By Van Ton-Quinlivan, CEO of Futuro Health
The U.S. is in the midst of a deepening mental and behavioral health crisis, with soaring rates of anxiety, depression, addiction, and trauma. But there’s a rising threat that’s often left out of the conversation as I have learned from my recent G7 Canada Brain Economy Summit participation: gambling addiction.
What was once limited to casinos is now as close as your smartphone. Americans are wagering nearly $1 billion a day on platforms like DraftKings and FanDuel. In 2024 alone, U.S. bettors spent an estimated $150 billion—a number driven higher by aggressive advertising and legalized sports betting in 39 states and D.C.
This surge is not without consequences. An estimated 2 to 4 million Americans will experience gambling disorder in their lifetime. One in six problem gamblers will attempt suicide. In Texas, despite strict gambling laws, calls to 1-800-GAMBLER are second only to California. In Pennsylvania, residents lost $238 million to online casinos in a single month.
And yet, gambling addiction remains a footnote in mental and behavioral health strategies, siloed from broader behavioral health initiatives.
A Workforce Ill-Equipped to Respond
The mental and behavioral health workforce is already stretched thin. According to Mental Health America, the U.S. has just one mental health provider per 350 people, and more than 152 million Americans live in designated shortage areas. This shortage is especially acute in rural and underserved communities.
When it comes to gambling-specific treatment, the numbers are even more alarming:
- Minnesota has just 8 certified therapists to serve an estimated 250,000 residents with gambling issues.
- Texas, home to 30 million people, has only three certified gambling counselors in spite of having the second largest call volume into 1-800-GAMBLER.
We need a workforce strategy that reflects the full landscape of mental and behavioral health, including gambling-related harm. And, we need to strengthen the pipeline not only for licensed professionals but also for the vital certificated roles that provide upstream prevention and support in mental and behavioral health.
What Can Be Done?
At Futuro Health, we work with states to strengthen the behavioral health talent pipeline, especially in under-resourced communities. Here’s what we advocate for mental and behavioral health workforce development:
- Upskill existing clinicians by embedding gambling-specific training into continuing education. Certifications like NCGC-I/II are already available and should be scaled.
- Grow certificated roles like Peer Support Specialists, Community Health Workers, Substance Used Disorder Specialists, and addiction-informed financial counselors. These roles can be trained faster and play a vital role in detection and early intervention.
- Grow talent from affected communities—especially rural, low-income, and minority populations where gambling harm is often highest.
A Call to Action
As was highlighted at the G7 Canada Brain Economy Summit, gambling addiction is not a niche issue—it’s a rising public health concern that warrants integration into our mental and behavioral health response.
