"No one takes it seriously": U.S. military personnel with gambling concerns: recommendations for expanding treatment and public health efforts.

INTRODUCTION: Gambling is increasingly recognized as a significant public health issue, with negative consequences for financial stability, social well-being, and overall health. Growing evidence indicates that U.S. military personnel and veterans are a high-risk group for gambling-related problems, including gambling disorder (GD). Despite the challenges posed by GD, military personnel rarely seek treatment or disclose their struggles. The present study aimed to identify and develop treatment and policy recommendations to improve help-seeking and disclosure among U.S. military personnel with lived experience of GD. METHODS: Semi-structured interview were conducted with 28 U.S. veterans and active-duty service members who reported current or past experiences with GD. RESULTS: Content analyses revealed four themes: (1) "Increase awareness," reflecting a need to raise awareness of gambling as a problem through gambling education, financial literacy training, and screening for GD; (2) "Open door policy," highlighting the need for a safe and confidential environment to disclose gambling concerns; (3) "Eliminate gambling and increase leisure," demonstrating a need to reduce access to gambling and promote healthy leisure activities within the military; and (4) "Increase resources for treatment," emphasizing the need for GD-specific treatment programs, greater awareness of available treatment options, access to on-base specialists, and peer support. DISCUSSION: These findings reveal treatment needs among U.S. military populations with GD and point to structural changes the U.S. military should adopt to reduce GD, promote help-seeking, and strengthen overall health, readiness, and well-being.