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Gambling, particularly through poker machines (commonly known as pokies), has been a significant public health concern in Australia for several decades. With the highest number of pokies per capita in the world, Australia faces unique challenges concerning gambling accessibility and its associated mental health risks. This article and statistical analysis examines the relationship between the widespread availability of pokies in Australian suburbs and its impact on mental health, including problem gambling, depression, anxiety, and suicidality.

The graph above represents the estimated mental health and social outcomes from a hypothetical ban on pokies in suburban localities. The key findings include:

1. Reduction in Gambling Participation: A 30% decrease in gambling participation is expected due to the reduced availability of pokies.
2. Improvement in Mental Well-being: A 25% improvement in mental health outcomes is anticipated as fewer people engage in problem gambling.
3. Reduction in Financial Stress: Financial stress would decrease by an estimated 20%, as individuals save money that would have otherwise been spent on gambling.
4. Reduction in Suicide Risk: A 15% reduction in suicide risk is projected, particularly among problem gamblers, who have a significantly higher likelihood of suicide attempts.
5. Increased Online Gambling: A 10% increase in online gambling is a potential unintended consequence, as individuals might shift to online platforms during a pokies ban.

Keywords: gambling and mental health in Australia, pokies accessibility and mental health, problem gambling Australia, impact of pokies on mental health, suicide and gambling

Australia is home to around 200,000 electronic gaming machines (EGMs), with over 180,000 of these located in pubs and clubs across every state and territory. New South Wales (NSW) alone accounts for approximately 50% of these machines (Productivity Commission, 2010). This widespread availability means that virtually every suburb in Australia has access to pokies, making gambling a highly accessible activity for many Australians.

Key statistics:

• 80% of Australians engage in some form of gambling each year.
• Approximately 39% of Australian adults play pokies.
• There are 4.3 pokies per 1,000 Australians, one of the highest rates globally (Productivity Commission, 2010).

Gambling addiction, or problem gambling, has well-documented links to various mental health issues. Problem gamblers are significantly more likely to experience mental health challenges compared to non-gamblers, with studies highlighting correlations between gambling and disorders such as depression, anxiety, and suicidality.

According to a study by Browne et al. (2016):

• 55% of problem gamblers suffer from depression.
• 25% of problem gamblers have suicidal thoughts.
• Individuals experiencing problem gambling are twice as likely to report high levels of psychological distress.

The ease of access to pokies has been shown to exacerbate problem gambling behaviour, leading to higher rates of gambling addiction and its associated mental health impacts. Research from Livingstone et al. (2019) indicates that areas with a higher density of pokies experience significantly greater rates of problem gambling.

• Proximity to pokies venues: A study in NSW found that people living within 5 kilometres of a pokies venue are more likely to engage in gambling behaviour and develop gambling-related problems (Doran & Young, 2010).
• Pokies-related gambling losses: Australians lose approximately $12 billion annually to pokies, with problem gamblers contributing to around 40% of these losses.

The economic and health costs of gambling extend far beyond financial losses. The increased rates of depression, anxiety, and other mental health issues among problem gamblers translate into substantial healthcare costs and loss of productivity.

The social and economic costs of gambling in Australia have been estimated at $7 billion per year (Productivity Commission, 2010), which includes:

• Mental health treatment costs.
• Unemployment and reduced productivity.
• Increased demand for social services.

The risk of suicide among problem gamblers is significantly higher than in the general population. A 2019 report by the Australian Institute for Suicide Research and Prevention found that problem gamblers are 15 times more likely to attempt suicide, and gambling-related suicides account for 1 in 5 suicides in certain high-risk regions (Suicide Prevention Australia, 2020).

Research shows that pokies are disproportionately located in low-income suburbs, exacerbating the financial and mental health burden on these communities. A study by Thomas et al. (2011) found that suburbs with higher levels of socioeconomic disadvantage have greater densities of pokies venues, contributing to increased gambling harm in these areas.

Key findings:

• 65% of pokies venues are located in low to middle-income areas.
• Residents in these areas are twice as likely to experience gambling harm compared to those in wealthier suburbs.

In Australia, pokies are a significant source of gambling-related harm. Approximately 39% of Australian adults play pokies regularly, and research indicates that around 15% of these players experience moderate to severe gambling problems (AGRC, 2023). Mental health issues are particularly prevalent among problem gamblers, with 55% of problem gamblers reporting depression, and 25% reporting suicidal thoughts (Browne et al., 2016).

A study by Monash University found that the proximity of pokies venues to residential areas significantly correlates with higher rates of gambling-related financial and mental health issues (Livingstone et al., 2019). This suggests that reducing the accessibility of pokies could have positive mental health outcomes by lowering gambling participation rates and associated harms.

Problem gambling, defined as gambling behaviour that disrupts or damages personal, familial, or professional life, is closely associated with pokies. These machines are designed to be addictive, and they contribute disproportionately to gambling harm. Studies have shown that up to 40% of pokies revenue comes from individuals classified as problem gamblers (Productivity Commission, 2010).

Possible Mental Health Outcomes of a Pokies Ban:

• Reduced Rates of Gambling Addiction: Banning pokies in suburban areas would directly limit access to one of the most addictive forms of gambling. Studies indicate that greater access to gambling venues correlates with higher rates of problem gambling (Livingstone et al., 2019). A reduction in the availability of pokies would likely lead to a decrease in the incidence of gambling addiction.
• Lower Levels of Depression and Anxiety: Problem gambling is frequently associated with mental health issues such as depression, anxiety, and stress. A ban on pokies would reduce the financial and emotional strain that gambling places on individuals and families, likely resulting in improvements in mental health for affected individuals (Browne et al., 2016).
• Decreased Suicidality: Gambling-related financial stress and mental health issues are significant risk factors for suicide. Research has shown that individuals with gambling problems are 15 times more likely to attempt suicide than the general population (Suicide Prevention Australia, 2020). Reducing access to pokies could significantly lower suicide risk among vulnerable individuals.

Evidence from the COVID-19 pandemic provides an illustrative example of what might happen if pokies were banned in suburban localities. During lockdowns, pokies venues were temporarily closed, leading to a significant reduction in gambling on pokies. The proportion of Australians who gambled on pokies dropped dramatically, and many individuals reported improved financial stability and mental well-being (AIHW, 2022).

In a survey conducted during COVID-19, participants reported lower stress levels and increased savings due to the closure of pokies venues, with some noting improvements in their mental health. A male participant stated, “My savings account has never seen so much money, and I’ve managed to get some order in my life” (AIFS, 2020). These results suggest that a long-term ban on pokies in suburban areas could lead to similar improvements in both mental and financial health.

Suicide prevention is a critical area where a pokies ban could have significant benefits. Problem gambling has been linked to a 15-fold increase in the risk of suicide attempts among affected individuals (Suicide Prevention Australia, 2020). Given that pokies are a primary driver of gambling addiction in Australia, reducing their availability in suburban venues could contribute to a notable decrease in suicide rates, particularly in areas with high densities of pokies machines.

Suburban areas with a high concentration of pokies often experience negative social and economic outcomes. The accessibility of these machines can lead to financial hardship, family breakdowns, and increased crime rates. Banning pokies from suburban areas could improve community well-being by addressing these underlying issues.

Possible Mental Health Outcomes of a Pokies Ban:

• Stronger Family Relationships: Gambling addiction often causes significant strain on relationships, leading to family conflict, divorce, and domestic violence. With fewer opportunities to gamble on pokies, individuals and families would be less likely to experience these stresses, leading to improved family cohesion and reduced domestic violence incidents (Thomas et al., 2011).
• Reduced Financial Stress: One of the major sources of stress for problem gamblers is financial ruin, with pokies contributing to massive personal and household debt. By reducing access to these machines, fewer people would be drawn into the cycle of gambling-related debt, leading to lower levels of financial stress and its associated mental health consequences (Gainsbury et al., 2014).
• Decreased Alcohol and Substance Use: Many suburban pokies venues are located in pubs and clubs, where alcohol consumption is closely linked to gambling. Problem gamblers often engage in excessive drinking, which can exacerbate mental health issues. A ban on pokies could reduce the co-occurrence of alcohol and gambling, contributing to better mental and physical health outcomes (Young et al., 2009).

While a ban on pokies in suburban areas could result in many positive mental health outcomes, it is important to consider potential unintended consequences.

Possible Negative Outcomes of a Pokies Ban:

• Displacement of Gambling Behaviour: While banning pokies in suburban areas would limit access to the machines, some individuals may turn to alternative forms of gambling, such as online gambling, which is becoming increasingly popular. This could shift the problem rather than solving it. Online gambling platforms are accessible 24/7, and their anonymity may increase the risk of addiction (Gainsbury, 2015).
• Increased Use of Illegal Gambling Venues: A pokies ban might drive some individuals to seek out illegal or unregulated gambling venues. These venues are less likely to have harm minimisation measures, such as self-exclusion programs or betting limits, increasing the risk of addiction and mental health issues.
• Potential Job Losses in the Gambling and Hospitality Industry: Suburban pokies venues contribute significantly to the revenue of pubs, clubs, and hotels, which, in turn, support local jobs. A ban on pokies could result in job losses, particularly in the hospitality industry. Increased unemployment could negatively affect the mental health of those affected, though this impact could be mitigated by transitioning workers to other roles (Productivity Commission, 2010).

To maximise the positive mental health outcomes of a pokies ban in suburban areas, supportive measures should be implemented to help individuals and communities transition away from gambling dependence.

Recommended Supportive Measures:

• Increased Access to Mental Health and Counselling Services: Individuals struggling with problem gambling should be offered increased access to mental health services, including counselling and support groups. Early intervention and ongoing support can help mitigate the mental health impact of gambling withdrawal (Browne et al., 2016).
• Public Education Campaigns: Public awareness campaigns should be launched to inform the public about the risks of problem gambling and the mental health consequences associated with pokies. Educating individuals about alternative forms of recreation and stress relief could reduce the desire to gamble.
• Investment in Alternative Entertainment Options: For communities that rely on pokies venues as a social outlet, investment in alternative forms of entertainment, such as community centres, sports clubs, and recreational activities, could help reduce the social isolation that often drives individuals to gamble (Livingstone et al., 2019).

Gabriela Byrne’s story exemplifies how the proximity of pokies venues can significantly contribute to gambling addiction. Gabriela and her friends used to meet regularly at a local hotel in their suburban neighbourhood to socialise. However, the hotel later converted into a pokies venue, and this shift in the environment began to shape her behaviour. Instead of chatting and socialising, Gabriela and her group of friends increasingly spent their time at the pokies machines.

What began as a group activity soon escalated into an individual habit for Gabriela. She began visiting the pokies venue alone, especially during lunch breaks as an escape from the stress of work. Within a few short weeks, her visits became more frequent—three to five times a day. The convenience and proximity of the venue made it easy for her to fall into a pattern of addiction, with each visit compounding the mental health and financial problems she was already facing.

This case shows how important the proximity of gambling venues is in fostering addiction. When pokies are easily accessible, it’s harder for individuals to resist the temptation to gamble. Gabriela’s story highlights the insidious nature of this issue, especially in suburban areas where these venues are common (Women’s Health Tasmania, 2019)​

Paul, a suburban resident, had a local pokies venue just a few blocks from his home. This proximity led to his routine stops after work, initially as a way to unwind. However, the convenience of the venue being so close m