# Suicidal thoughts, problem gambling severity and utilisation of health care and social services: A population-based study in Finland

## TL;DR

This study finds that people with problem gambling are more likely to have suicidal thoughts and use health care and social services in Finland.

## Contribution

The study identifies a strong link between problem gambling, suicidal thoughts, and service utilization in a large population-based sample.

## Key findings

- 31% of individuals with problem gambling reported suicidal thoughts.
- 96% of those with both problem gambling and suicidal thoughts used health care services in the past year.
- Young, male, and excessive alcohol users with gambling and suicidal thoughts were less likely to use health services.

## Abstract

•Suicidal thoughts are common among people with problem gambling, even after accounting for other confounding factors.•Of individuals with both problem gambling and suicidal thoughts 96% had used health care and 37% social services in the past year.•Those with both suicidal thoughts and problem gambling were more likely to use services than those with suicidal thoughts alone.•Gamblers with suicidal thoughts who had not used health services were more often young, male, and excessive alcohol users.•Improved screening, early detection, and better integration of services are needed to address gambling problems and suicidality.

Suicidal thoughts are common among people with problem gambling, even after accounting for other confounding factors.

Of individuals with both problem gambling and suicidal thoughts 96% had used health care and 37% social services in the past year.

Those with both suicidal thoughts and problem gambling were more likely to use services than those with suicidal thoughts alone.

Gamblers with suicidal thoughts who had not used health services were more often young, male, and excessive alcohol users.

Improved screening, early detection, and better integration of services are needed to address gambling problems and suicidality.

Persons harmed by problem gambling have an increased risk of suicide and suicidal thoughts. Social and health care services have an important role in recognising and supporting persons harmed by gambling problems and suicidal thoughts.

We analyse population-based survey data from the Healthy Finland survey of permanent Finnish residents aged 20 years or older (n = 28,154). We study associations between gambling and suicidal thoughts, and use of health care and social services among individuals engaged in gambling and experienced suicidal thoughts in the past year. The analysis uses χ2 tests and logistic regression models.

Of persons harmed by problem gambling (PGSI score ≥ 8) 31 % had suicidal thoughts. Among persons harmed by problem gambling and having suicidal thoughts, utilization of health care and social services was more common compared to non-gamblers with suicidal thoughts. Individuals who engaged in gambling and experienced suicidal thoughts in the past year but had not utilized health care services were more often young, male, and excessive alcohol users. On the contrary, those who had used social services, engaged in gambling and had suicidal thoughts were experiencing more often long-term illnesses and severe psychological distress.

Suicidal thoughts are prevalent among persons harmed by problem gambling. Social and health service systems need to better recognise the association between gambling and co-occurrent suicidal thoughts. In addition, services need to be developed to offer effective treatment and support with high levels of integration.