Raising awareness about the issue of problem gambling and getting treatment to those in need is a significant challenge. However, it’s particularly difficult when trying to reach immigrant communities whose cultures and circumstances are different than those for most other Minnesotans.
In an effort to develop culturally specific services for gambling treatment, the Minnesota Department of Human Services established a pilot project three years ago with Progressive Individual Resources (PIR). PIR is a social service agency that provides services to adults, children and families from diverse backgrounds, and specializes in working with new African immigrant refugees to promote healthy social adjustment.
“We have many unique challenges in getting members of these communities to seek treatment,” says Richard Oni, Ph.D, PIR executive director. Those barriers include both practical and psychological issues.
“First, this is a population that lacks resources,” says Fardowsa Mohamed, clinical service coordinator. “They are not mobile and do not drive, so transportation is a big obstacle.”
Beyond the issues of physically getting to an appointment, there are other issues unique to the community. The stigma associated with having a gambling problem—and mental health issues such as addiction in general—is bigger than in other communities. And because the communities are small and so many people know each other, there are privacy concerns, even when practitioners emphasize confidentiality of services.
There can also be confusion about the exact definition of gambling. “The first thing that comes to mind is casinos, but non-western gambling can be defined in so many ways,” says Fardowsa. “We allow clients to identify what gambling might be and to determine what other things they might be doing that constitute gambling.”
A variety of strategies can help create awareness about problem gambling to immigrant communities. One of the most important is building trust in the community. “While they are all Africans, they come from different places.” says Billy Banjoko, addiction therapist. “Even the greeting is different with each culture. Learning about the individual culture is important in making potential clients comfortable with the process.”
Another approach is to avoid shaming. “We try to talk about it as an illness and ask how we can assist them and ask how help is offered in their country,” says Fardowsa.
Other avenues of outreach include making appearances at well-attended cultural events and establishing connections with community leaders, including mosques and other places of faith. “One of the keys to our efforts is repetition, so the more we can communicate the message, the more likely it is to make sense to people in the community,” says Chuck Egbujor, clinical supervisor.
A unique strength offered by PIR is its multi-cultural staff, which means there’s a good chance that a client can be matched with a counselor from the same background and culture. PIR is also unique in the way it provides “wraparound” services, which emphasize a more holistic view of addiction and mental health and support a client in all life aspects.
Still, the process of educating immigrant communities about gambling addiction can be slow. “The system just doesn’t understand that with these groups it requires patience and humility, and to accept that not everything is well understood,” says Dr. Oni. “But what’s important is that when these people need the service, it will be there for them.”