‘Gas on a fire’: Missouri sports betting could increase bankruptcies and suicides, experts warn

Missourians will be able to bet on sports this year, though not by the start of football season.

That’s in part because of a decision by Missouri Secretary of State Denny Hoskins to reject the Missouri Gaming Commission’s emergency rules, which would have fast-tracked the rulemaking process.

Jan Zimmerman, chair of the Missouri Gaming Commission, said the emergency rule would have given highway patrol staff more time to complete the “extensive” process of investigating license applicants.

But Hoskins wrote in a statement that the regular process — including a public comment period and a review by a state committee — was needed to ensure “the people of Missouri are appropriately informed and have a say in the final decisions.”

In a constitutional amendment that voters narrowly approved last year to legalize sports betting in Missouri, the state was given a deadline of Dec. 1, 2025, to launch sports betting. The state is on track to meet that deadline, Zimmerman said.

The commission in May approved Missouri’s new sports betting rules, which “cover everything from processing license applications to disciplinary action,” Zimmerman said.

“Every phase of sports wagering allows us to provide oversight,” she added.

License applications are currently open. Zimmerman said “untethered” licenses, which go to operators not connected to a casino or stadium, will be issued in August while other licenses will be issued in November.

While “everyone is anxious for the end of baseball season (and) the beginning of football season,” Zimmerman said, “it’s important that the gaming commission staff get it right … Our responsibility is to protect the industry and the folks who work in the industry, but also to protect the citizens of Missouri.”

The state expects to collect about $28 million in tax revenue from sports betting annually. However, how much money will go to schools — a key selling point used during last year’s campaign — is still unclear.

Some of the taxes collected will first be used to cover the commission’s regulatory expenses, according to the amendment. After that, $5 million or 10% — whichever is more — will be sent to the Compulsive Gaming Prevention Fund. The rest will be used for K-12 and higher education.

A new fund for problem gambling

The amendment created the Compulsive Gaming Prevention Fund, which is distinct from the Missouri Department of Mental Health’s Compulsive Gamblers Fund.

Overseen by the state treasurer and managed by the Gaming Commission, the new fund will help provide compulsive gambling counseling and support services, develop problem-gambling treatment and prevention programs and distribute grants to organizations that help people with compulsive gambling problems.

Unlike other state appropriations — which, if unspent, typically go back to the general revenue fund — this fund will roll over into following years.

That’s a critical part of addressing compulsive gambling in the state, according to Keith Spare, chair of the Kansas City Port Authority Problem Gambling Advisory Committee and the Missouri Alliance to Curb Problem Gambling.

“In the case of this $5 million, if it is not spent, it stays in the fund to be spent later. That’s incredible, because that means you have something to plan on,” he said. “Missouri funding will now be, for the first time in history, secure for problem gambling.”

Roughly 3.1 million Missourians participate in some form of gambling each year, according to a 2022 study. About 200,000 met the criteria for a gambling disorder and another million met enough criteria to be considered at-risk.

An estimated 1.2% of adults globally have a gambling disorder. In the United States, the legalization of gambling and the proliferation of sports betting have made compulsive gambling — which experts consider an addiction similar to alcohol and drugs — more widespread, especially among young men.

New data suggests that when a state legalizes gambling, the number of bankruptcies rises between 20% and 35%. Financial hardship is one of the main reasons that nationally, an estimated one in five compulsive gamblers considers or attempts suicide, said Spare, a retired substance use and compulsive gambling counselor.

With sports betting going live in Missouri this year, Spare and other experts are worried that outcomes like bankruptcy and suicide will become more severe even if the number of people with gambling disorders doesn’t rise much.

“When you have the prevalence of gambling online — and this is going to be largely online — you have the ability to gamble day and night, basically in a private setting,” he added. “That’s putting gas on a fire.”

A fresh start?

The money allocated to the Compulsive Gaming Prevention Fund will help the state better serve people with compulsive gambling problems. But Spare’s main concern is whether the department — which he said “has largely abandoned problem gamblers” — will spend the money effectively.

“I’ve said to (the department) from the beginning: ‘You need an advisory committee. You need people who can tell you what’s a good idea, what’s not a good idea, and here’s how to do it,’” he said.  “But like they’ve done all along, they want to do what they want to do and not have any public input.”

The Missouri Department of Mental Health repeatedly declined requests for an interview and only replied to one of several questions sent by The Beacon.

In that response, a spokesperson wrote that the new fund is managed by the Gaming Commission, but that in the recently approved state budget, the General Assembly approved $4 million from the fund to go to the Department of Mental Health.

That money includes $1.5 million for “prevention and education services,” $500 thousand for “adult psychiatric services” and $2 million for “treatment of alcohol and drug abuse.”

Spare said that although the Department of Mental Health requested some money from the older fund — the Compulsive Gamblers Fund — for several years, “last year, they drew down nothing.”

He said that when he asked the department’s director of behavioral health, Nora Bock, about her division’s limited use of the fund, he was told, “‘Well, my counselors don’t know that there’s many gamblers out there.’”

“Well, that’s all in how you ask the question,” Spare told The Beacon. “If you say, ‘Do you have a gambling problem?’ every gambler is going to say no … Her opinion is that if there isn’t a lot of demand (for counseling), there isn’t a lot of problem gambling. Well, that doesn’t mean people aren’t dying.”

The department did not respond to The Beacon’s questions about Spare’s concerns.

Spare said a major reason for low demand for help is a lack of awareness that is due, in part, to the fact that counseling and other services are only advertised on casino, lottery and sports betting ads.

“There’s a difference between marketing to get gamblers in treatment … (and) traditional advertising for casinos and the lottery,” he said. “You need to find a way to get advertising to the general public and to the gamblers about when this is a problem, why it’s a problem and what to do about it.”

He said the state has spent decades “getting alcohol and drug abuse to be recognizable” so that people can identify the warning signs of addiction in their loved ones and help them find care, but “there’s nothing like that for problem gambling.”

“We need advertising that says not to gamble, to be aware that if you do gamble, these are the problem signs, and if you see them in your family member or neighbor or co-worker, raise the alarm,” Spare said.

Accessing care

Even for those who do seek help, state resources are limited, Spare said.

Nine agencies have contracts with the Department of Mental Health to provide compulsive gambling counseling services at no cost to qualifying Missourians. However, of those, only six have a certified gambling disorder counselor on staff.

Calls to the 1-888-BETSOFF number are routed to these counselors. In the Kansas City region, the state has partnered with University Health in Kansas City and Family Guidance Center in St. Joseph.

Jordyn Johnston, an alcohol and drug counselor at University Health, is also a gambling disorder counselor, providing in-person and remote counseling for people living anywhere in Missouri.

She currently works with eight compulsive gambling patients and said she has seen demand increase over time, particularly in rural areas.

Part of that increase could stem from the legalization of sports betting in Kansas in 2022, with many Missourians crossing the border to place wagers.

“I live on the Kansas side, and I actually see people pulled off on the 435 ramp on Saturday mornings, placing their bets,” Johnston said. “There’ll be like five to 10 cars lined up on those off-ramps.”

As demand for services increases, it places more strain on the state’s gambling disorder counselors, many of whom are also alcohol and substance use counselors. While Johnston works with eight patients with a gambling disorder, she works with 35 to 40 patients with substance use disorder.

She said that as the state prepares for another potential increase in the number of people seeking care for gambling disorders, she’s hopeful that University Health and other organizations will bring on more counselors.

Spare said Oklahoma offers a virtual training for problem gambling counseling that, for a $4,000 annual fee, an unlimited number of Missouri-based counselors can attend. But he said the Department of Mental Health hasn’t expressed much interest in the Oklahoma program.

While the state hotline refers people to the handful of agencies that have partnered with the state, there are other counselors across Missouri, Spare said. Port KC’s Problem Gambling Advisory Committee paid for dozens to be trained in the last few years alone.

The problem, he said, is that there isn’t a comprehensive list of public and private counselors able to provide problem gambling care, which makes it harder to find a local counselor or gauge how well the current supply of counselors could keep up with a potential increase in demand.

Johnston said that if people with gambling disorders aren’t able to access care, the repercussions could be dire for them and their families.

“The rate of suicide is increasingly high for those people, because gambling is an addiction where it doesn’t really have those outward symptoms. … A lot of the things that they go through are really hidden, and even their family doesn’t know,” she said.

“A lot of it is financial problems — they’re in so much debt, they’ve gambled away their house, and they really feel like there’s no other option left, (like) there’s nothing else for them and suicide is the only option,” she added.

Building a better sports betting system

Spare said Missouri could learn from neighbors like Kansas and Oklahoma, which pay for specialists and counselors statewide and offer a hotline staffed by trained gambling counselors.

“In Missouri, we have a hotline paid for by the gaming industry that’s answered by college students … All they try to do is make referrals,” he said.

Asked what the state should do with its new fund, Spare advocated for a full range of services, including individual and family counseling, inpatient treatment and “first and foremost, an advertising campaign … that gets people to come for treatment.”

He also pushed for a “no wrong door” approach through which mental health and substance use counselors are also trained to provide gambling disorder care so that “wherever someone shows up looking for care, it’s available.”

That care must also be long-term, Spare said, likening it to addressing substance use disorder.

“Addiction is a mental disease. It’d be like saying, ‘We’re going to give you six weeks of medicine for schizophrenia and then we’re not going to worry about you,’ he said. “It’s crazy, but some people think that way: ‘Why aren’t you over it? Why don’t you quit? Why did you start again?’ Because it’s an addiction.”

The Beacon’s Blaise Mesa contributed to this story.

This article first appeared on Beacon: Missouri and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.