Joerg Haefeli and Kurt Gschwind, College of Social Work (HSA) Lucerne, Institute of Higher Education, Services and Research (WDF), Lucerne, Switzerland

Switzerland in transition - new rules - prevention of problem gambling

Ladies and gentlemen

It is a pleasure to have the opportunity of speaking about the Swiss casino world, and above all about our endeavours, for the first time within a European framework, towards the prevention of problem gambling. We should like to express our thanks to the European Association for the Study of Gambling, and in particular to Mr Peter Remmers, for the invitation.

The College of Social Work Lucerne
This concept was developed at the College of Social Work in Lucerne (abbreviated as HSA). The College is part of group of five Universities of Applied Sciences in Central Switzerland (abbreviated as FHZ) which have amalgamated in the heart of Switzerland.
The HSA provides diploma training in social work and socio-cultural animation. The Institute of Higher Education, Services and Research (abbreviated as WDF) is also affiliated to the HSA. We act as a competence centre in the areas of social work, prevention and addiction, social culture and application-orientated research.
The project entitled careplay® was developed by my colleague Kurt Gschwind, psychologist and lecturer at the HSA Lucerne, and myself. My name is Joerg Haefeli. I am also lecturer at the HSA Lucerne. We both are projectleaders of careplay®.
We shall start by telling you about the legal conditions that have been in force for casinos in Switzerland since April 1st 2000. Then Kurt Gschwind will talk about prevention work as we understand it, and finally I shall describe our work for the prevention of problem gambling.

What are the social conditions for casinos in Switzerland?
It may surprise you to hear that gambling in casinos was legally prohibited in Switzerland until 1993. Seven years ago this law was rescinded by means of a referendum as part of the reorganisation of the federal budget.
The fact that the law remained in force for so long is partly the result of our democratic structures, which make any change in the Federal Constitution a long and wearisome business. Another reason may be that Switzerland is such a small country, for there are ample opportunities for gambling in the neighbouring countries of Germany, Italy, Austria and France. In 1993, however, over twenty casinos in Switzerland opened with a reduced maximum stake of approximately three dollars and this meant that the gambling facilities consisted almost exclusively of slot machines.
The new legislation will mean that from t he year 2002 on, it will be possible to run casinos on the lines with which you have been familiar for many years in your countries. However, the Swiss gambling laws impose conditions that are probably unique in Europe.
The Swiss government will permit only a specific number of casinos, namely twenty-eight at the most, and the state will stipulate the location and size of the casinos by means of concessions. The casino managements must prove, by means of a social concept, that they will do everything in their power to combat the harmful effects of gambling. Furthermore, there will be restrictive conditions and official checks with regard to money laundering. Internet casinos are still prohibited in Switzerland.

The legal conditions relating to social protection are as follows:

1. The casinos are required to collaborate with prevention and addiction experts.
2. The casinos are required to display information about the risks of gambling and advice on where to obtain help.
3. The casino staff must be trained in recognising and addressing gamblers at risk and be able to inform them about where to obtain help.
4. The casinos are required to prohibit admission to gamblers playing above their means. Problem gamblers must also be permitted to impose a ban on themselves. These gambling bans are networked by a technical system throughout Switzerland. A prohibited gambler forfeits the right of admission to a Swiss casino.

These legal conditions enable us to adapt our experience in other areas of prevention to the conditions of the casino managements.

Kurt Gschwind will now define what we mean by prevention and describe how we have adapted our model to the casino world.

Ladies and Gentlemen
The WDF Institute has gathered experience in prevention over many years. We have created a wide range of projects in the fields of addiction, violence and other problems, whereby we always work on cause-orientated principles. We regard the emergence of acute social problems as a starting point or driving force for a change in systems such as Colleges, children's and young people's homes, the authorities etc.

In our projects, the responsible persons and employees of institutions and organisations learn to interpret problems as a starting point for effective changes in their structure and communication culture. Our emphasis falls primarily on early recognition and early registration of the problems. We have developed a theoretical model based on our experience with various large-scale projects, some of which were carried put and evaluated on behalf of the Swiss Confederation. The fact that this model is cause-orientated makes it suitable for use with a number of different problems. Our conception of prevention revolves round the focal process of change. The fundamental principles are the following:

Commitment
The partners in a project undertake to participate in compulsory and on-going collaboration which is neither voluntary nor based on an "according to demand" principle. Training, practical advice and triage with the help of trained experts are carried out and constantly checked, assessed and adapted by the project partners.

Networking
Unlike the much-quoted but usually uncommitted voluntary co-ordination, the reliable networking of all participants in projects is essential for effective prevention. This demands clearly structured communication. The project participants must mutually elucidate their tasks and fields of competence, and determine, check and adapt the form of their collaboration.

Intervention on the structural level
Institutions or organisation participating with us in a prevention project are convinced that the project must be organised as an intervention on a structural level, and that their working climate and management culture will be influenced and changed through the work.
The training, on-going practical advice and triage of problem gamblers envisaged for the casino staff is a tricky task. It must not take a repressive form but must be regarded as promotive and supportive help for the people affected. Early registration is not a "police action" but a supportive action regarded as a social responsibility.

Long term effects
These conditions have a powerful preventive effect. Spectacular short-terms results are, however, unlikely. The effectiveness develops on a long-term basis.
The starting point of our problem gambling prevention is based on our knowledge of the development of the addiction. There is a specific prevention level for each stage of a developing addiction.
The development of problem gambling is an on-going process, beginning with the non-gambler The beginner may win considerable sums of money during the introductory stage, and he (or she) may fall a victim to the illusion that they have the power to influence whether or not they will win. Gambling is coupled with positive emotions, and the beginner develops into a "fun" gambler. When, however, things get out of control, he is unable to stop gambling and develops an addiction.
Up to the level of gambling for fun, gambling is usually unproblematic and should be encouraged by the casino management. Gamblers who go beyond their means more than once are defined as deficit gamblers. The step from here to addiction, or to becoming an excessive or desperate gambler, is small. I am sure you are aware of this continuum, which has also been observed in other forms of addiction.

There is a relevant prevention level for every stage of addiction development:

Primary prevention for the introductory stage
Secondary prevention for the critical stage when the first and subsequent problems connected with gambling emerge
Tertiary prevention for the chronic stage, i.e. prevention of relapses during and after treatment. The importance of this level of prevention should not be underestimated.

The addictive level as the start of the downhill path.
The addiction stage is particularly important. Critics of gambling maintain that approximately ninety per cent of slot machine gamblers are in this stage.
The different levels and fields and their interaction

The following is a possible list of the areas and forms, which must interact in effective prevention and early registration.
The early recognition and registration of potential problem gamblers are the basis of our project. They can, however, only be effective if other areas within the casino are included in the work. For this reason, groups are formed to work behind the scenes in addition to the work at the front in the casinos. The existence of these groups is the precondition for adequate discussions on individual cases in the early registration of suspected problem gamblers. This obviously has an effect on the working climate in the casinos.
Casino managements are, of course, aware of the importance of a positive atmosphere in the casinos, but it is not so easy to get potential problem gamblers to the "right" advisory address at the "right" moment by means of well-organised and networked triage. Jörg Haefeli will describe how this works in practice in our prevention model.

The careplay® project as a response to the legal conditions in social protection

A number of casino managements in Switzerland commissioned us to develop a social concept and to implement it in practice. How did we go about it?

We developed the concepts by means of project management in collaboration with the casino management. Once of the first things we did was to create an office for problem gambling prevention under the name of careplay®. This office is affiliated with the WDF Institute which is part of the University of Applied Sciences, Services and Research in Lucerne.

This provided the basis of the structures enabling us to begin with the implementation of the planned measures.

The social concept is based on three fundamental elements:

Early recognition: training, practical consultation, exchange of experience for the casino staff
Sensitisation: information: guest brochures (information about the risk of gambling, self-assessment sheets on the dangers of addiction), and the operation of an Internet platform (www.careply.ch)
Advice and help: triage: contact and advice centre, development of an external treatment network, and operation of a hot line

As regards training, careplay® co-operates with a Dutch partner, Jellinek Consult in Amsterdam. We have adapted their training concept to Swiss conditions, and our instructors are trained for their job in collaboration with Jellinek Consult.
The careplay® training concept is based on a multistage model that takes the different functions of the casino staff into consideration. The spectrum ranges from information events to intensive communication training courses. Organised group discussions for the exchange of experience and case discussions are held as a support and an aid to the transition to the practical level.
The aim of these measures for casino employees is to activate their sensitivity for the early recognition of potential problem gamblers and promote their competence in dealing with such persons. They are not intended to turn casino employees into social workers. The object is to enable them to address the issue of problem gambling with the casino customers and draw their attention to the available help. The staff members ensure that contact with support centres can be reliably established through the triage process.
The aim of the contact centre is to construct and develop a network. The information and experience acquired by the practical advisory groups flows directly back to the everyday life of the casino and is implemented in practice.

Research and development
Besides providing information for casino customers and operating an Internet platform, we also carry out research. We acquire important data connected with problem gambling and collect scientific data about problem gambling in Switzerland. Unfortunately, there are no reliable data sets available to date, or at any rate only in a rudimentary form.

Triage: careplay® as a contact and advice centre
The careplay® centre is the first contact centre for gamblers seeking help. We operate a free help-line and information platform as a basic level aid. careplay® provides triage work in its contacts, i.e. it provides information about the best possible expert advice according to the individual situation and place of residence. This may take the form of various therapies, social advisory services, debt rehabilitation or similar supportive measures. The optimal development of this network is one of our most urgent and important asks.
Swiss law also provides for prohibited admission. Prohibition from admission to casinos may be requested at the contact centre by the affected persons, or it may be ordered by the casinos. It is imposed and supervised by the casinos and is technically networked throughout the country, thereby ensuring that prohibited persons cannot gain admission into Swiss casinos.

Final remarks
The intensive collaboration between the casino managements and addiction and prevention experts is the most important basis for successful work. It is not yet possible to say just how successful it will prove to be.
Neither we nor the casino managements know just how we shall deal responsibly with the shady side of gambling, under entirely new conditions, in around two years.
"We like to take care of good customers", a casino employee told us recently. But the fact that these "good customers" often become problem gamblers is all too often ignored. We must succeed in transforming the equation of "too much prevention of problem gambling equals too little profit for the casino managements" into a responsible policy by the casino managements. We are convinced that a positive working climate and well trained, satisfied staff members are a crucial factor in the prevention work in casinos.

Lucerne, 13.9.2000