The psychiatric hospital business has gone through some tough times lately, but there's one treatment area that's not shrinking: gambling addiction.
"I see it growing," said Mark Crea, who sells interactive materials to about 1,000 psychiatric hospitals and clinics.
Crea, vice president of sales and marketing for Serenity Support Services, Carson City, Nev., was on the road recently in the upper Midwest. "In Minnesota, there's a casino within an hour's drive of everyone in the state."
Only about a half-dozen hospitals have inpatient programs for compulsive gamblers, but some 40 outpatient facilities are operating such programs. And that number is increasing, according to gambling treatment officials.
One of the best-known hospital programs, by Charter Behavioral Health System, is located in America's gambling capital, Las Vegas.
This year, Charter converted the 10-year-old program from inpatient to intensive outpatient treatment. At any given time, there are about 10 patients in the program, going through 24 three-hour treatment sessions.
Typically, insurance benefits do not pay for treatment of compulsive gambling, noted hospital spokeswoman Janet Sepede. An outpatient program is less expensive for the patient, she added.
Gambling, which used to be concentrated in Las Vegas and Atlantic City, N.J., has spread throughout the country as states have turned increasingly to lotteries, casinos and other forms of government-sanctioned gaming to fund their treasuries. The expansion has been accompanied by growing behavioral health problems.
For example, in February, a distraught mother of two in the Chicago area committed suicide after losing her family's savings and home by gambling at the area's riverboat casinos.
Last year, calls to a national toll-free help line, 800-GAMBLER, were up 21% to 39,352.
"Gamblers are earning less and losing more," said Ed Looney, executive director of the Council on Compulsive Gambling of New Jersey, which maintains the hotline. The average gambling debt owed by callers was $25,151, up 10% from 1993. Meanwhile, the average income of callers was $40,220, down 14% from the previous year.
Gamblers reach the "compulsive stage" when they are unable to resist the urge to gamble, and that affects relationships, jobs or results in illegal activity, Looney said.
About 95% of Americans gamble on something, but only 5% will turn into compulsive gamblers, propelled by availability and opportunity, he noted.
For example, only a few Mississippi residents called the hotline in the early months of 1993. But the state began opening casinos that year, and the national hotline was receiving 70 to 100 calls a month from Mississippi residents by late 1994.
Despite states' determination to get into the gambling business, only a handful are paying for treatment for compulsive gamblers. Connecticut, Iowa, Massachusetts, Minnesota, New York, Oregon and Texas use funds generated from gambling to pay for outpatient treatment for compulsive gamblers.