Invisible Obstacles: Audit of Consumer Experience When Calling Gambling Helplines in the United States.

Gambling helplines offer an important entry point to treatment for individuals who experience harm from gambling problems. To date, research has not directly explored callers' expectations for helplines or whether helplines consistently connect individuals to services and resources. Across two studies, this research (1) explored the expectations for helpline interactions among 179 adults in the United States who had gambled within the past year, and (2) examined the customer experience of contacting gambling helplines in 48 states using an audit methodology. In Study 1, when asked about their expectations, survey participants placed the greatest importance on receiving nonjudgmental, compassionate support from a knowledgeable human rather than an automated system. Further, participants indicated they were unlikely to call the same helpline again should their first experience not meet expectations. In Study 2, trained research assistants posing as customers requesting to be connected with treatment services conducted 96 audit calls (i.e., 2 per state, excluding the two states without legalized gambling). Overall, 91% of calls were answered, but only 66% of answered calls led to a treatment referral. When combining metrics for call length, provision of a concrete treatment referral, and a call experience coded as helpful, only 31% of calls were successful. Results suggest that while gambling helplines provide a critical access point to treatment, substantial barriers may limit their effectiveness. Efforts to improve access to care for those experiencing gambling-related harms must consider the expectations gamblers hold for helplines, as well as the obstacles callers are likely to encounter when making a call, and work to improve the referral process.