The Coroners (Determination of Suicide) Bill [HL] is a private member’s bill that was introduced by the Lord Bishop of St Albans on 9 June 2021. The second reading debate is scheduled to take place in the House of Lords on 19 November 2021.
The Lord Bishop of St Albans has described the purpose of the bill as follows:
Gambling can have serious detrimental long term mental health effects. […] There is currently no statutory duty to record gambling as a relevant factor in the determination of a suicide. This bill would create this requirement so that accurate data relating to gambling-related suicides can be recorded and collected. This bill would assist in better understanding gambling-related suicides and its victims, which will help to inform future policy and medical interventions aimed at treating problem gambling.
This is the second time that the Lord Bishop of St Albans has introduced the bill. The bill was first introduced on 16 January 2020 but failed to receive a date for second reading before the end of the 2019‒21 parliamentary session.
What would the bill do?
The bill would require a coroner or jury to record an opinion at a coroner’s inquest as to any factors relevant to a death by suicide. This would include whether the deceased had a gambling addiction. The bill would also give coroners the discretion to disclose information to relevant people or organisations that support vulnerable persons. The identity of the deceased would not be disclosed.
The bill contains one substantive clause, and would make these changes via amendments to the Coroners and Justice Act 2009 and the Coroners (Inquests) Rules 2013 (the 2013 rules). The 2013 rules provide a national framework of procedural good practice for investigations and inquests. They are used alongside the Coroners and Justice Act 2009.
The bill would extend to England and Wales only and would come into force two months after the day it is passed.
How would this differ from the coroners’ current regime?
Coroners do not currently record an opinion on factors (such as gambling addiction) that may have been relevant to a death by suicide.
Coroners are independent judicial officers responsible for investigating the causes and circumstances of certain deaths. They will determine several things, including who the deceased was, and how, when and where the death took place.
The majority of deaths are not reported to the coroner. In most circumstances it will be the deceased’s doctor who issues a medical certificate with the cause of death (for example, where a person dies following treatment for an illness).
However, coroners are expected to open an inquest where a person has died:
- if it is a violent or unnatural death;
- where the cause of death is unknown; or
- where a person has died whilst in custody or state detention.
Inquests are fact-finding inquiries that consider the cause and circumstances of a death. This typically involves public hearings that can take place with or without a jury.
At the end of an inquest, the jury or coroner (if there is no jury) will decide the medical cause of death and provide a conclusion (previously referred to as a ‘verdict’) on the circumstances of the death. The chief coroner’s guidance on conclusions states that the conclusion should be a description of how (or by what means) the deceased died, rather than the broad circumstances. This is normally a description of the mechanism of death, for example: ‘suicide’. The chief coroner’s guidance states that the conclusion should be based on facts and must not include the coroners or jury’s opinion, other than on those matters which the law allows, such as who the deceased was and how, when and where the deceased died. The conclusion is recorded on a ‘record of inquest’.
How prevalent is problem gambling in the UK?
Data on problem gambling in the UK remains limited. The term ‘problem gambling’ describes gambling behaviour that has negative consequences and a possible loss of control. For example, this could include a person spending over their limit, gambling to win back money, or feeling stressed about gambling.
The Gambling Commission’s most recent data on problem gambling for the year to June 2021 suggested that overall participation in any gambling activity was 42% of 4,010 people who responded to the surveys. The rate of problem gambling was 0.4% of those respondents, compared to 0.5% in the previous year. Additionally, the Gambling Commission noted that the rate of gamblers who experience a moderate level of problems leading to some negative consequences had “decreased significantly” to 0.7%, compared to 1.4% in the previous year. The Gambling Commission is responsible for regulating the gambling industry in Great Britain.
However, concerns have previously been raised by academics about discrepancies between official statistics on problem gambling and how they may not represent the true scale of the issue. For example, a 2019 YouGov survey commissioned by the charity GambleAware estimated that 2.7% of adults in Great Britain were problem gamblers, compared to an estimate of 0.7% in the 2016 England, Scotland and Wales health surveys and previously cited by the Gambling Commission.
Are problem gambling and suicide linked?
The correlation between problem gambling and suicide has been considered in recent years.
In 2019, the charity GambleAware and the Gambling Commission released results of a small-scale research study that examined the link between problem gambling and suicide. It found that problem gamblers were more likely than others to have suicidal thoughts, attempt suicide and to self-harm. Problem gamblers were also found to be more likely to feel lonely and isolated when compared to others.
However, the report also highlighted that research on the link between problem gambling and suicide remained limited, and its study had been based on data retrieved in 2007. The report included a recommendation that more research and data should be obtained to better understand the correlation between problem gambling and suicide.
Academics have recently considered suicidality and problem gambling amongst young adults in Great Britain, as covered in a January 2021 Lancet journal article. The article authors, Heather Wardle and Sally McManus, analysed data collected from a 2019 emerging adults gambling survey. This was a cross-sectional and online sample survey of 16- to 24-year-olds in Great Britain. The authors argued that there was “substantial association between problem gambling and suicide attempts, with the prevalence of suicide attempts increasing sharply with problem gambling”. This was identified in both young men and women. They argued that young people with problem gambling behaviours should be considered at risk of suicide.
Most recently, Public Health England (PHE) published its ‘Gambling-related Harms Evidence Review’ on 30 September 2021. The review consists of six technical reports that considered several aspects of gambling in England, including the prevalence of gambling-related harms, including mental and physical health.
It referred to two quantitative studies that reported that deaths from suicide were “significantly higher” amongst adults with gambling disorders when compared to the general adult population. It also said qualitative studies had supported a link between gambling and suicide and self-harm.
When considering the costs to society from gambling-related harms, the review estimated that the annual economic burden of harmful gambling was approximately £1.27 billion (expressed in 2019 to 2020 prices). Of this figure, the estimated excess cost of suicide was £619.2 million (based on the wider social costs of an estimated 409 suicides that were associated with problem gambling).
The review concluded that harmful gambling should be considered a public health issue because it was associated with harms to individuals, their families, close associates and the wider society. It said that more needed to be done to prevent and reduce harms associated with gambling.
Following the PHE review, the Parliamentary Under Secretary for the Department for Digital, Culture, Media and Sport, Chris Philp, said that the Government is “determined to protect vulnerable people from exploitation by aggressive advertising or unfair practices that entrench problem gambling”.
What has the gambling industry done to address problem gambling?
Companies in the gambling industry have outlined steps they have taken to support responsible gambling. This includes participation in awareness campaigns such as ‘when the fun stops, stop’. The international betting and gaming operator Paddy Power Betfair said that awareness campaigns have been successful in communicating responsible gambling messages with audiences. Some have also introduced self-help tools on their websites. For instance, companies such as Coral have introduced spending control, time management and budget calculator tools, as well as dedicated gambling advice pages.
However, campaign groups have argued that the gambling industry has not gone far enough. Gambling with Lives, a charity and campaign group established by bereaved relatives of young people who committed suicide as a result of problem gambling, has called for a change in approach to address problem gambling. It has stated that the current approach of encouraging “responsible” or “safer” gambling is ineffective and increases harm.
PHE published a qualitative analysis of stakeholder perspectives as part of its gambling related harms evidence review. Stakeholders included commercial organisations in the gambling industry in Great Britain.
PHE said it found differences between how commercial and non-commercial stakeholders represent the problem of gambling-related harms. It said commercial stakeholders “represented the sources of harm as complex”, and “portrayed that [this] harm was experienced by a minority of problem gamblers”. It also said commercial stakeholders thought that responses to harm should be focused on individual intervention and treatment, and “generally did not acknowledge that gambling can harm affected others”. ‘Affected others’ refers to people, such as relatives, who are affected by problem gambling in addition to the problem gambler. In comparison, PHE said that non-commercial stakeholders generally viewed gambling as “clearly harmful”, acknowledged that gambling can harm affected others, and believed that responses to preventing harm should be via a whole systems approach.
However, PHE did note some overlap between commercial and non-commercial stakeholders. It said that most agreed that increasing consumer awareness and vendor responsibility could help to prevent and reduce harm.
What has been said in the House of Lords?
During the debate, the Lord Bishop of St Albans described harmful gambling in England as a “significant social problem”. He expressed concerns about the welfare of gamblers and the role that gambling operators play:
It is significant that, in many instances of gambling-related suicide, gambling operators, far from attempting to intervene on behalf of a gambler’s welfare, are still actively encouraging the person to gamble right up to their death—indeed, sometimes after the person has died they receive calls and offers of free gambling. There is virtually no incentive for operator intervention.
Baroness Merron, the Shadow Spokesperson for Digital, Culture, Media and Sport, noted that gambling-harm presented a complex picture of behaviours, circumstances and effects. She highlighted several public health aspects in the PHE review that were linked to gambling harm. This included a link between higher levels of alcohol consumption and harmful gambling.
Lord Parkinson of Whitley Bay, the Parliamentary Under Secretary for the Department for Digital, Culture, Media and Sport, set out what the Government planned to do to address the problem. He made reference to limited data on gambling-related suicides in the UK and noted that the Department of Health and Social Care is working to improve data collection in this area. He also stated that NHS England was investing £57 million in suicide prevention as part of the NHS long-term plan.
The Lord Bishop of St Albans urged the Government to support the Coroners (Determination of Suicide) Bill to ensure that “more accurate” data can be collected on the number of gambling-related suicides.
- House of Lords Library, Public Health England: Gambling-related Harms Review, 11 October 2021
- Charles Livingstone and Angela Rintoul, ‘Gambling-related suicidality: stigma, shame and neglect’, The Lancet, 1 January 2021, vol 6 no 1, e4–e5
- Public Health England, The Impact of Covid-19 on Gambling Behaviour and Associated Harms: A Rapid Review, September 2021
Photo by Steve Sawusch on Unsplash.