New program addresses addiction among the homeless, helpless

Lee Scrivner

Monday, Sept. 4, 2000 | 9:55 a.m.

Lora Smythe, a case manager at Mojave Mental Health, has a client who practically lives at the casinos.

Impoverished and diagnosed as mentally ill, Smythe's client has developed a gambling addiction.

"Any money she gets she drops into video poker machines," Smythe said. "If she wins anything, she will just gamble it again the same day.

"When her money is gone, she survives by inserting her slot card into other players' machines. She will ask them: 'Do you mind if I rack up some points on your playing?'

Smythe's client uses casino comps to stay in hotel rooms and eat buffet food, but the high cholesterol diet has led to health problems.

The addiction has exacerbated an impulse disorder, depression and her poverty, Smythe said.

Her symptoms are common among Las Vegas' least stable resident gamblers: the homeless and the mentally ill, mental health case managers say.

"Gambling addiction often worsens an already dismal situation," Carol O'Hare, executive director of Nevada Council on Problem Gambling, said. "It is a particularly dangerous addiction for people struggling with homelessness or mental illness, because they often miss mainstream opportunities for treatment." To address this problem, MASH Village Transitional Living Center, 1559 N. Main St., has created a new gambling education program for residents who are suspected of struggling with the lure of casinos. Mojave Mental Health deals with the gambling addictions of its mentally ill clients as part of their overall treatment plans.

Marge von Koenigseck, addictions case coordiator at MASH Village, teaches the six-week course to those who are simultaneously battling homelessness and a gambling addiction, focusing on a new facet of the addiction each week.

She and her students meet Monday through Thursday mornings. Topics include the value of money, the symptoms of addiction and the effects of addiction on family members.

"That this is Las Vegas is definitely a factor for many here who are already struggling with homelessness from drug and alcohol addiction, domestic violence or mental health problems," von Koenigseck said. "They're often led by the fantasy that hitting a jackpot will solve everything.

"We try to educate them about the real consequences of compulsive gambling."

Social service professionals and gambling addiction awareness advocates concede that to gauge statistically the extent of problem gambling among financially or mentally unstable populations can be difficult.

"Many homeless by nature of their transience elude detection. And it is often more socially acceptable to admit that you have a drug problem than a gambling problem," O'Hare said.

Thus many case workers must closely monitor their clients' expenditures to determine if they have a gambling problem.

"Our long-term residents must pay a portion of their living expenses," Nerda Swindell, MASH Village resource program manager, said. If they fail to make any payments, "they are mandated to take the gambling education course," she said.

That's the first step, but by no means the only one counselors use.

"When we think our clients are putting all of their allowance into gambling," Tom Strahler, a case manager at Mojave Mental Health, said, "we try to limit their access to funds, which is the same way we treat drug addiction."

Other addictions give a clue that a client may have a gambling problem. A gambling addiction usually coexists with other addictions that can impair judgment. "Over 50 percent of pathological gamblers have former or current alcohol or drug problems," O'Hare said.

In addition, Strahler said, certain mental illnesses are more likely to spawn problem gambling.

"Right now six of my 26 clients have a problem with gambling addiction. For two of them it is an ongoing, major issue," Strahler said. "Certain types of mental illness seem to be particularly susceptible to gambling addiction. Our schizophrenics are not gamblers. It seems to be more often connected with people who have impulse disorders.

"But their gambling doesn't worsen the symptoms of their mental illness directly. It increases stress levels, which can then worsen their symptoms."

On the other hand, Strahler said, some of the symptoms of serious mental illness can actually be alleviated by the repetitive nature of gambling.

"While they are playing video poker, they can often tune out some psychotic symptoms," he said. "But the financial consequences of such a reprieve can be grim."

"Many people are forced to keep returning here through a revolving door because of their gambling addiction," von Koenigseck said. "Hopefully this new program will help to break that cycle."

Lee Scrivner

is a reporter for the Sun. He can be reached at (702) 259-2319 or by e-mail at scrivner@lasvegassun.com.