselling and treatment services that are culturally appropriate and sensitive to the needs of First Nations people. Studies have found that First Nations-specific gambling counselling services have been effective in reducing gambling-related harms (Delfabbro et al. 2014; Dickerson et al. 2015).

And yeah, well, consider if they needed it [a referral], and then that’s the thing, too, is that they’re not retelling the story. We’re able to do that initial intervention and then therapeutic support. And if they need that extra advocacy through financial counsellors and the like, we don’t have a financial counsellor on board, although we’ve certainly been trying. Yeah, there’s a great need… to keep it all internally. You’re having to refer out to a financial counsellor, but then that FNGAP worker, they are that causal link, so they’ll actually go with the client to the financial counsellor. So at no point they are left by themselves – that can be daunting in itself.

Policies, regulations and awareness programs

Finally, government policies and industry regulations that promote responsible gambling and protect consumers can also act as protective factors. This includes regulations around advertising, gambling venue access and self-exclusion programs (Hing et al. 2016a).

In three workshops with approximately 15 FNGAP agency staff, we collected information that is crucial to addressing the development, delivery and evaluation of FNGAP programs. Staff found it difficult to focus predominantly on gambling harms, as people will ‘not participate’ if the message is too negative. For example:

We don’t put up a title on the door ‘gambling counsellor’, because nobody would come through it.

Thus, all attempts are made in this report to transform the negatives around gambling into an empowerment strategy for dealing with gambling harms.

De-stigmatising ‘problem’ gambling

The stigma attached to ‘problem’ gambling can prevent people from seeking help and support, making it difficult to address the issue (Hing et al. 2014). Therefore, destigmatising harmful gambling is a crucial step towards reducing its negative impact on Aboriginal and Torres Strait Islander families. There are several strategies for de-stigmatising harmful gambling, which are outlined here. Not using negative words about gambling in any outward-facing work with communities and promoting safe gambling instead. A good example of this is the My Moola Indigenous money management program as a gambling harm minimisation tool (Hing et al. 2018). For example, Gippsland and East Gippsland Aboriginal Co-operative (GEGAC):

… does not use the term ‘problem gambling’, using the term ‘safe gambling’ instead. Community events that provide information and ‘safe gambling’ messages in the context of fun activities in culturally safe environments are a central feature of GEGAC’s model… … Let’s just say that I was to have an event with a barbecue primarily aimed at Gambling Awareness. I don’t think many of them [will] turn up. Yeah, they might come and get a free snack because it smells good. But they keep walking. As opposed to if I had, you know, a Men on Country Day, got them engaged with the boys, and they did a smoking ceremony and something like that, and then you can have connection happiness. And then working out, by the way, you know, you just got to easily slide it [conversations about gambling] in there… It's our mission to normalise gambling. We want gambling to be an everyday topic we want to talk [about]. We want it talked about [in the] corridors, and stairwells in the lifts, and in the doctor’s offices, and in the dentist, and blah, blah. We want people just to talk about [gambling] like drug and alcohol use now, you know, which was very taboo 25 years [ago].... And in doing that, we can talk about safe recreational gambling as opposed to gambling harm.

Increasing community awareness and education. This can be done through community-based programs, campaigns and workshops that provide balanced information on the benefits and risks of gambling. Such programs could promote that:

In pre-colonial times, gambling was a feature of First Nations society. Gambling can be a fun experience, if done with mindfulness at the forefront. There are opportunities for people to learn how to say no to others, pressuring them to increase their gambling frequency. Many companies target First Nations people for ‘easy money’ – e.g. Telstra (ACCC 2021) , Stolen Wages (Andrews 2021) and EGMs (Young, Lamb & Doran 2011). Provide support and resources for those affected by gambling. Work up a strategy to deal with gambling advertising.

[My co-worker has] been out and about liaising with our health prevention team in a netball and football carnival and trying to talk about alternative recreation space. But the challenge is advertising, you know, one minute they’re saying [gambling is] a good recreation, and we are saying be aware of the harm. So it takes work to balance that.

Co-designing First Nations gambling policies and programs. This ensures that the programs are culturally appropriate and sensitive to the needs of the community. It also helps to build trust and engagement between the community and service providers. De-stigmatising harmful gambling for First Nations Australians requires a collaborative effort from government, service providers and community members. By increasing awareness, involving communities and addressing root causes harmful gambling can be reduced and prevented.

The reasons for gambling are boredom, isolation, air conditioning and shared housing.

Difficulty in defining ‘harmful’ gambling, and who is harmed by gambling

In other parts of Australia, public gambling activities have been criminalised which enables police or council officers to intervene. Fogarty (2013) examined gambling in a Northern Territory Indigenous community, with local members interpreting problem gambling as ‘a person neglecting or rejecting social relationships and obligations due to gambling’. During our consultations, people shared their thoughts on this:

Gambling becomes harmful at the moment that I guess it is a dependent thing, or it’s something that someone can’t say no to at any time. But obviously, it’s so different to anyone and each individual… I don’t think you can really label when it becomes harmful. And I think unless you can really get the person to acknowledge and have that lightbulb moment of ‘Shit, if I didn’t go and spend 300 a week on the pokies or bingo or whatever it is, I might not have to go and borrow money’… [People will say:] Nothing wrong with me. It’s my money. I do what I want to do with it. Yeah. I’m putting food on the table, or I want to go and put it on a horse, or I want to go and drink it and smoke it.

According to Whiteside et al. (2020), in ‘previous eras a more collectivist approach to gambling meant that funds were redistributed within the community, but today commercial gambling is draining funds from communities and the money lost is unrecoverable’ (AH&MRC NSW 2008). As a result of this, community cohesiveness is undermined (Phillips 2003) and many within the community become socially isolated (Hing et al. 2015).

In this place, too, the families are supporting a lot of extended families as well. So there’s already those pressures and socioeconomic pressures and disadvantage and all those other things that everyone’s quite aware of. All added to it. Yeah, and it’s all linked. Because if you’ve lost money, then you are getting stressed. So you’re using (alcohol or other drugs) more, you’re drinking more... the crime’s linked in there as well. So it’s all about just taking a few of those needles out of that Jenga game and it all crashes.

Instead of a focus on gambling, people could be focusing on ‘preparing for Treaty’ programs, understanding what wealth and prosperity means to them, what their value of money is and whether it needs to be changed.

So, as long as we can justify that [justify is a wrong word because it sounds like it’s tokenistic]. But as long as we’re able to validate and prove purpose in what we’re doing, why we’re doing it, and how we’re doing it, we can pretty much do a lot…

This could overcome some of the difficulty in identifying harmful gambling. Similarly, we could be asking families what aspirations they have for themselves and their children, then putting in place strategies to strengthen the overall family position in preparation for Treaty. These kinds of discussions could happen at community events, in groups. People we consulted suggested:

Fishing competitions, sporting events around love the game, art competitions and community murals, BBQs – they can listen to sizzling sausages rather than ding ding of machines! So, I think for me in particular, my drive and my direction is to give people that other open door, and try and empower them to have the courage to actually, you know, step out and come to women's days and men's days and things like that. And hope, you know, you can only cross your fingers, but they have an absolute ball and they want to come back next week. So, they're filling up their happy bucket, and then they might not want to, you know, might not want to go back [to gambling activities].

Maintaining confidentiality

Maintaining confidentiality for First Nations Australian gambling clients is crucial for various reasons. Firstly, as highlighted by the Australian National University’s National Centre for Indigenous Studies, First Nations communities often have complex and unique cultural practices that require respect and sensitivity. Thus, breaching confidentiality can lead to a loss of trust between the client and the service provider, hindering the client’s willingness to seek further help (ANU 2021). Secondly, First Nations Australians often face social stigma and discrimination, including in the context of gambling, which can negatively impact their mental health and wellbeing (AIHW 2020). Breaching confidentiality can further exacerbate these issues, causing emotional distress and harm to the client. To attain confidentiality for First Nations Australian gambling clients, it is essential to establish a culturally appropriate and safe environment. This can include ensuring that the service provider is knowledgeable about First Nations cultures and histories, developing a clear and concise confidentiality policy, and making sure the client is fully informed about their rights and the limitations of confidentiality (Australian Psychological Society 2010). Service providers should also consider involving First Nations people in the development and delivery of their services to ensure cultural appropriateness (Australian Psychological Society 2010). Finally, it is essential to comply with relevant laws and ethical guidelines related to confidentiality and data protection. Maintaining confidentiality is crucial for First Nations Australian gambling clients to ensure that they receive culturally sensitive and appropriate care, and to protect them from harm and discrimination. Achieving confidentiality requires the development of culturally appropriate policies and practices, as well as compliance with relevant laws and ethical guidelines.

There are many clients that might look for anonymity and might look to go [a] mainstream [gambling] service. Yeah, cos no one wants to know if you've got gambling trouble, you’re gonna fake it till you make it until you really can't. Especially with the grapevines the way that they are. There was a thing that we used to report on called GH Connect. The mainstream gamblers help services fill in, and it can track clients. And we had real troubles with that. We've struggled with it for a range of reasons; we would get comments [confidentiality breaches].

Targeted groups: Especially young people and Elders

Maybe we should be collecting some information about gambling, like actual gambling modes? Do we actually see people face-to-face coming to us who are having issues with bingo? Or is that just something we think that was [an issue], or [has] sports betting become an issue for some of the younger men.

For vulnerable young people and Elders, harmful gambling can lead to several issues, including financial problems, mental health issues and social isolation. According to Calado, Alexandre and Griffiths (2017), gambling is a common activity among adolescents, and problem-gambling behaviours can lead to negative outcomes such as academic problems, family conflicts and increased risk for substance abuse. Moreover, older adults who engage in gambling may be at risk for developing cognitive impairment or dementia, which can exacerbate their financial problems (Shaffer 2017). In addition to these issues, vulnerable populations may face unique challenges in accessing gambling-related resources and support. For example, elderly individuals may have limited mobility or lack access to transportation, which can make it difficult for them to attend counselling or support group meetings (Hing et al. 2016a). Similarly, young people might be hesitant to seek help for fear of stigma or punishment from their parents or school authorities (Calado, Alexandre & Griffiths 2017). Finding strategies to address these issues has become a major issue for Aboriginal and Torres Strait Islander communities, especially when there are comorbidity factors such as drugs and alcohol use. that relate to harmful gambling for young people include:

1. mental health disorders such as depression, anxiety and ADHD
2. substance abuse or addiction
3. trauma or abuse
4. peer pressure or influence
5. social isolation or lack of social support
6. low self-esteem or self-worth
7. family history of gambling addiction
8. financial difficulties or poverty.

Comorbidity factors identified by workers that relate to harmful gambling for the elderly include:

1. loneliness or social isolation
2. physical health problems and chronic pain
3. cognitive decline or dementia
4. loss of independence or control
5. financial difficulties or retirement
6. depression or anxiety
7. history of addictive behaviours
8. lack of knowledge or awareness about the risks of gambling.

Mobile devices, apps and harmful gambling behaviour

Mobile devices and apps have become increasingly popular among people all over the world, including Aboriginal and Torres Strait Islander Australians. While these devices and apps have many benefits, they can also be a source of harm especially when it comes to gambling. Research has shown that gambling addiction is a serious problem among Aboriginal people in Australia (Hing, et al. 2014), and the availability of mobile devices and apps has made it even easier to gamble. These devices and apps allow people to gamble anytime and anywhere, which can lead to harmful behaviour (see Grooming for children, adolescents and young adults). Furthermore, many mobile gambling apps use psychological tactics to keep people engaged and encourage them to continue gambling (Griffiths & Auer 2019). This can lead to people spending more money than they can afford and experiencing negative consequences, such as financial problems, relationship breakdowns and mental health issues. To address this issue, staff identified the need to raise awareness about the risks associated with mobile gambling and the predatory nature of app-based gambling, and the link between ‘losing at the pokies and then going home and chasing losses’. This can include education campaigns, counselling services, and self-exclusion strategies and cultural programs.

Tailored approaches to harmful gambling

Tailored approaches for addressing gambling issues among Aboriginal and Torres Strait Islander people should consider a range of factors that include age, impact, affect, type, direct, indirect and intergenerational gambling culture. Workers identified that the age of the individual affected by gambling as having varying experiences with gambling and requiring different interventions. For example, tailored approaches must consider both the direct and indirect impacts of gambling on Aboriginal individuals and their communities: direct impacts may include financial hardship while indirect impacts may include social stigma and cultural dislocation. These tailored approaches must also consider the impact of intergenerational gambling culture on First Nations individuals and their communities. This includes the role of traditional practices and cultural norms in influencing gambling behaviour.

Desirability to move celebrations to gambling venues

Yeah, well, what I've seen probably in the last 12 months is when it rains, and 21st [birthdays] are all starting to come up, or they start looking at venues. So they have to go to the pokies, so the Elders can sneak in and put a quick press through, and you know, they just get an hour in and out, so when the party for slowed down a bit, they'll go in and have a bit of a press and then come back in and go back out. That's the thing, and then you’ve got those the environmental aspects of that, exactly that, where they are going into the air conditioning, because it's hot as hell outside and yeah, having a press and a few… starts to be quiet drinks, but then they turn loud and overspend.

Grooming children, adolescents and young adults

Several staff in FNGAP agencies recognised that young people are being ‘groomed’ into gambling.

You know, even things like Candy Crush, it's grooming (desensitising children to gaming behaviour).

Online and mobile devices can contribute to the grooming of young people for gambling addiction in several ways:

Online gambling is easily accessible through mobile devices, and young people can access gambling websites and apps with just a few clicks. This ease of access can make it difficult for young people to resist the temptation to gamble. Social media platforms can also contribute to gambling addiction by promoting gambling content, advertisements and endorsements by popular influencers. Young people may be influenced by these messages and develop an interest in gambling. Some online gambling sites and mobile apps offer free-to-play games, which may be designed to attract young people to the site. These games may use gambling mechanics such as loot boxes or virtual currencies, which can make them addictive and lead to real-money gambling. Many online gambling sites and mobile apps are not regulated, making it easier for young people to access them. This lack of regulation can also make it difficult for young people to know whether a site is legitimate or safe. Peer pressure can also be a factor in grooming young people for gambling addiction. Young people may feel pressure from their friends or social circles to gamble, which can lead to them developing harm from gambling.

Overall, it is important for parents, educators and society more generally to be aware of the risks associated with online and mobile gambling, and to take steps to prevent young people from being groomed for gambling addiction. This includes educating them about the risks of gambling and limiting their access to online and mobile gambling sites and apps.

Chasing losses and shame

‘Chasing losses’ is a term used to describe a situation in which a gambler continues to gamble in order to recover money that has been lost. This behaviour is common among individuals who gamble to harmful levels and can have significant negative consequences.

So you go into the social setting, and everyone's watching, everyone knows where the ding ding goes off. And you know, you walk out of there without a ding ding ding, and it's like, oh, well, that's a shame job, and you're already feeling bad about yourself for what you've done. So you go and try and win it back in private. It's [as] if they don't get you one way, they get you the other.

Research suggests that chasing losses can lead to increased gambling behaviour and contribute to the development of gambling-related harm. One study found that individuals who engaged in chasing losses reported more gambling-related harm, had higher levels of debt and experienced more financial stress than those who did not engage in this behaviour (Lambe, Mackinnon & Stewart 2018).

In addition to financial consequences, chasing losses can also have emotional and psychological effects. Research has shown that individuals who engage in chasing losses experience higher levels of stress, anxiety and depression than those who do not (Lambe, Mackinnon & Stewart 2018). Furthermore, the act of chasing losses can become a habit and lead to the development of a gambling disorder. A study conducted by Toneatto and Ladouceur (2003) found that individuals who engaged in chasing losses were more likely to develop gambling-related harm and less likely to seek help for this harm. Therefore, it is important to address the behaviour of chasing losses in individuals who gamble to harmful levels. Treatment options such as cognitive behavioural therapy have been shown to be effective in reducing this behaviour and improving overall outcomes for individuals experiencing gambling-related harm (Hodgins, Toneatto & Makarchuk 2007).

Relationship between gambling and violence

There is a growing body of research that suggests a significant association between gambling and violence against men, women, aged people and children. Several studies have examined this relationship and found that individuals who engage in problem gambling are more likely to perpetrate violent behaviour towards themselves and others. For instance, a meta-analysis conducted by Afifi et al. (2010) found that individuals with gambling problems were more likely to report perpetrating physical violence, verbal aggression and domestic violence. Similarly, a study by Volberg et al. (2006) found that individuals with gambling problems were significantly more likely to report perpetrating physical and emotional abuse towards their intimate partners. Moreover, elderly individuals who gamble may experience financial and emotional abuse from family members, caregivers and others who seek to take advantage of their vulnerability. According to Relationships Australia (2023), financial exploitation of older adults is a common form of abuse and can involve coercion, manipulation and misuse of their funds for gambling or other purposes. Children may also be at risk of experiencing violence related to gambling, particularly if they are exposed to parents or caregivers with gambling problems. Research has shown that children of parents with gambling problems are more likely to experience physical, emotional and sexual abuse, as well as neglect (Dowling et al. 2015b). There is evidence to suggest that harmful gambling increases the likelihood of violence among First Nations people. For instance, a study conducted by Cloutier and colleagues (2018) found that harmful gambling was positively associated with physical and emotional partner violence among a sample of Aboriginal adults in Canada. Additionally, a report by the Australian Institute of Family Studies (2019) noted that gambling-related harm can lead to increased stress, financial strain and relationship breakdowns, all of which can contribute to an increased risk of family violence. Furthermore, a study by Li and colleagues (2021) found that harmful gambling was positively associated with intimate partner violence and family violence among a sample of First Nations people in Australia. The authors suggest that this relationship may be mediated by factors such as financial stress, relationship conflict and substance use. The evidence suggests that harmful gambling may increase the likelihood of violence among First Nations people, although more research is needed to fully understand the nature of this relationship and the underlying mechanisms involved.

Low uptake of programs

For us, the main aim of our [FNGAP] program is community engagement elements. So we’re not throwing that gambling is a problem down everybody’s neck, but we're trying to build a place to have those open and safe conversations about this is what it can look like for some people.

There are several factors that contribute to the low uptake of programs addressing gambling harm among First Nations people. One key factor is the lack of culturally appropriate services and resources that are tailored to the specific needs and preferences of communities (Crisp et al. 2018). Additionally, many First Nations people may not be aware of the services that are available to them, or may face barriers to accessing these services, such as geographic isolation, transportation challenges, or stigma associated with seeking help for gambling problems (Dickerson et al. 2019).

But when we do run gambling programs, they [potential clients] try and avoid that little sector like the big black plague because no one wants to hear about it.

Another contributing factor is the lack of trust in mainstream service providers and a preference for community-based solutions (Crisp et al. 2018). Furthermore, the impacts of social and economic disadvantage need to be considered in developing and delivering services, as these experiences can increase the risk of gambling-related harm (Marshall, Rocchi & Stacy 2019). To address the low uptake of programs addressing harmful gambling among First Nations people, it is important to engage with communities and prioritise the development of culturally appropriate services and resources (Dickerson et al. 2019; Marshall, Rocchi & Stacy 2019). This may involve working with community leaders and Elders to ensure that services are respectful of cultural protocols and values and incorporating traditional healing practices into treatment approaches (Crisp et al. 2018). Additionally, efforts should be made to increase awareness of the services that are available, and to address barriers to accessing these services (Dickerson et al. 2019).

Financial literacy: Transitioning from harmful to safe gambling practices

In an evaluation of the My Moola Indigenous money management program as a gambling harm minimisation tool, Hing et al. (2018) found that course participants considered financial goal setting, financial security and financial literacy to be essential skills. However, many First Nations people only have low to moderate knowledge about most financial topics such as banking and investment, loans and credit, financial planning and goal setting, identifying spending leaks, budgeting and saving, superannuation and purchasing a home. In analysing the data from the pre-training survey, evaluators found a correlation between lower levels of financial literacy and more positive attitudes toward gambling, frequent gambling on high-risk gambling forms, experiencing more gambling-related harms, having a higher problem-gambling severity, and engaging in more risky financial behaviours while gambling. This correlation suggests that improving financial literacy has the potential to reduce gambling-related harms. The evaluators compared pre- and post-program survey results and found several aspects of financial literacy that did improve. Individuals reported higher levels of self-confidence in money management, financial knowledge and engagement in saving behaviours.

So we did a lot of work around education on that, but also supporting with budgeting and resources of sort of money, management and everything else as well to even setting up all about most of the families with Coles online or Woolworths online, where they had their standard order once a fortnight to be able to fit in with their budget, which allowed them to end up saving, saving money.

Many individuals applied their improved financial literacy to ensure their own gambling remained affordable and without harmful financial or other consequences and to also influence others to reduce any counterproductive gambling behaviours. My Moola helped to prevent and minimise harmful gambling among participants by influencing occasional gamblers to budget, save and keep gambling at affordable levels, and supported heavier gamblers to reduce their gambling frequency and expenditure and to set limits on their gambling (Hing et al. 2018).

Addressing harmful gambling: Interventions and principles

The National Aboriginal and Torres Strait Islander Health Plan 2021–2031 (Department of Health 2021) sets the national policy direction for Indigenous health and wellbeing. The Plan promotes culture and local-led initiatives to address harm to health and wellbeing and advocates for holistic interventions.

The FNGAP program logic articulates the critical strategies in its program as follows:

1. Raise awareness of gambling-related harm using a culturally safe and responsive approach: Inclusive of education and awareness campaigns to increase knowledge and understanding of the risks associated with gambling, as well as the resources available for individuals and families affected by gambling harm. These awareness-raising strategies can be delivered through various media channels and can be tailored to the specific needs and cultural context of the First Nations community.
2. Build protective factors against gambling harm: Prevention programs that are led by the community and incorporate traditional cultural practices and values may be more effective in addressing gambling harm in First Nations communities. These programs can provide opportunities for community members to come together, share their experiences and develop strategies to address gambling harm.
3. Provide First Nations communities with positive alternatives to gambling: Economic development initiatives that provide alternative sources of income and employment opportunities can help reduce the reliance on gambling as a source of income in First Nations communities, promoting access to Country services and cultural activities, and promoting more intergenerational activities in communities. This is difficult to do when people do not have alternatives to gather out of the weather (e.g. Shopping centres, food courts, recreation centres, sporting arenas) and in pursuit of better health and wellbeing options.
4. Provide effective counselling/referrals for people experiencing gambling-related harm: Access to treatment and support services is essential for individuals and families affected by gambling harm. These services should be culturally sensitive and responsive to the unique needs of each community. The Foundation requires that FNGAP agencies provide financial and therapeutic counselling or warm and supportive referral pathways to mainstream services.

5. Engage with ACCOs and other organisations to provide more culturally safe gambling-related harm services: Including regulation and enforcement of gambling activities can help prevent and reduce gambling harm in First Nations communities. This can include measures such as limiting the availability of gambling venues and machines, enforcing responsible gambling practices and implementing harm minimization strategies. The legislation underpinning the Foundation limits the scope of work in this area. Alternative strategies include advocating, educating and engaging colleagues in other organisations about the impact of gambling related harm and working within a coalition or a community of practice.

FNGAP members understand that each intervention will need to be tailored to the specific cultural context and needs of a community, and that it is imperative to engage with community members and leaders throughout the planning, implementation and evaluation of these interventions to ensure they are effective and sustainable. If this level of engagement can be achieved, then these interventions align with the policy, programming and decision-making initiatives embedded in state and national policies and programs and will go a long way to support self-determination, Treaty and truth-telling.

Cultural dosing: Culture as a protective factor against harmful gambling

The amount people spend on gambling, compared to their overall income, is managed in agencies across the world by guidelines and coherent strategies that are referred to as a clinical dose. Many people understand the term clinical ‘dose’ in relation to gambling harm, i.e. the amount of money to spend on gambling each day and therapeutic interventions needed to change harmful gambling behaviours are considered in a clinical context. A recommendation in the FNGAP evaluation, however, called for culture-led practices and cultural strategies to be embedded in all of FNGAP’s work. This allows for the agency to give consideration to ‘cultural dosing’, a time-boxed intervention that develops people’s cultural exposure to mitigate the frequency and spend on harmful gambling. One example of a cultural parenting program for Aboriginal people in Australia suffering from harmful gambling is the Ngallu Wal Aboriginal Child and Family Centre’s Gambling Harm Prevention Program (Breen, Hing & Gordon 2014). This program focuses on promoting culturally appropriate approaches to gambling harm prevention and providing support for families and children affected by gambling. Incorporating cultural values and practices, including storytelling, art, and dance, as well as community involvement and engagement, the program is designed to address the specific cultural and social factors that contribute to gambling harm among First Nations people in Australia. A cultural dose might involve FNGAP staff to develop and deliver:

An eight-week cultural parenting program to reset the family’s finances and cultural immersion to ensure the health and wellbeing of ‘our future Elders’. A series of workshops on spear-making to use on Country. Over a 12-week period, commit to weekly participation in a dance group, in preparation for a performance at an upcoming community event. Establish a cultural immersion experience in which Elders can Welcome babies to Country. Workshops or sessions focused on cultural practices and values – participants might engage in activities such as storytelling, art-making and dance, as well as group discussions and education about how to prepare for a Treaty.

Women’s weaving workshops, men’s carving workshops and art shows. Engage First Nations entrepreneurs in developing the capacity to participate in First Nations fashion, cooking and business development of ‘side hustle’ products for sale in markets.

In developing interventions aimed at promoting self-determination, the literature emphasises taking a co-design approach that promotes community engagement and builds local capacity, ensures that culture is integrated into programs, and facilitates partnerships capable of collaborating in holistic ways to actively reintroduce cultural determinants of health and wellbeing across the life-course (Whiteside et al. 2020; Department of Health 2021). Combining these strategies and principles within a holistic framework will require consideration of the following strategies.

Yellow: Intervention strategies Blue: Questions to support focused, targeted interventions across the life course to developing strategies to break the cycle of harmful intergenerational gambling culture and to promote understanding that gambling can harm multiple people in families, across their lifetime and between generations. Orange: The cultural determinants of health and wellbeing.

FNGAP has identified five key strategies areas that need to be implemented in its work. Implementing these strategies will require different investments of time and resources, as well as the development of further education resources and interventions. Implicit in this work is the need to coordinate key targeted actions across all services, and contribute to co-design, evidence generation and knowledge translation activities.

Addressing cultural determinants of health and wellbeing: A life-course approach

The guide Country Can't Hear English provides insights into cultural determinants of health and wellbeing (Arabena 2020). Cultural determinants are premised on extensive and well-established knowledge networks that exist within communities and in community-controlled sectors, human rights and social justice frameworks. The embedding of cultural determinants into every-day practices embraces ideals that include individual and collective rights, and freedom from discrimination, assimilation and destruction of culture. It also sets up opportunities for First Nations peoples to live their best life. Broadly speaking, culture is comprised of a group’s ideas and self-concepts – e.g. artefacts, attitudes, beliefs, customs, norms, symbols and values – and the lived experience of these in different contexts (Jones, Thurber & Chapman 2018). Culture also includes historical events and standards of behaviour that evolve and change over time (Bessant & Watts 2007). An evidence paper developed by the Mayi Kuwayu Study (Salmon et al. 2018) linking First Nations culture and wellbeing against the cultural determinants, has identified the following core elements needed for Aboriginal and Torres Strait Islander people to maintain culture.

Connection to Country

Improved procedures for Native Title and land claims. Increased First Nations management of Country. A focus on holistic relationships between societies and their Country by incorporating more

programs such as Caring for Country to reinvigorate links between health and environment.

People returning to Country when unwell to reinvigorate links between health and

Environment.

Other strategies supporting the hunting and gathering of food on Country that benefits

individuals by promoting physical activity and the community through food sharing.

Encouraging non-Indigenous peoples, particularly health practitioners, to gain an understanding of the importance of Country.

Cultural beliefs and knowledge

Practising holistic care and healing programs that incorporate culture and combine First Nations healing methods with biomedicine. Funding and developing First Nations cultural centres. Providing children with cultural experiences and knowledge through family interactions,

community collaborations and school influences, such as involvement in NAIDOC (National Aboriginal and Islander Day of Observance Committee) Week.

Assisting people affected by forced removal programs with family tracing and reunion.

Keeping young people out of detention and child protection services by using First Nations-led programs that provide spiritual guidance and support from Elders and other mentors.

Research shows, for example, that the employment of Aboriginal grandmothers providing care to Aboriginal mothers in metropolitan Perth has improved the health of babies (Bertilone & McEvoy 2015). Similarly, a 2010 study of Aboriginal people with cancer showed that Indigenous healing processes were preferred by some because they helped with reconnection to heritage, land, culture and ancestral spirits (Shahid et al. 2010).

Language

Evidence suggests that there is a positive relationship between language and improved wellbeing, one that is associated with better physical health, social and emotional wellbeing, healing for intergenerational trauma, community interconnectedness, cultural continuity and higher bush food consumption. This relationship can be encouraged by:

community members attending, participating and using language in ceremonies, particularly those involving songs establishing a choir (e.g. Mullum Mullum Elder’s Choir uses Aboriginal AUSLAN as a language that connects them all together) providing adequate funding to assist access to language resources, including children’s books combined with a strong family and community focus on storytelling and reading in language more radio and TV broadcasting in language bilingual models of education.

Family, kinship and community

A strong sense of community exists within many places. Work with Torres Strait Islander communities, for example, has shown there is a strong connection with family and kinship even for those who had never been to the Torres Strait (Salmon et al. 2019:22). With intrinsic responsibilities and obligations that confirm and reinforce membership, kinship has positive effects on maintaining cultural knowledge, particularly for children. This is achieved by:

restoring, promoting and maintaining health with community-based programs using family and kinship networks to pass on knowledge about health information ensuring children are raised in a safe and happy environment where their wellbeing, education and safety are shared with older family members and community addressing inequity in the social determinants of health, such as access to education,

employment and housing

maintaining social and cultural structures that strengthen connection to kinship, family, culture and land.

School sporting programs also help in a number of ways by improving children’s school attendance, their attitudes toward learning, social and mental skills, physical and mental health and wellbeing, social inclusion and cohesion, and connection to culture. Team activities that prioritise health and wellbeing also reduce people’s exposure to harmful influences and behaviours.

Cultural expression and continuity

The Mayi Kuwayu Study (Salmon et al. 2018) recognises that resistance and resilience are as much a part of a contemporary Aboriginal and Torres Strait islander culture and identity, as are the effects of colonisation. Strategies to encourage these include:

reclaiming history with the support of therapy transmitting culture and connection through ceremonies, art and singing holding Welcome to Country ceremonies having creation stories recognised in children’s books, holding smoking ceremonies (e.g. Bubup Wilam Early Childhood Centre has regular smoking ceremonies for the children), artefact making and painting supporting Aboriginal and Torres Strait Islander young people as artists, performing stories

through hip hop and rap

playing musical instruments in both Indigenous and non-Indigenous settings holding playgroups and pre-school in aged care centre maintaining and learning about culture to help children with identity and education connecting with land and learning from Elders, e.g. collecting, eating and sharing bush tucker.

Creating cultural spaces has also been key. For example, art centres have social and cultural benefits as well as positive effects on the economic, physical, psychological and emotional development of both individuals and communities, while playing football has been found to provide a contemporary space for some Aboriginal men to maintain and develop hunting techniques (Salmon et al. 2019).

Self-determination and leadership

This domain relates specifically to reclaiming and using governance structures that contribute to the healthy patterns of individual, family and community life. Identified strategies that are linked to better wellbeing include:

participating in leadership programs introducing culture-based governance models developing and supporting youth leaders and role models having culturally safe policies and practices such as those that bring cultural considerations into policy development, planning and training ensuring Aboriginal and Torres Strait Islander control.

There are several ways in which the effective implementation of cultural determinants could be enhanced. These include the following:

Local ethics committees consider all policies and programs developed outside of the community and without local community leadership prior to their implementation. Membership of local ethics committees would include cultural leaders to ensure policies and programs align with Aboriginal and Torres Strait Islander people’s desire for cultural continuity, and to facilitate equity, reciprocity, respect and responsibility (AIATSIS 2012; NHMRC 2018). Developing and promoting local cultural principles and protocols – such as leadership from Elders or culturally strong people in heritage protection – for facilitating, negotiating and overseeing the implementation of contracts, agreements, workforce orientation and development, representative and advisory committee structures, training courses and guidelines to enhance cultural security.

Providing untied funds to community organisations to progress the maintenance or revitalisation of cultural determinants to reflect local Aboriginal and Torres Strait Islander priorities, perspectives and voices, and elevate local power over their governance, design and delivery (Williams 2018). Committing resources to ensure culturally relevant knowledge translation, that is aligned both to cultural governance and Elder wisdom structures, can occur throughout the implementation process. Ensuring multigenerational and intergenerational considerations are accounted for in the implementation process to ensure knowledge transmission, learning and exchange. Facilitating learning and exchange strategies across and between local and regional language groups, organisations and individuals to drive the creation, development, production and distribution of cultural works. Supporting locally driven research that is completed by local community researchers. Negotiating Intellectual Property rights. Embedding resources that facilitate people’s connection to Country and language development in all policies and programs relating to Aboriginal and Torres Strait Islander peoples.

Ultimately, all cultural determinants will need to facilitate and support community members to achieve their individual and collective autonomy, and promote empowerment, healing and relationship strengthening. Not only are these approaches likely to improve health and wellbeing outcomes, but they can also positively impact other social determinants (education, employment, housing) that are essential to supporting Aboriginal and Torres Strait Islander people to live their best life.

Measures advocated for by community members

Implementing cultural determinants will require a shift from top-down, centrally managed planning procedures to participatory, bottom-up, community-driven processes. This change will enable locals to act collectively and promote an enhanced engagement, cultural continuity, a revitalisation of traditions and increased empowerment (Wahid et al. 2016). Additional benefits will include corporate and environmental innovation, healthier ecosystems and entrepreneurial action. The following changes will be relevant for systems and institutions wanting to implement cultural determinants:

Eliminating institutional obstacles together with introducing beneficial policies that lead to improved incentives. Improving access by community members to opportunities and resources that facilitate cultural determinants according to their needs and priorities. Engaging Indigenous businesses. Including cultural knowledge holders on Boards or involving them in decision-making

positions within organisations.

Supporting cultural determinants work. Assessing the extent to which agencies have supported the implementation of cultural

determinants, built coalitions and changed and/or improved their work practices (e.g. cultural safety).

Measuring organisations progress/capacity (e.g. cultural safety). Building capacity at a local level is an important ingredient for the sustainable implementation of cultural determinants, as it not only provides local stakeholders with an opportunity to participate in decision making but also enables community ownership, a key component of empowerment.

Other indicators will be on a more personal level, such as:

greater self-assurance in their cultural abilities increased alertness and sharing of views the sharing of information with their children being able to have a conversation in language for one hour with other members of their family.

This is because cultural determinants characterise empowerment as a deliberate and continuous process that is grounded in the community. It includes empathy, collective action, critical reflection and reciprocal respect – a process that gives those with a lesser share of important resources better opportunities for accessing and managing such resources. Bennet (2002) adds that empowerment involves strengthening the capacity of communities and individuals to participate, direct and hold accountable institutions that influence their lives. For individuals, empowerment includes processes that help them to manage their resources, develop their decision-making abilities, and work cooperatively with others. Approaches involving social mobilisation are frequently classified as empowerment, implying that this is an ongoing process rather than an isolated event. Bennet (2002) calls this ‘mobilisation empowerment’, a process that extends the connections, capabilities and information necessary for lifelong empowerment. This process can give communities a fresh understanding of themselves and also increase cohesion and the potential for cooperation.

Implementing cultural determinants will require a shift from top-down, centrally managed planning procedures to participatory, bottom-up, community-driven processes. This change will enable locals to act collectively and promote an enhanced engagement, cultural continuity, a revitalisation of traditions and increased empowerment (Wahid et al. 2016). Additional benefits will include corporate and environmental innovation, healthier ecosystems and entrepreneurial action. The following changes will be relevant for systems and institutions wanting to implement cultural determinants:

Eliminating institutional obstacles together with introducing beneficial policies that lead to improved incentives. Improving access by community members to opportunities and resources that facilitate cultural determinants according to their needs and priorities. Engaging Indigenous businesses. Including cultural knowledge holders on Boards or involving them in decision-making

positions within organisations.

Supporting cultural determinants work. Assessing the extent to which agencies have supported the implementation of cultural

determinants, built coalitions and changed and/or improved their work practices (e.g. cultural safety).

Measuring organisations progress/capacity (e.g. cultural safety). Building capacity at a local level is an important ingredient for the sustainable implementation of cultural determinants, as it not only provides local stakeholders with an opportunity to participate in decision making but also enables community ownership, a key component of empowerment.

Other indicators will be on a more personal level, such as:

greater self-assurance in their cultural abilities increased alertness and sharing of views the sharing of information with their children being able to have a conversation in language for one hour with other members of their family.

This is because cultural determinants characterise empowerment as a deliberate and continuous process that is grounded in the community. It includes empathy, collective action, critical reflection and reciprocal respect – a process that gives those with a lesser share of important resources better opportunities for accessing and managing such resources. Bennet (2002) adds that empowerment involves strengthening the capacity of communities and individuals to participate, direct and hold accountable institutions that influence their lives. For individuals, empowerment includes processes that help them to manage their resources, develop their decision-making abilities, and work cooperatively with others. Approaches involving social mobilisation are frequently classified as empowerment, implying that this is an ongoing process rather than an isolated event. Bennet (2002) calls this ‘mobilisation empowerment’, a process that extends the connections, capabilities and information necessary for lifelong empowerment. This process can give communities a fresh understanding of themselves and also increase cohesion and the potential for cooperation.

Healey (1998) emphasises the importance of collaborative approaches for public participation and in increasing the legitimacy of decisions. As a collaborative approach can bring diverse stakeholders together, it can assist to solve complex problems like climate change by reducing conflicts and helping to build consensus. What is also needed is a tolerance for Indigenous innovation. This is because the successful implementation and uptake of cultural determinants may be particular to Indigenous knowledge systems, embedded in Indigenous implementation science and not easily identifiable by people outside of the community. Thus, both trust-building exercises and empowerment will be key. Measurement was identified as a weaving together of many threads. Participants noted culture is embedded in policy, procedures and in organisational structures, and there is a genuine commitment to implementation. However, measuring the impact of implementation occurs at the intersection of a range of ideals and experiences. The Country Can’t Hear English guide includes measures that have been determined by the community as important, as well as cultural measurement frameworks (Arabena 2020).

The implementation of FNGAP strategies that prepare people for Treaty, and address gambling harm, could include the following measures:

1. Using a life-course approach: A life-course approach recognises that gambling harm can impact individuals at different stages of their lives. Strategies should be designed to address gambling harm across the lifespan, from early childhood through to old age.
2. Incorporating cultural values: It is important to incorporate cultural values into any strategies designed to address gambling harm. This might involve working with First Nations cultural advisors to develop programs that align with cultural practices and values.
3. Taking a trauma-informed approach: First Nations communities in Australia have experienced significant trauma and intergenerational trauma. A trauma-informed approach recognises the impact of trauma on individuals and communities and seeks to create a safe and supportive environment for healing.
4. Building capacity: It is important to build the capacity of First Nations service providers to deliver effective programs and services. This might involve providing training and support to First Nations service providers to ensure they have the skills and knowledge needed to address gambling harm in a culturally sensitive way.
5. Promoting community ownership: Community ownership is essential for the success of any strategy designed to address gambling harm. It is crucial to involve First Nations community members in the design and implementation of programs and services to ensure they have a sense of ownership and investment in the process.
6. Monitoring and evaluation: Finally, it is important to monitor and evaluate any strategies designed to address gambling harm. This will help to identify what works and what doesn't work, and allow for continuous improvement over time. Evaluation should be done in a culturally sensitive way, with First Nations community members involved in the process.

The following issues were identified in the workshops with FNGAP Agency staff.

Limitations on data collection

1. Current reporting templates do not advise how to overcome clients ‘telling you what they want to hear’ rather than ‘what they want to tell you’. We find that to overcome stigma, in working with community, if you're asking for feedback (from a client), they'll be very respectful, very nice to me. Aunty may say what she thinks. But generally, they'll be very respectful and whatever. If you give them a piece of paper to fill in anonymously, you are probably more likely to overcome any of that stigma or embarrassment about asking the service provider to assess to understand your outcomes.
2. Current program-related data collected are basic demographics, but this additional information is not passed on to the VRGF. So that's where we draw our data from. And that's how we report to the VRGF, so how many clients have you seen under the last reporting period, this many males, this many females, those sorts of basic demographics. But again, it doesn't really tell. Often the VRGF will ask out of interest over the top of that, what are the gambling modes that people are most presenting with? And we will report that anecdotally. We don't capture it now in our database.
3. We might need different methods to collect client information, and measure the impact of our services on the health and wellbeing outcomes of clients, families and communities (direct and indirect impacts on gambling). I did a survey with some happy faces once you know, one of those. It didn't really work out. There are better ways of getting [feedback]. So maybe we can collaborate with VRGF to get those sorts of resources at hand, rather than just the templates that we can use for everyday use.
4. The possibility of having a joint report from all programs, rather than a single report from each service. I think that if we could bring the paper reports down to something relatively short and straightforward. Then meet regularly to discuss the programs then the nuances come out in conversation, which is what I find when I meet with you all. There's more in that conversation than there ever is on that report, which is normal. And I think also in conversation, people remember stuff that they've done or complexities that they've experienced. So it might be talking about how the fishing [day] combines with gambling prevention, and then somebody else says here we've got that same issue with this program. So in terms of telling the story of the whole program, I do think a joint report is a lot more potent than individual reports. But that’s my own view at the moment…

Having a compound report like that is going to give more weight or more power to the negotiations, and the information that you provide to the government is going to make a difference? Because I can see where there is going to be, you know, we all need to do our own individual reporting. I agree with that. But I can say that there may be a space where you know, doing something combined may offer a bit more where it leads to.

The adequacy of the reporting template

1. It is difficult to quantify the percentage of time spent on FNGAP. So the regional services would be looking at their referring out sometimes to mainstream services because the resources are not as in-house as ours. So yeah, that takes time. And I guess there are some questions about what percentage of staff time are given to these sorts of issues. I just make it up? I don't know. 5% or 10%?
2. The planning and reporting template is not working. People indicated struggling to find time to fill out the form, that is not opened, has not been seen and feedback has been mixed. So I think, for us, sort of with all our reporting requirements, I think storytelling is a massive piece that we always ensure. I guess in terms of whenever we are going for a grant or a program or whatever, we can really ensure that we can continue to document in a way that can really define the storytelling of the work that we're doing and community stories as well at the same time.
3. Better for FNGAP staff to report on how time is prioritised across the week, rather than measuring the number of people who come to programs.
4. The template does not match with what we are doing and there is nowhere to record the range of activities we do. If the template asked questions about what sort of activity, ’[as in] fundamentally, what do you do?’ Another heading is what else did you do? Apart from that, was there something else that you did with this group? And by the time we get to the bottom’ it's at all. I actually put that in the first bit, you know, so then you g’, I'm gonna cut and paste. ’… So I'd rather see sections that said, What did you do [for] other activities? You know, with what groups or something? Because otherwise, you think, we've missed the boat on this…
5. The length of the template and the expectations for delivering detail in the reporting template is unclear. So the template, you know, doesn't say in 300 words, so I could write a 1500-word essay about something. So one with more direction like, what do you [think is] okay? … How much do they want to know? Because, you know, what do you want out of this?

Measuring the success of the program

6. It is difficult to measure the success of the program. It is difficult to compare the impact of the gambling awareness programs within services, across organisations and in regions. If you're asking me to assess the outcomes, the measures become pretty complex and, you know, did I provide a good service as a financial counsellor if I rescued the client and put a bandaid over a few things and the client was delighted? (But) I may not have achieved some of the fundamental goals of providing a gambling counselling service, so you must be careful.
7. Reporting burden is real and staff feel pressured to choose between serving clients and serving funding agencies. Look, sometimes in some of the programs that I used to run, I got so busy in doing the [work that] I was making it up in the reporting, which wasn't fair because I was misrepresenting the work that was happening out there in the community. And it was also complicated to give accurate advice back to funders. So I was really, really pressured. I felt very pressured in my community organisations to make sure that everyone's needs were met. And I always privileged the people who were coming in through the door who needed assistance rather than the funding bodies.
8. It is difficult to know how to measure the success or value of the work done with recidivist clients, or clients with different gambling types. There are some possible approaches to understanding the successes of the program across user types (recidivist/’dose’ clients) and gambling types (online bingo, Sportsbet, pokies or racetrack), e.g. Randomised Control Trials.
9. The flexibility of the program is both a blessing and a curse even though the flexibility is appreciated. And yes, we do have those templates for reporting. I think sometimes the flexibility that we all have to do different things is both a blessing and a bit of a curse sometimes in disguise. ‘So I guess for me I'm really appreciating the flexibility to build the program, how the mob wanted you. Instead of dictating, you must do this, you must do that. Oh, my God, we're not meeting KPIs. You know, what staff need in the different organisations may be completely different, so for me, I appreciate the flexibility.
10. It could be useful to include people’s personal capacity to pay for everything they need through the fortnight, which is the greatest indicator of program success. So generally speaking, though, it is having cash at the end of the week conservatively instead of being skint. It is limiting or reducing the dependence on services for that extra food, better support and all those sorts of things. It's being able to afford to put the money on credit on your phone and fuel in the car. And being able to do a few luxuries, like having a different brand in the supermarket.

Continuous quality improvement

11. There is a need to record what is not working well for the program – we need space in the reporting template to do that. So I guess we struggle with some of the templates that we're currently using because it's tough to know. When we put the draft, we know whether we try and paint the picture of the things that are happening, and sometimes I put in what didn't really work, you know, I don't know if that's funding authority. They want to know whether or not. I think that's where we, that's where we get better learnings from. Yeah, you know, if an Elder tells me that we shouldn't bother doing that next time because it's rubbish. That's a great learning, you know
12. We need to ensure the quality improvement delivered by the program is mapped back into people’s lives and experiences, and these need to be recognised in the way we do reporting. The way that we've been doing it is through a narrative story. So within the reporting, we might pick somebody that's attended the community activity days and in a sense, do a brief case study on their journey. Their engagement with the program and their hesitation for want of the better word actually faded over time. We've had people that have come in with addictions of a wide-ranging variety and actually have got stable after, they've actually obtained work. (We created case studies / stories / videos) to be able to just showcase, I guess, the impact and the work that the staff and everyone involved are doing, but also in many ways to be able to show the growth and the strength of our communities as well. Which is really great.
13. There is power in coming together and talking about the work, such as in the summation of one discussion in which the facilitator reported back to everyone. … just in that one little conversation, I see how we could fill out reporting and planning templates. Because what I've just been able to do in that little yarn was find out that there are some exciting research or more profound understanding opportunities, particularly around how people are playing the online games. I've heard that there are different age group issues now. So you've got older people where it used to be one domain, but that's kind of leaking through. I'm now hearing how gambling feeds into our cultural processes of extended families, and it's really mapping itself against those extended families.’ And also, there is becoming like terrible news feeds out of Fox TV or something. It's becoming a 24/7 access point for people to throw a whole lot of money away in ways that are now giving you warm referrals through doctors and those kinds of things. So I can already see ways in which you can start to do your forward planning but also to do your reporting. And that all came out in just that little yarn. You know, I started off there talking about how you're doing the delivery work. And what (an Agency team member) was able to say is, you know, they’ve got rolling groups of 40 students through giving the same kind of information about who he is. And then they are personalising and creating rapport with young people so they will feel more comfortable or at least know who (the Agency team member) is and what they do.

And because they've engaged with him in a therapeutic environment, like our work, that he's actually cultivating a therapeutic relationship with children going forward, that's going to be powerfully impactful for them when they actually get to that age where it might be a significant risk. So that really talks to me about a method that he uses to start to develop relationships. He also talked about a barbecue that is an on Country in the bush natural environment. It's not in a venue or a hole or anything like that. So helping people connect back to the Country and to not be saturated with the big bells and whistles and the sounds that you hear. You're creating a different soundscape for people by taking them to a barbecue. They're listening to the sausages on their bloody barbecue plate. Not friggin that ding ding ding going off in their wallets or on their phones, brilliant work.

I’ve just heard that you've also done fantastic information dissemination. All your posters and all the information is out there, and you've put it in really accessible places. I love going to the toilet and reading the back of the toilet doors. I'm so pleased to put it all there. There's something about the back of those toilet doors in our community orgs. They're an excellent place for disseminating information.

Addressing the themes in reporting through coordinated action

The effective collection and reporting of information is crucial for the success of the First Nations Gambling Awareness Project (FNGAP) and its collaboration with the Foundation. In order to ensure comprehensive data gathering, the information collected goes beyond basic client demographics. It encompasses various aspects such as reporting on emerging issues and trends, successful partnerships and warm referrals, as well as areas that require improvement. Furthermore, the reporting framework provides space to share details of community presentations, develop case studies on client experiences, and gather feedback through short surveys. It also encourages the reporting of strategies related to "cultural dosing" and multigenerational engagement. To facilitate joint reporting, regular meetings across all service delivery sites to compile a comprehensive report on activities across the services. A community of practice approach is proposed for adoption among workers, fostering collaboration and knowledge sharing. Recognising the challenges of finding time for reporting, the templates are designed to provide structure and streamline the process. The inclusion of weekly touchpoints, scheduled reporting tools, and the use of ‘stoplight reporting' further enhance the effectiveness of monitoring and measurement. With a focus on continuous improvement, the reporting framework aims to involve the community in developing measurement frameworks and offers professional development opportunities. Ultimately, the goal is to document both successes and areas for improvement, ensuring that the FNGAP and Foundation can make informed decisions to address gambling harm and achieve their shared objectives.

Implementing a Performance Measurement Framework

A Performance Measurement Framework for First Nations gambling programs in Australia would provide a structured and systematic approach for evaluating the effectiveness of these programs. Such a framework would typically include the following elements:

1. Goals and objectives: Clearly defining the goals and objectives of the gambling program and ensuring that they align with the needs and priorities of the First Nations communities.
2. Key performance indicators (KPIs): Identifying the KPIs that will be used to measure the success of the program. These may include factors such as the number of participants, the rate of problem gambling among participants, and changes in gambling-related behaviour.
3. Data collection and analysis: Establishing methods for collecting and analysing data related to the program’s KPIs. This could involve surveys, interviews, or other methods of data collection.
4. Reporting: Creating a system for reporting on program performance, including regular reporting to program stakeholders and the wider community.
5. Continuous improvement: Developing a process for continuous improvement of the program based on feedback from stakeholders and program participants.
6. Cultural sensitivity: Ensuring that the performance measurement framework is culturally sensitive and respectful of First Nations people’s values, customs and traditions.

By implementing a Performance Measurement Framework, FNGAP can more effectively track their progress, identify areas for improvement, and demonstrate their impact to stakeholders and funders. This can help ensure the ongoing success of these programs in addressing gambling-related issues within First Nations communities.

Performance Measurement Framework reporting

The workers proposed that reporting, as it currently is, is time consuming and neither clear nor practical. They suggested that there would be more benefit from writing short reports on a monthly basis and then coming together with an independent facilitator every three months to develop a joint report that identified a focus area for improvement, and developed specific performance measures that are agreed to by all parties. In this strategy, a reporting timeline should consider the frequency of meetings so the workers can achieve the following.

1. Determine the overarching goals and objectives of the opportunity for joint reporting

initiative: This will help to guide the development of specific performance measures and indicators that are appropriate for a focus in which all agencies have a role and responsibility to report.

2. Identify key performance indicators / measures: Once the goals and objectives have been

established, the next step is to identify the key performance measures that will be used to track joint progress towards these goals. These measures could include things like the number of services participating in joint reporting, the frequency of joint reporting meetings, the quality of the reports generated, and the impact of the initiative on service delivery.

3. Establish performance targets: With the key performance measures identified, the next step is

to establish performance targets for each measure. These targets should be realistic and achievable, and based on the goals and objectives of the initiative.

4. Monitor performance: Once the performance measures and targets have been established, the

next step is to monitor performance against these targets. This will involve regular reporting and analysis of data related to the key performance measures, as well as regular meetings with stakeholders to discuss progress and identify areas for improvement.

5. Take corrective action: If performance is not meeting the established targets, corrective action

should be taken to address any issues or challenges that are identified. This could involve revising the performance measures and targets, or implementing new strategies and initiatives to improve the program’s performance.

6. Evaluate outcomes: Finally, the performance management framework should include an

evaluation component to assess the outcomes and impact of the opportunity for a joint reporting initiative. This could involve conducting surveys or focus groups with service providers and users to gather feedback on the initiative, as well as analysing data related to service delivery and outcomes. The independent facilitator could write an in-depth report on the work and outcomes, which could be used to guide future improvements and adjustments to the initiative.

Monthly reporting requirements

Key Performance Indicators

Number and type of emerging issues, trends and community activities reported on FNGAP’s social media Number and type of successful partnerships and warm referrals reported and their impact Percentage of positive feedback received Number and type of community presentations held and number of people present Number and type of completed client surveys and documentation of feedback provided Number and type of ‘cultural dose’ strategies reported Number and type of multigenerational engagement strategies used Number and type of financial literacy/empowerment programs delivered and evaluated

Targets

Report on at least three emerging issues, program activities, information sharing exercises or trends per week on social media channels, particularly the new Yarn Up website. Establish or sustain two successful partnerships per quarter, and document how these partnerships have benefitted men, women, young people and Elders Hold and report on at least one community activity and/or cultural dose activity per month Collect at least 20 completed client surveys per quarter outlining how the program has transformed their experiences Implement and report on the type, accessibility and acceptability of cultural dosing strategies used in the month prior Engage with at least 10 multigenerational, men’s or women’s groups per quarter Hold at least three joint meetings of all FNGAP funded program staff to share information, strategy and resources

Monitoring and measuring performance

Track the number of emerging issues and trends reported in reports Keep a record of successful partnerships and warm referrals Monitor the feedback received and address any issues accordingly Keep a calendar of community presentations and track attendance Collect and analyse completed client surveys Keep a record of reported cultural dosing strategies and implement successful ones Track the number of multigenerational engagements and record feedback received

At every three-monthly joint meeting, an agenda be developed in which all FNGAP staff present and:

Analyse the monthly reports on emerging issues and trends to identify any patterns or themes Evaluate the success of partnerships and warm referrals and identify areas for improvement Identify key issues in client feedback and develop strategies to address them Review attendance at community presentations and adjust schedules as needed Analyse client survey data to identify areas for improvement in the client experience Review reported cultural dosing strategies and implement successful ones Analyse feedback received from multigenerational engagements and adjust strategies as needed Decide on ‘key focus areas’ for all FNGAP staff – and determine the length of time for the focus.

Action

Implement strategies to address emerging issues and trends Develop new partnerships and warm referrals based on feedback received Address negative feedback and implement solutions to improve the client experience Adjust the schedule of community presentations to increase attendance Implement changes to improve the client experience based on survey data Implement successful cultural dosing strategies Adjust multigenerational engagement strategies based on feedback received

Review and refine

Continuously monitor and measure performance against targets Gather feedback from the community and adjust strategies as needed Regularly review the performance framework and make adjustments as necessary to ensure that it remains relevant and effective Develop a ‘community of practice’ between FNGAP workers, and generate reports from meetings of the staff

This report is the result of extensive consultations with FNGAP staff and the Victorian Responsible Gambling Foundation. The findings detailed herein will be used in the development of the FNGAP’s performance framework and program guidelines, reporting templates for use by the FNGAP staff, and in the development of agendas and strategies for focusing the discussions of joint FNGAP Community of Practice meetings.

1. FNGAP to be more overtly strengths-based, and FNGAP and Foundation having a role to play in supporting communities’ financial aspirations (pp 5, 6, 12)
2. FNGAP and Foundation to adopt the principles of Table 1, and incorporate into their Guidelines (pp 13-14)
3. Foundation to promote programs to address the specific needs of different generations and genders (pp 16-19)
4. Review Foundation’s Harm Framework from a First Nations perspective (p 6)
5. Continued focus on First Nations Health and Wellbeing as holistic; incorporating physical, mental, emotional, social, environmental and cultural determinants (pp 39 - 41)
6. Foundation to work with children and young people to address intergenerational transfer of harmful gambling culture (p 19)
7. FNGAP to incorporate culturally appropriate Traditional Healing practices involving Elders and community members (p 20)
8. FNGAP to incorporate a trauma-informed lens which acknowledges historic and systemic issues in prevention and intervention efforts (p 20)
9. FNGAP conducts school-based presentations on the risks and consequences of gambling, and strategies to resist gambling-related harms (p 20)
10. FNGAP conducts community-based programs, campaigns and workshops that provide balanced information on the benefits and risks of gambling (p 22)
11. Along with increasing awareness and involving communities, FNGAP works to identify and address root causes of harmful gambling (p 23)
12. Foundation to deliver training on engaging and preparing communities for Treaty (pp 11- 13)
13. Foundation to fund research to establish if harmful gambling may increase the likelihood of violence among First Nations people, and to understand fully the nature of this relationship and the underlying mechanisms involved (p 29)
14. Foundation to create campaigns or other efforts to increase awareness of the FNGAP services that are available, and to address barriers to accessing these services (p 30)
15. Foundation to continue to fund and expand on financial literacy programs (p 30)
16. Foundation to provide training and handbook resources to FNGAP on Cultural Dosing: Culture as a Protective Factor (p31-37), Strategies to Address Contemporary Gambling Issues in Victoria (p 38) and Addressing cultural determinants of health and wellbeing: A life-course approach (p 39)
17. FNGAP to adjust reporting over time to increase efficacy and cultural safety, starting with a yarning group reporting process, and working towards those suggestions on Table 5 (p 51- 52)
18. Implement a Performance Measurement Framework, so that FNGAP can more effectively track their progress, identify areas for improvement, and demonstrate their impact to stakeholders and funders (p 52-55).

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