Improving the Detection of Gambling in Suicide Death: An Investigation to Inform Surveillance of Gambling Harms

Abstract: Background: Previous studies have reported a positive association between gambling and suicide. Unlike other addictive behaviors like drugs or alcohol use disorders, there are no routine prompts for death investigators to capture whether gambling was a factor in a suicide death. This study was designed to understand how gambling suicides are investigated and ways to improve detection. Methods: Semi-structured interviews were conducted in Australia with 32 people who had either 1) survived a gambling suicide attempt, 2) been bereaved by gambling suicide, or 3) professionals who worked in areas aligned to this topic. Transcripts were analyzed using reflexive thematic analysis. Interpretation was considered in the context of the authors’ experiences identifying suicides in Australian mortality datasets. Results: Identifying gambling suicides is challenging due to the ways information is gathered, weighted, and reported during death investigations. This is compounded by the stigma and shame associated with gambling which can work to conceal gambling-related harms, and limit data available to death investigators. Conclusions: Advancing awareness of gambling as a driver of suicide is needed to improve surveillance. Policy options available to regulators include establishing centralized gambling transaction datasets. Giving death investigators access to data related to gambling engagement of people who have died unexpectedly would enable them investigate gambling in these deaths efficiently and comprehensively. This information could be used to inform the design of interventional support to users of gambling products.