Lee Willows and Frankie Graham are former gambling addicts who at their lowest both battled with suicidal thoughts. They have since dramatically transformed their lives and now lead two hugely respected charities in YGAM and Betknowmore. Their devastating experiences is what now motivates them to work tirelessly to reduce gambling-related harms. The two Lived Experience leaders are now working together on a number of pioneering projects including Safer Gambling Training for operators.

Can you explain how you arrived in your current position/job and how you are working together?

Lee Willows: After almost losing everything I cared about to a severe gambling addiction, I was grateful to be in recovery and I spent several months thinking about how I pick myself back up.  Having worked in education for 25 years, I am passionate about its value so after speaking to lots of people and undertaking research, I decided to establish YGAM. I was determined to turn my very negative experience into something positive to help others. In doing this, I wanted to meet other addicts and hear their stories to help me learn.  What I discovered quickly was that this space was full of academics, which was good, but what about insight from those directly affected. Using Google, I came across Frankie who was running a treatment hub close to Angel underground station in London. We met, got on incredibly well and found out that we had a lot of similarities in terms of our journey of addiction.  We stayed in contact, became mentors to each other and we are now working together.  YGAM provides education and Betknowmore is about support. I am delighted to be now working in partnership with Frankie on a number of real meaningful projects that will help ensure people do not go through the experiences we did.   

Frankie Graham: I lived with a gambling addiction from late teens until my mid-30’s when my life became increasingly chaotic including involvement with alcohol and drugs. I began to be involved in criminal activity, and conversely, this is what ‘saved’ me. In 2006, I was arrested, went through the criminal justice system, and was given a suspended sentence. The trauma of that experience, plus the untold harm and stress it caused to my family, placed me into a state of acceptance. I recognised that I had to change, if not for me, then for my family. I committed to recovery, and engaged with various therapies, self-help methodologies, and volunteering. The change was rapid. After joining the YMCA in 2007 supporting young offenders, I decided in 2013, to leave my post and enrolled onto a business start-up scheme with a purpose of creating an organisation that could fill what I perceived to be the ‘gaps’ in gambling support and treatment. Betknowmore UK was established as a non-profit, social enterprise. I met Lee around 2015 and our relationship has developed to where we find ourselves working together and making a difference.

We hear a lot about ‘Lived Experience’ – what does that mean to you and how is it important to the work that you do?

Lee Willows: It is pleasing to see more contributions made from people with direct experience of the tragic harm that gambling can cause some individuals, such as the YGAM Founders. Lived Experience or what the Commission is terming ‘Experts by Experience’ is a really important part of the conversation. I think that Lived Experience could also include a chorus of different voices and not just those who have experienced gambling disorder, but who represent the wider player spectrum. Personally, as someone who lost everything to a gambling addiction, I am always grateful for the opportunity to contribute my insight and experiences as such a level of inclusion would have been unheard of five years ago. By taking this much broader approach it would be amazing if different people within the debate can find some common themes to focus on and move forward in a progressive and non-judgmental way.

Frankie Graham: Lived experience provides personal insight, knowledge and empathic understanding. It is, and will be, at the core of all of Betknowmore’s work. Our proudest achievements as an organisation, are supporting individuals to overcome gambling harms, then providing the pathway for them to move into paid employment within the gambling support sector.  I strongly believe EBE’s are going to be an invaluable addition to the national treatment and support network, bringing with them new learning from the broad church of EBE voices and opinions. Our new service, Peer Aid, will be at the forefront of this work.

Frankie Graham, Chief Executive of Betknowmore

What’s your vision for training staff in the gambling sector and what’s required to make that vision a reality?

Lee Willows: I have learned a lot over the last five-years. I believe there are some talented people in the sector who are genuinely working hard to improve player protection and safer gambling initiatives. I think the customer facing teams in gambling operators can develop by understanding gambling-related harm through the lens of lived-experience. It is vital that operators focus more on the outcomes after identifying and interacting with customers who may be at risk or experiencing harms. What’s missing and what might build upon all the work the sector are doing is a National or even an International Standard that colleagues within the sector can take with them throughout their career, and which includes regular mandatory updates and refresher courses.  It would build trust with regulators and it would encompass all consumer facing staff working across every gaming vertical.  For example, doormen have an SIA Licence and in UK gambling there are Personal Licence Holders.  I think having one single standard might speak volumes with government and regulators.

Frankie Graham: I think the gambling sector has undergone a lot of change in the last two to three years. The change has been driven by heightened awareness and acknowledgement that gambling does have associated risks, and that those risks can translate into serious and chronic harms if not properly identified and managed.  There is still a lot of work to be done. To move towards a consistent level of customer service, like Lee, I believe there needs to be a basic level of competency, courtesy of training and staff development. As an example, in Australia, when a person wants to serve alcohol, they need to gain a ‘passport’ – which is provided after training.  The new BGC could perhaps explore this as an option for their members?

Some people view gambling as being intrinsically wrong or bad – how do you view it and from a public health perspective does it have more in common with alcohol or tobacco?

Lee Willows: Most forms of gambling are restricted to people aged 18 and above therefore things such as product design, marketing, education and awareness of the risks should be age-appropriate. I’m not sure it’s as simple as comparing it to either tobacco or alcohol because I know from personal experiences that gambling addiction is like no other. I do think some of the comparisons to tobacco are slightly unjust if we use science because each drag of tobacco will damage someone’s health regardless of amount or frequency yet we know the majority of people can enjoy gambling safely. Like we have seen in other industries, there are effective ways to protect the health of the business and customers simultaneously and maybe some lessons can be learnt. However, the current public perception towards gambling addiction seems far less compassionate compared to attitudes towards both alcohol and tobacco addiction. This can only be improved by increasing understanding and raising awareness.

Frankie Graham: My personal view on gambling is that like any activity with inherent risks, education, awareness, and access to adequate support are fundamental.  We have to ensure the activity is as safe as possible, and that the proper systems are in place to identify gamblers ‘at risk’ and take the correct course of action to safeguard them.  Of course, the industry must also keep working to drive up standards and put player protection first.

I think a bigger issue for the third sector is the ‘red line’ some draw around funding, without maybe properly understanding the existing funding structure, which is exceptionally challenging. There is minimal government or local authority funding, which is very different to other issues identified as ‘public health’ matters. For example, few London boroughs have dedicated gambling support services, whereas local drug and alcohol services are commissioned with multimillion-pound budgets. We believe that local services are essential to working with communities and identifying individuals vulnerable to gambling harms.

We can certainly learn lessons from other issues that have had a public health approach to reduce their negative impact, such as tobacco and alcohol. However, each activity has its own characteristics and gambling is quite unique in a lot of aspects.

What similarities and differences are there between gaming and gambling?

Lee Willows: To start with, one is regulated and the other isn’t which many people don’t know and in YGAM workshops we make the difference between the two very clear. We also address the blurred lines between gaming and gambling focusing on products such as lootboxes. I welcome the news that the government is to launch a call for evidence into loot boxes later this year. Loot boxes that contain the element of chance should not be sold to children under 18 in my opinion.

The number of young people video gaming is far higher than what you would experience in arcades and when they are gaming they are often not with their mums, dads or guardians and in a highly immersive gaming environment. Forcing a young person to ‘come off’ the game – can result in huge family arguments, which in many ways demonstrates the immersive nature of gaming and some of the potential mental health issues associated with it. YGAM ran a Parliamentary Symposium on gaming and there was a real sense from the gaming representatives that some thought the sector simply didn’t need regulating, although I think regulation could actually be a positive initiative.  

Frankie Graham: I believe there are overlaps between the two activities. I would point to the immersive nature of both experiences, the uncertainty of rewards in gaming are similar to the ‘near miss’ experience in gambling. Both are accessible through the same technologies and the content and gameplay can be difficult to distinguish. I am interested in the neurological conditions both can stimulate. For example, if a teenager playing video games develops a tolerance within their neuro / reward pathways to gameplay stimulation, which if migrated to gambling behaviour, would it make them more vulnerable to gambling harms? 

Lee Willows, Chief Executive of YGAM

What impact has COVID-19 had on (a)your work (b) the incidence of gambling-related harm?

Lee Willows: We have approached the lockdown positively and used the time and space to reset the dial. Things that we simply haven’t had the time to look at have been revisited.  We have updated our educational resources with Pete Woodward taking responsibility for our work in universities and Amanda Atkinson doing the same with the educational work we undertake with parents many of whom simply don’t know about Loot Boxes or Skins. In terms of the impact on gambling-related harm, I’m in regular contact with colleagues from treatment organisations that share the same mission as YGAM and I think it is crucial to track any trends or changes in consumer behaviours due to lockdown. For YGAM, we have seen a huge increase in the demand for our resources from teachers and parents and I suspect this is because they are aware that young people are spending more time at home, potentially leading to more online play.

Frankie Graham: The short-term impact of Covid-19 has triggered a review of how we are supporting gamblers and the mechanisms we are using to do so. This also applies to our training offer where there has been a shift towards remote and virtual materials. We are working hard to migrate content to other formats and to ensure that they retain the same impact and benefits. The legacy of COVID-19 may be fuelling the growth of remote gambling where I think the industry needs to do more work including the deployment of more resources around prevention and remote interventions. You would need to ask what is the operator’s role in supporting individuals who have been identified as experiencing harms? What are the thresholds of support, and how are they adapting safeguarding procedures? 

What can the industry do to help you and make a positive difference?

Lee Willows: Of course what we are able to deliver is determined by the resources that we have and as an organisation we think on a big scale. We are always grateful for the support we receive from organisations within the gambling space that share our enthusiasm for training, education and fostering social responsibility at every step of the player journey. I would like to see all stakeholders including the Government and the regulator take a diverse and inclusive approach which enables us to establish a proper dialogue. I welcome the continued and constructive engagement from the dedicated people working right across the industry and third sector.

Frankie Graham: My biggest concern at present is the disturbingly low percentage of gamblers who require help, but not engaging with support / treatment services. Operators have data of those at risk, or already experiencing harms. Can we better signpost them into support? We also need to explore the effectiveness of the current safer gambling messaging, and ensure that individuals are putting health first, gambling second.

Finally, what’s next for this partnership?

Lee Willows: We have both worked extra-long hours over past 12 months and we are now almost ready to launch some exciting new projects. We have complimented our own lived experience insight with evidence-led content to develop 8 online training modules for staff working for gambling operators. Our Safer Gambling Training website will be going live in coming weeks and we are looking forward to it making a real impact.

Frankie Graham: The other big project we are collaborating on is a Mindful Resilience program. We have appointed a highly qualified clinician to lead this groundbreaking programme which will see us develop, deliver, and evaluate training to healthcare professionals on gambling, gaming, and digital behavioral addictions. The programme will be initially starting in London in September 2020, expanding to the West Midlands in 2021 and then a potential national rollout in 2022.