I am pleased to share another article published in BJPsych Open. This article examined the links between gambling-related harm, death by suicide, and contact with mental health services in Wales. Using person-level, routinely collected health records linked via the SAIL Databank, we conducted a 30-year case–control study (1993 to 2023) to test whether a recorded gambling diagnosis predicts death by suicide and patterns of mental health treatment contact prior to death.
What we found
- Gambling diagnosis predicted death by suicide in our models (OR: 30.94; 95% CI 3.57 to 268.28; p=0.002). Do take note of the large CI!
- Among those who died by suicide, individuals with a gambling diagnosis had more mental health treatment contacts overall before death, particularly in-patient contacts; there was no difference for out-patient contacts.
- Many gambling diagnostic codes appeared in primary care, underscoring the importance of GP recording and screening.
Why this article matters
- A historical gambling diagnosis appears to be a meaningful risk signal that services could use alongside other indicators to identify people at elevated risk.
- Consistent coding of gambling-related harm in primary and secondary care would strengthen research and enable earlier support.
- Linking GP, hospital, and mortality data at scale via SAIL shows how routine data can inform targeted interventions.
Summary
Overall, the study indicates that a recorded gambling-related diagnosis is strongly associated with death by suicide and that those with such a diagnosis have more contact with mental health services - especially in-patient care - before death.
Primary care is the main setting where gambling harm is coded, highlighting GPs as important for early identification and referral. These findings suggest practical opportunities to embed screening and tailored support within existing touchpoints, while also underscoring the need to improve the quality and consistency of gambling-related coding.
The results should be interpreted with caution given likely under-recording, small cell counts resulting in wide confidence intervals, and the observational design, which limits causal inference; nevertheless, they provide actionable directions for prevention and service improvement.
Reference
Gambling, suicide, and mental health treatment utilisation in Wales: A case-control, whole-population-based study
Matthew Jones, Pippa Boering, Kishan Patel, Daniel Leightley and Simon Dymond. BJPsych Open, 2025.