The Casino Industry's Role in Responsible Gaming

Thank you for inviting me to speak at your first annual Gaming Summit. My name is Judy Patterson, and I am senior vice president and executive director of the American Gaming Association, the national trade association representing the commercial casino-entertainment industry. It’s not often that I find myself in your beautiful state, since our members operate only in the 11 states currently classified as ‘commercial casino’ states.

Regardless of whether your state has a lottery, charitable gaming, pari-mutuel wagering, slots at the tracks, casinos, or any other forms of gaming, it’s important for you to understand problem gambling. All of us gathered here today - academics, regulators, industry representatives, and the treatment community - obviously share an interest in this subject, and we all have different roles. I appreciate the opportunity to tell you about what our segment of the industry has done on this issue.

Before I begin, I want to first tell you a little bit about the American Gaming Association. Our mission at the AGA is to help people better understand the gaming-entertainment industry. We bring the facts about the industry to the public, elected officials and the media. We address national issues and help develop industrywide programs on critical issues such as problem and underage gambling.

Let me start by saying that the AGA’s achievements in this area are by no means the only achievements by the casino industry. Before the AGA was ever founded, many of our companies had instituted educational programs and funding for problem gambling that served as models for us. Harrah’s Entertainment, which manages a Native American casino in your neighboring state of Arizona; Boyd Gaming Corporation; and Grand Casinos, Inc., now part of Park Place Entertainment, were all pioneers in responsible gaming.

At the state level, our companies have supported education and research programs. In Nevada, for example, casinos are contributing more than $200,000 to the state council on problem gambling. Many other states, including Missouri, Louisiana, Illinois and Mississippi, provide significant financial assistance to support gambling help lines and other statewide programs, over and above the support provided through gaming tax revenue.

While there had been a lot of individual achievements like these at the company and state level, the initiatives had not been of a national scope. That’s why when the AGA first opened its doors five years ago, we decided problem and underage gambling was something we needed to address. This was an industry problem, and we weren’t going to pretend it didn’t exist. While we knew that the vast majority of Americans gambled responsibly, we also recognized that there were those who did not, and they deserved our attention. From day one, we set this as one of our highest priorities and decided to take a leadership role in finding ways for the industry to help those who cannot help themselves.

We started by looking to the scientific experts, and asking for their advice. How could the industry as a whole have an impact on this issue? How could we work to minimize problem gambling? We’re not medical experts, but if our customers or our employees have a gambling disorder, we want to do something to address it. Their advice for us was this: The areas where you can make a real difference are in education and funding for new research.

With that mandate, the AGA set out to broaden public awareness of problem gambling, particularly among our employees and customers, as well as to fund new research. Today, I’d like to outline for you the progress we’ve made so far on both of these fronts. You might want to refer to the big chart to my left/right. I’ve also brought individual copies of it for you to take home.

The AGA’s education efforts all fall under the general umbrella of our Responsible Gaming National Education Campaign. To help spearhead those efforts, the AGA in 1995 created a Responsible Gaming Task Force, a multidisciplinary group charged with identifying, developing and implementing responsible gaming programs and policies throughout the gaming industry.

The task force is made up of vice presidents of administration, human resources, operations and communications, and general counsels from more than 12 AGA-member companies, and leading experts in the area of problem and underage gambling from universities and state problem gambling councils.

With their guidance, the AGA developed a variety of materials to inform gaming industry employees and customers about disordered gambling. These materials included a comprehensive Responsible Gaming Resource Guide, which was produced in collaboration with Carl Braunlich of Purdue University and Marvin Steinberg of the Connecticut Council on Compulsive Gambling. The Resource Guide compiled examples of model responsible gaming programs and included step-by-step instructions for:

• Establishing responsible gaming programs
• Setting up training programs for staff supervisors
• Assembling educational information for non-supervisors
• Establishing employee assistance programs for problem gamblers
• Providing educational programs for casino guests and the entire community

It also included contact information for organizations and groups that are involved with problem gambling throughout the country. The widely used resource guide is now in its second edition.

From there, the AGA went on to publish two educational pamphlets that were distributed to all 250,000 casino-industry employees - one titled ‘A Discussion of Disordered Gambling and Responsible Gaming’ and the other ‘Keeping It Fun: A Guide to Low-Risk Gambling.’ We continue to receive requests for these materials.

Two years ago, we produced a multimedia package called the PROGRESS Kit, which included all the elements necessary for companies to implement employee and customer education programs on compulsive and underage gambling. This kit included sample posters and brochures on problem gambling, underage gambling and cash access in casinos, as well as training curricula. The curricula, developed for use by gaming industry employees, focused separately on disordered gambling and on underage gambling prevention.  These curricula were developed jointly with the North American Training Institute and have been certified by the American Academy of Health Care Providers in the Addictive Disorders. To date, we have distributed approximately 150 copies of the PROGRESS Kit to our member company properties and sold an additional 20 at cost to other companies and organizations.

The AGA, in conjunction with the task force, also organized seminars across the country to exchange ideas, develop strategies for responsible gaming practices and provide the impetus for additional action. We have also made videotapes of several of these programs available. At the annual industry trade show and conference, we conducted a seminar titled ‘Understanding Gambling and Its Potential Health Consequences, which was co-sponsored by the National Center for Responsible Gaming, the Nevada Council on Problem Gambling and Harvard Medical School. This same seminar was featured at the Southern Gaming Summit, co-sponsored by the Mississippi Casino Operators Association and the Mississippi Council on Problem Gambling.

In addition, we conducted responsible gaming certification courses and workshops to increase awareness, introduce innovative programs, and further educate casino employees and regulators. Moderated by experts in the field of disordered gambling, these courses provided an overview of disordered gambling and responsible gaming programs.

Because this is such a difficult issue, the AGA has tried some creative approaches to increase awareness of problem gambling. The AGA designated the first week of August every year as Responsible Gaming Education Week. During this weeklong event, companies devote activities to increasing awareness among employees and the general public about disordered gambling and the importance of responsible gaming.

To maximize the event’s impact, we’ve encouraged the involvement of everyone involved in the gaming industry - from treatment providers to regulators to other segments of the gaming industry. In past years, many Native American casinos have participated, including two right here in Albuquerque: Sandia Casino and the Isleta Gaming Palace. Last year, our most ambitious program so far, included a live broadcast, ‘Responsible Gaming: Keeping It Fun,’ a panel discussion from Las Vegas featuring top experts in the field. To kick off the week’s activities, more than 500 people at eight sites across the country watched the event via satellite downlink, and hundreds more watched a live Webcast of the event. In addition to casino employees, the audiences included members of state councils, regulators and lottery officials and employees. The program also was distributed on videotape to all our member companies, regulators and state councils.

I’d like to give you just a sense of the content of that program, which received great support from treatment providers, state councils, regulators and others. This clip begins with employee interviews, moderated by veteran reporter Sander Vanocur. It includes as panelists Punam Mathur, director of community and government affairs for MGM MIRAGE, and Howard Shaffer, director of the Division on Addictions at Harvard Medical School.

If you’d like to see the entire program, it can still be viewed by clicking on the click link above. This year, we will observe our fourth annual Responsible Gaming Education Week Aug. 8-12. We expect to do another live broadcast and would welcome your participation.

At the same time that we launched the Responsible Gaming National Education Campaign, we began to address what was one of the most critical problems relating to pathological gambling: the lack of quality research. The scientists had told us that we needed to have a better understanding of its causes. We needed to improve diagnostic methods and identify empirically valid prevention and treatment programs. We were also told that we needed to expand the number of researchers from the relatively small number currently working in the field, and to broaden the research into related disciplines.

To accomplish those goals, the commercial casino industry - working with the AGA - founded the National Center for Responsible Gaming (NCRG) in 1996 to fund research on pathological gambling. In doing so, we created the first independent, nonprofit organization in the country dedicated exclusively to peer-reviewed research on gambling. The organizational structure and decision-making procedures of NCRG were modeled after the National Institutes of Health to ensure that the highest standards were used in evaluating research grant proposals. The Advisory Board included academics, health and social services professionals, and other experts in the field of addiction.

Our critics and even our supporters told us that industry-funded research would never have credibility. But we have proven them all wrong.

The NCRG has received accolades from many corners for the quality of its research. Research conducted for the National Gambling Impact Study Commission by the National Research Council of the National Academy of Sciences - one of the most prestigious research organizations in the country - criticized much of the research on this topic done in the past but cited a growing body of research by the NCRG that they considered quality research. As another measure of the quality of the research being done, the principal investigators for the two NCRG projects completed thus far already have had the results of their work published in some of the leading journals in the nation, including the American Journal of Public Health and the journal Addiction.

I am extremely proud of the progress this organization has made in such a short period of time. To date, the NCRG has awarded more than $3.2 million in support of 20 scientific investigations of gambling disorders - an unprecedented level of funding for this area of research. The grants have been made to respected universities and medical research centers such as Harvard Medical School, Washington University School of Medicine and Massachusetts General Hospital.

The NCRG’s first research grant, made to Harvard Medical School’s Division on Addictions, was for a meta-analysis of 120 prevalence studies, which produced the first reliable estimates of this problem. For years, opponents of our industry had inflated the number of people who truly experience this disorder. With this study, however, we were able to say that an estimated 1.29 percent of the U.S. adult population are pathological gamblers. Those numbers have stood up to scrutiny; research conducted for the National Gambling Impact Study Commission estimated the number to be 0.1 percent and 0.9 percent.  The Harvard study also indicated that the majority of those people with gambling disorders also experience other psychiatric disorders, such as alcoholism, drug abuse and depression.

Other NCRG-funded investigations are examining disordered gambling from a variety of disciplines. The projects are being conducted in the areas of youth gambling, diagnostics, treatment, neuroscience, genetics, epidemiology, and the behavioral and social sciences. The first-ever study of casino employee health for all forms of risky behavior was undertaken in part through NCRG funding.

The research conducted by NCRG investigators also has served another purpose of the organization: increasing public awareness of pathological gambling. The NCRG has sponsored two conferences where scientists have presented results of their research. The first conference, held in 1999 at George Washington University in Washington, D.C., brought together 15 of the most noted research scientists in the United States and Canada with 150 people from across the nation to discuss research trends in gambling studies and the impact of NCRG support.

The latest conference, held just last month in Las Vegas, featured 28 prominent scientists in dialogue with gambling researchers, counselors and other interested individuals from around the nation focusing on co-morbidity issues - or, to put it in layman’s terms, the co-existence of other disorders, such as depression or alcoholism, that make it difficult to determine whether pathological gambling is a unique disorder or the consequence of other disorders. Approximately 175 individuals attended the NCRG conference, including leaders in comorbidity research, academic researchers, treatment providers, gaming regulators, staff from state health departments, representatives from the National Institutes of Health, gaming industry employees and others interested in the field. Among the topics discussed were how to measure pathological gambling; youth gambling; the genetics of pathological gambling; the state of current treatment therapies; and Native American perspectives on comorbidity.

Plans already are under way for the third annual conference this December. This year, we hope to follow this academic meeting with a workshop at which we expect to apply some of the results of NCRG-sponsored research to practical workplace issues in the casino.

More than 25 donors - casino operators, slot manufacturers, the Culinary Union, and industry vendors and suppliers - have committed more than $7 million to the NCRG. Sandia Casino, which as I mentioned earlier participated in Responsible Gaming Education Week, also is a donor to the NCRG. The National Gambling Impact Study Commission, the federal panel created by Congress to conduct a two-year examination of our industry, said this in their final report: ‘Perhaps surprising to some, the largest source of funding for research on problem and pathological gambling is the commercial casino industry.’

Aside from our accolades from the commission, the recognition from the research community has been the most meaningful. The most significant measure of that recognition came just a couple months ago, when the grant-making responsibilities of the National Center moved permanently to Harvard Medical School’s Division on Addictions. The new organization that will carry on those duties, the Institute for Research on Pathological Gambling and Related Disorders, will build on NCRG’s work by advancing society’s understanding of all types of addictive disorders through scientific research. The NCRG will continue its work to expand public education efforts in the field of pathological and youth gambling.

Through this combination of education and research funding, we are fulfilling a responsibility that we have as good corporate citizens in our communities and as business leaders. It is also the role the experts have told us we should play. Our hope is that these activities will all work to advance our understanding of pathological gambling so that we can better treat and prevent this disorder.

But our job hasn’t ended there. As the association representing commercial casinos, we also play a leadership role in shaping industry policy. We have accomplished this goal in two ways: 1) by adopting voluntary guidelines to establish and encourage industrywide standards; and 2) by forging alliances with third-party groups on issues of mutual concern.

The AGA developed and adopted comprehensive voluntary guidelines to address all aspects of disordered and underage gambling to ensure that customers and employees have the necessary information to seek help, if needed. We also developed voluntary guidelines pertaining to advertising and marketing of gaming in casinos operated by members of the AGA. The purpose of the guidelines is two-fold: 1) to ensure responsible and appropriate advertising and marketing of casinos to adults that reflects generally accepted contemporary standards; and 2) to avoid casino advertising and marketing materials that specifically appeal to children and minors.

In addition, the AGA has collaborated with third parties, including the National Center for Missing and Exploited Children, state problem gambling councils and the Harvard Medical School Division on Addictions, on issues of mutual concern. With technical assistance from the National Center, casino employees in Las Vegas, Atlantic City, and the Mississippi Gulf Coast received training on how to respond to cases of unattended children on or outside casino properties, in addition to training through other AGA-sponsored seminars.

One of the most innovative and effective efforts I have come across in generating third-party support occurred in Missouri, where the industry’s state association forged an alliance with other local groups that share a concern about pathological gambling. The Missouri Alliance to Curb Compulsive Gambling, whose members include the Missouri Riverboat Gaming Association, Missouri Gaming Commission, Missouri Lottery and state Department of Mental Health, has implemented a wide range of activities to increase public awareness of this disorder, including educational programs and radio and television public service announcements. This alliance has been so successful it is being replicated in other states, including Illinois, Louisiana and Iowa.

To address concerns about cash access in our casinos by those who have a gambling disorder, we also have been pro-actively working with our financial services partners to develop voluntary self-exclusion programs from cash access machines on the casino premises. Next week, representatives from the AGA and state associations from across the country will be meeting with these companies to learn more how their technology can help us minimize this problem, and to encourage them to develop that technology if it doesn’t already exist.

As I indicated at the beginning of my remarks, we can’t underestimate the importance of working together. We share a common goal - to minimize pathological gambling - and we all bring different strengths to the table. Several years ago, I worked for the American Bar Association, and one of my jobs was to help develop public-private partnerships to make much-needed improvements to the justice system.  I worked with many national associations as a part of that effort. 

Not surprisingly, we found that there is no magic silver bullet, no one solution for many of the problems with the justice system. Nor is there one single culprit or sole cause of a problem. We concluded that it takes many committed organizations and individuals working together to make lasting solutions to society’s deepest problems.

Problem and underage gambling is as serious and compelling an issue as those we faced as lawyers. And just as it will take public-private partnerships to fix the justice system’s problems, it will take many organizations like yours and mine - and many of the other interested parties in this room - to successfully address the issue of problem and underage gambling.

Even though gambling has been around for a long time, problem gambling is a relatively new phenomenon. The gaming industry is only part of the solution. And, as I hope I have demonstrated to you today, the casino industry is working diligently to address the issue of problem gambling. We are strongly committed to finding answers and solutions. We, as an industry, know that we must take care of our own problems. But we are just a piece of the puzzle.  To complete the puzzle, we must put all of the pieces together. We still have a long way to go to meet the challenges that lay before us.

I’d like to close today by discussing the issue of reality with you. 

The reality is that gaming is entertainment that many people enjoy.  The origin of gaming dates back to ancient times.  In Egyptian tombs dating back before 2000 B.C., and Chinese excavations from as early as 600 B.C., dice with markings almost identical to our modern-day dice have been discovered.

In our own country, lotteries provided funds to construct Harvard College … the University of Virginia … and our Capital City, Washington, D.C.   After the Civil War, lotteries helped rebuild the South.

Gaming is not new to our country, and its popularity is likely to continue to grow. Americans consistently show overwhelming support for casino entertainment. More than 80 percent believe that it is acceptable for themselves or others. That is the reality.

Unfortunately, some people have a problem gambling responsibly.  This is also a reality we must deal with. It seems only logical that we spend our time trying to find solutions to the problem. Many of us in this room - by virtue of the fact that we came together today to discuss this issue - can play a role. We must be certain that we are focusing our efforts and resources effectively to get help to those who need it. We must not spin our wheels on a matter so important.

Thank you for asking me to be with you today.