Table 1.

A taxonomy of harms experienced by people who gamble

	General	Crisis	Legacy
Financial Harm	• Reduction or loss of capacity to purchase luxury items such as holidays, electronics • Reduction or loss of discretionary spending such as non-gambling related entertainment or other family members’ activities (ie. children’s sports) • Erosion of savings • Activities to manage short term cash-flow issues: o Additional employment or other forms of income generation o Accessing more credit o Use of credit cards (kite flying) o Selling or pawning items o Pay day loans o Non-payment or juggling of large bills such as utilities or rates • Cost of replacing items sold or pawned as part of short term cash strategies • Reduction or loss of non-immediate consequence expenditure o Insurance (health, home, car, income protection, business) o Repairs or maintenance costs (home, car, business) o Health promotion activities (check-ups, long term medications, allied health support) o Household items • Reduction or loss of expenditure on items of immediate consequence: o Children’s expenses (education) o Medication or health care o Clothing o Food (including use of food parcel) o Housing or accommodation o Needing assistance with bill payments from welfare organisations or inability to pay bills (eg utilities) o Transport costs (petrol, fares)	• Loss of sources of additional funds (ie no further credit available) • Loss of capacity to meet requirements of essential needs (food) • Loss of normal accommodation requiring temporary accommodation or resulting in homelessness • Loss of major assets (car, home, business) • Bankruptcy	• Reliant on welfare • Restrictions due to bankruptcy or credit rating • Ongoing financial hardship • “Forced” cohabitation or involvement in unhealthy relationship due to financial constraint • Further financial harm from attempts to manage debt (ie. Non-reputable finance providers for debt consolidation) • Ongoing issues relating to financial security, poverty, or financial disadvantage. • Higher costs associated with poor credit rating including premium cost of pay as you go services or increased security bonds.
Relationship Disruption, Conflict or Breakdown	• Dishonest communication within relationships with spouse, partner, children, family, friends or community • Unreliable or unavailable to spouse, partner, children, family, friends or community • Reduced amount of time spent with spouse, partner, children, family, friends or community • Reduced quality of time spent with spouse, partner, children, family, friends or community • Disengagement or withdrawal from relationship responsibilities. • Increased levels of neglect of relationships • Pervasive neglect or disengagement from relationships • Reduced engagement in family or social events, • Tension with spouse, partner, children, family, friends or community • Minor or occasional conflict due to increased involvement in gambling or suspicion of increased involvement with gambling • Serious or regular conflict due to increased involvement in gambling or suspicion of increased involvement with gambling • Major or constant conflict due to increased involvement in gambling or suspicion of increased involvement with gambling • Loss of trust from relationship with spouse, partner, children, family, friends or community • “Punishment” by spouse, partner, children, family, friends or community • Episodic distortion of relationship roles (infantilising the person gambling, others including children having to take parental type role) • Incidence or escalation of family violence or intimate partner violence	• Threat of separation or rejection from relationship with spouse, partner, children, family, friends or community • Actual separation or rejection from relationship with spouse, partner, children, family, friends or community • Social isolation • Loss of relationship (temporary or permanent) with spouse, partner, children, family, friends or community • Distortion of relationship roles (infantilising the person gambling, others including children having to take parental type role) • Incidence or escalation of family violence or intimate partner violence	• Social isolation due to ongoing estrangement from relationships with spouse, partner, children, family, friends or community • Vulnerability to problematic gambling relapse due to isolation or relationship breakdown • Inability or reluctance to participate in social functions at gambling venues • Ongoing “punishment” or resentment from spouse, partner, children, family, friends or community • Relationship rebuilding or reconciliation • Ongoing involvement of family court in parenting or co-parenting • Long term damage or estrangement from relationship/s with spouse, partner, children, family, friends or community • Ongoing distortion of relationship roles (infantilising the person gambling, others including children having to take parental type role) • Loss of psychological development through lack of appropriate social interaction • Incidence or escalation of family violence or intimate partner violence
Emotional or Psychological Distress	• Emotional and psychological distress caused by living outside of your value system • Experience of distorted cognitions or erroneous beliefs • Emotional or psychological distress of hiding gambling from others (including lying and creating alibis for lost time and money) • Reduced feelings of self-worth and pride • Increased feelings of shame • Increased feelings of inadequacy or personal failing because of inability to control gambling to recreational levels • Perceptions of being stigmatised • Emotional or psychological distress of inability to control gambling • Increased feelings of insecurity and vulnerability • Emotional or psychological distress caused by other harms • Emotional or psychological distress due to harm caused to others (guilt) • Loss of “face” or reputation due to impact of other harms • Desperation from not being able to recoup losses. • Emotional or psychological distress of not wanting to accept problems with gambling • Loss of sense of future or ability to get ahead • Increasing feelings of powerlessness • Fear and distress from follow up and harassment by creditors (legal and illegal)	• Extreme emotional or psychological distress in relation to other harms • Extreme emotional or psychological distress due to harm caused to others • Extreme emotional or psychological distress caused by living outside of your value system • Complete loss of feelings of self-worth and pride • Extreme shame • Extreme sense of hopelessness and powerlessness • Suicidal ideation • Loss of “face” or reputation (stigma) if problem with gambling becomes publicly known • Shame from utilising responsible gambling measures such as exclusion or seeking treatment. • Extreme fear and distress from follow up and harassment by creditors (legal and illegal)	• Experienced, perceived and internal stigma • Ongoing guilt and shame • Emotional and psychological impacts of managing recovery or harm minimisation strategies including constant vigilance and behavioural adaptation • Ongoing feelings of insecurity and vulnerability • Ongoing emotional and psychological distress in relation to other harms • Ongoing emotional or psychological distress due to harm caused to others • Ongoing emotional or psychological distress caused by having lived outside of your value system • Ongoing vulnerability to suicidal behaviours
Decrements to Health	• Increased sedentary behaviour during time spent gambling • Biological manifestation of emotional and psychological distress eg. increased blood pressure, loss of sleep • Reduced levels of self-care: o nutrition o hygiene o sufficient sleep o compliance with medical care o physical activity o reduced quality of living circumstances (ie. cannot afford heating) • Incidence of disease or injury due to reduced levels of self care • Increased risk due to gateway effect, interaction with, or exacerbation of other health risk factors (drinking, smoking, illegal substances) • Increased risk due to gateway to, interaction with, or exacerbation of comorbidities (depression, anxiety, biophysical chronic disease) • Increased experience of family violence due to involvement in gambling • Incidence of self-harm • Minor health ailments (headache migraine) relating to focussing on a screen for long periods of time with particular gambling products	• Physical impacts of living rough due to homelessness, including increased risk of disease, violence and impact of poor living conditions • Experience of violence due to involvement in gambling • Medical emergency (including mortality) due to onset, exacerbation, or failure to diagnose condition due to gambling • Serious self-harm • Attempted (or completed) suicide	• Ongoing disability or decrement to health through attempted suicide or other forms of self-harm • Ongoing increased risk of disease or decrement to health due to legacy effects of risk factors or poor self-care • Ongoing disability or decrement to health due to other medical conditions exacerbated or advanced due to involvement with gambling.
Cultural Harm	• Reduced engagement in cultural rituals • Culturally based shame in relation to cultural roles and expectations • Reduction of contribution to community and cultural practices of the community • Reduction of cultural practices • Reduced connection to cultural community • Harm to individual through reduced connection to community and culture in terms of increased social exclusion or isolation	• Extreme cultural shame in relation to culturally based roles and expectations • Loss of ability to contribute to community • Impact (loss) on cultural practices • Damaged or lost connection to community and culture • Harm to individual through reduced or lost connection to community	• Ongoing cultural shame in relation to roles and expectations • Ongoing reduction or loss of contribution to community • Ongoing reduction or loss of cultural practices • Ongoing loss of connection to community • Ongoing harm to individual through reduced connection to community
Reduced Performance at Work or Study	• Reduced performance due to tiredness or distraction • Increased absenteeism due to time spent actually gambling, tiredness, ill health or lack of transport due to gambling • Workplace or educational institution consequences of use of work or educational institution resources for gambling activity • Reduced availability to contribute to the community through volunteer work	• Loss of job due to theft or fraud involving employment or educational institution • Loss of job, suspension or exclusion from educational institution due to poor performance • Exacerbation or contribution to other harms due to job loss (including loss of wage) • Rejection from volunteer work	• Reduced opportunity for employment or enrolment due to past poor performance or criminal activity • Ongoing impact in participation in volunteer work (linked to reputation and restriction of activities)
Criminal Activity	• Vulnerability to illegal activities that can provide fast access to funds • Engagement in crimes of negligence - acts such as child neglect (leaving children unsupervised) • Engagement in crimes of opportunity - petty theft including from family members • Engagement in crimes of opportunity - property crimes for funds, illicit lending, fraudulent efforts to attain funds • Engagement in crimes of duress - relating to repaying debt such as drug trafficking and prostitution	• Arrest and/or conviction of criminal activity of opportunity • Arrest and/or conviction of criminal activity of duress • Arrest and / or conviction of criminal activity of negligence	• Impact of criminal record on future employment opportunities, voluntary and community opportunities, travel restrictions • Disruption to relationships of custodial sentence • Ongoing impact on spouse, partner, child, family and friends due to impact of criminal record or custodial sentence through other mechanisms • Trans-generational impact of criminal record or custodial sentence • Shame and stigma of criminal conviction or involvement in criminal activity
Lifecourse and Intergenerational Harms • Generational loss relating to financial security or stages of financial achievement (ongoing impact caused by inability to secure or loss of major asset, superannuation) • Loss of lifecourse events such as engagement/marriage/having children (generational loss) • Loss of primary relationships and social connection (including parents/children/community) • Having to move towns/states due to impact of gambling or other harms • Homelessness • Change to career due to impact of gambling or other harms • Incarceration due to gambling