Rise of Asian Casinos Highlights Risks of Pathological Gambling
> 11/5/2007 9:01:52 AM

Last week, we spoke about the merits and pitfalls of a plan to bring big casinos to Massachusetts. Governor Deval Patrick based his proposal on Canadian casinos that are obliged to spend a portion of their revenue on on-site pathological gambling clinics. While it is prudent to learn from the experience of other countries, it can be dangerous to assume that outcomes will be similar in different environments. Political and cultural factors can determine the difference between profitable entertainment and destabilizing temptation. To see this difference, one has only to look to Asia, where a number of multi-billion dollar gambling projects are in the works. The unique political and cultural climate in each country determines the extent to which mental illness is recognized, prevented, and treated.

A Time article last week covered the benefits and dangers of gambling in Asia. The article mentions gambling in many Asian countries, but it focuses mainly on the rise of gambling addiction in China. Singapore has equally ambitious casino projects, but addiction is not a run-away problem there because the government is aware of the potential problems, motivated to act, and able to exercise tight social and legal control. For example, the government of Singapore helps organize the annual conference of the National Council on Problem Gambling. The Chinese government, however, lacks both an adequate awareness of the problem and the ability to exert effective social control. China has only one government-supported gambling addiction group, the tiny Resilience Centre with only three counselors and no easily accessed website.

Even in times when the Chinese government had the will to eradicate gambling, it was unable to do so because gaming is so entrenched in the culture. Mahjong and other methods of casual gambling have been part of Chinese culture for centuries. When the Communists took control of the country, they declared that gambling was one of the "sins" to be eradicated along with drug addiction. They were unable to keep drugs out of the country because of foreign opium pushers, but the resistance to their anti-gambling initiatives came from the Chinese people.

The lack of top-down control from the Chinese government leaves the support of gambling addicts to the average citizen, who often does not even view gambling as a potential problem. This obliviousness, combined with the taboo against seeking help for mental illness, leaves much of the gambling addiction treatment to foreign-inspired programs like the informal groups meetings held by Reverend Jimmy Tan every night in Macao. While close-knit Chinese families provide firm safety nets for many problems, they can only do so if family members recognize gambling as a problem. Any society contemplating sending an invitation to casinos needs to make sure that the citizens are educated enough about the potentiality of compulsive gambling to spot red flags and seek out treatment for those who cannot control their impulses.

One strategy that China uses to control gambling is officially confining it to the two autonomous regions instead of allowing it on the mainland. It is debatable whether this is a strategy to be emulated because the concentration of gambling in Macao and Hong Kong has created an industry that is largely viewed as out of control. Macao alone is too much of a temptation for many of the 2.2 billion people that live less than a five hour plane flight away. In 2006, Macao surpassed Las Vegas in annual gambling revenue, and a host of problems came with the economic boost.

In Hong Kong, casinos are illegal, but other forms of betting, like race tracks, are booming. A Chinese University of Hong Kong report from 2004 showed that 17.2% of suicide victims in Hong Kong had a history of gambling. 5.3% of the population there has engaged in pathological gambling, as opposed to approximately 2% in the United States. This gap could easily close, however, as there are no known racial components to risks for pathological gambling. Instead, cultural and political change could bring improvements.

The lesson to be learned from the Asian situation is that gambling can be a great boon to the economy, but it is only a positive development if problematic gambling is contained with a combination of social awareness and mechanisms for intervention. It is easy to calculate the influx of money that casinos will bring, but it takes greater acuity to see the suicides and crime that will also come without careful control. If laws require that casinos funnel money into raising awareness and treating addicts, then they may be able to reap the rewards of a booming entertainment industry while protecting the vulnerable portion of their population. Ultimately however, casinos will always put some citizens in danger; it's just a question of whether governments are comfortable taking this  risk to gain the enormous revenue that sanctioned gambling can bring.

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