Gambling Harms Severity Index

Developing a holistic framework of gambling-related harms and recovery, measuring harm in others, and benchmarking to health utility indices
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Gambling Harms Severity Index

Developing a holistic framework of gambling-related harms and recovery, measuring harm in others, and benchmarking to health utility indices
Title: Gambling Harms Severity Index
Funded by: GambleAware
Funding amount: £545,800
Location: UK
Dates: June 2024 – January 2026
Project partners: National Centre for Social Research, Bristol Hub for Gambling Harms Research, Gambling Lived Experience Network (GLEN), Gordon Moody
University of Plymouth PI/Co-I: Dr Ryan Statton (PI), Dr James Close (Co-I)
 

Overview

Our research represented a multi-stage project, comprising the development of a holistic framework of gambling-related harms and recovery, the measurement of harm in directly affected (GHSI-10) and affected others (GHSI-AO-10), and the benchmarking to health utility indices. 
We have worked with ARA Recovery For All, BetKnowMore UK, Gordon Moody, the Gambling Lived Experience Network, and Primary Care Gambling Service in the development and refinement of scales, as well as continued testing in a clinical setting.

Objectives 

  • Holistic framework of harm and recovery: Drawing from literature and extensive interviews with people who have experience of harm as a result of their own gambling and as an affected other.
  • Co-designed measure of harm: Building on the framework to co-develop a non-stigmatising measure of harm, both for people harmed by their own gambling and for affected others.
  • Decrements to health: Using standard, health economic approaches to robustly estimate the impacts that gambling harm has on wellbeing and capability in people harmed by their own gambling and affected others.
  • Co-locating gambling harm: Making use of novel decision making analyses to rank gambling harm alongside harms from drugs and alcohol.

The GHSI-10 and GHSI-AO-10 represent a paradigm shift in how we understand and measure gambling harms.

By directly capturing actual harm rather than risk, and by including the voices of affected others, these tools provide a foundation for evidence-based policy and practice truly aligned with public health principles.

James CloseDr James Close
Associate Professor in Medicine and Psychology

The health utility findings are particularly striking. At severe levels of harm the decrement in quality of life is substantial – comparable to impacts seen in chronic health conditions.

This establishes gambling harm as deserving recognition based on measured impact, not defensive comparisons.

Ryan StattonDr Ryan Statton
Research Fellow in Psychology

Context of the issue

Gambling is increasingly recognised as a public health issue, following similar trajectories to tobacco, drugs and alcohol. The 2023 White Paper on gambling reform acknowledges the need for better understanding and measurement of gambling-related harms. However, until now, measurement tools have been limited, often lacking cultural specificity to the Great Britain context and failing to adequately represent affected others.
Traditional screening instruments like the PGSI focus on identifying "problem gamblers" within a diagnostic, individualised model. These tools are increasingly recognised as outdated and potentially stigmatising.

How the project addresses the issue

This research addresses these limitations by providing theoretically-grounded, empirically-validated tools developed through participatory methods with those most directly affected.
The work establishes gambling harm as deserving of recognition based on measured impact. By demonstrating substantial health utility decrements and using modern psychometric approaches, the research provides robust evidence for proportionate public health responses.

Centre for the Psychology of Health and Wellbeing

The Centre for the Psychology of Health and Wellbeing (CPHW) at the University of Plymouth brings together researchers in clinical, cognitive, social, and environmental psychology to understand and improve health in real-world contexts.
The CPHW's interdisciplinary research addresses health and wellbeing across the lifespan, and integrates theoretical models and methods from neuroscience, cognition and applied social and health psychology.
Blue rose petal with dew for the CPHW