As part of the state's casino rollout, the Massachusetts Department of Public Health hired researchers to look at whether there's enough treatment for problem gambling in the state.
Addiction specialists from the Cambridge Health Alliance have been following the supply and demand of gambling treatment since before the MGM casino opened last year in Springfield.
"I think the question you have to ask — and that we don't have a good answer to yet — is what that treatment demand is," said researcher Sarah Nelson, who recently joined her colleagues in presenting their findings.
Nelson said the health centers that offer gambling treatment generally don't have waiting lists. In other words, they have no problem meeting demand.
But that's only a piece of the story.
"Are there people with problems who simply aren't seeking treatment? And how do we help at least make sure that they're aware of all the resources that are available?" Nelson said.
At the time of Nelson's survey, out of 137 health organizations licensed by the state Department of Public Health, only 27 of them had even one counselor certified in gambling addiction.
Nelson said southestern Massachusetts had the fewest number of counselors trained in problem gambling.
While other counselors do screen patients for gambling problems, Nelson said they often don't know where to send those patients outside of Gamblers Anonymous.
"Different types of treatment are going to work for different people," she said. "So some people may want to have access to something like Gamblers Anonymous or self-help resources, whereas other people might want, you know, more formal treatment in an outpatient setting."
Nelson's group does not recommend opening a new center just for gambling addiction, but rather training more counselors who already treat drug and alcohol abuse — and "helping them recognize that really it's not that big a leap from what they're already doing," she said.
Jessica Collins with the Public Health Institute of Western Massachusetts pointed out that problem gambling is not the only negative fallout from the casino. She said she appreciates the state's focus on issues like crime or stress-related chronic disease, including a grant to her organization to address casino-related community problems.
But Collins said she's also hearing from mental health providers who want more guidance around problem gambling.
"[They say] 'It's like we don't even know the questions to ask,'" she said. "You know, 'We need to kind of think about a different methodology now that we have a casino in our presence.'"
One group that provides counselor training is the Massachusetts Council on Compulsive Gambling. But Executive Director Marlene Warner said the council's state funding for training and recovery went down — from $1.5 million two years ago, to $700,000 today. As a result, she said they've had to scale back those services.
"We have a lot of money devoted to this topic in Massachusetts," Warner said. "And I don't know that we're adequately spending it or thinking about it in a thorough and comprehensive way. It's been a long time coming. I'd like to really kind of see that effort stepped up."
Warner's organization is separately paid by the state to administer the program GameSense on the casino floor. GameSense staff teach customers how the odds in gambling actually work and can direct them to get professional help.
Warner said GameSense is popular among patrons, but there's no evidence yet that it's reducing problem gambling.
"It is very hard to determine," she said.
The state’s director of problem gambling services, Victor Ortiz, declined an interview, but sent an email defending the state's efforts to address problem gambling, and listing several new initiatives funded in part by casino revenue.
This story first published on New England Public Radio.
This segment aired on December 27, 2019.