Tuesday, August 29, 2006

The Harrah's casino in Reno expects to see one of its regulars in the next
few days. But this man won't receive the typical welcome when he walks
through the door. Instead, a Harrah's casino manager will approach him and
bring up an unpleasant topic: recent comments the man made to a casino host
about refinancing his house and gambling with his retirement money. After
expressing concern, the manager will give the man a problem-gambling hotline
number and a chance to enter himself into a database that will stop mailers
from being sent to his home, among other self-help services. The
unidentified man is an unwitting participant in a program that casino giant
Harrah's Entertainment implemented several months ago that is believed to be
the first and most aggressive problem gambling effort of its kind in the
country. The "ambassador" program - taking its name from the casino managers
charged with approaching gamblers with information about programs many
casinos have offered for years - has captured the attention of problem
gambling treatment experts normally skeptical of casino efforts to help
compulsive gamblers. Casinos in Nevada and many other states are required by
law to post problem gambling hotline numbers, offer self-help pamphlets and
educate casino workers about warning signs. Harrah's also allows gamblers to
sign up on a "self-exclusion" list that applies to all of its casinos
nationwide. These efforts, which acknowledge problem gambling as a
legitimate mental health disorder similar to alcoholism, require gamblers to
take the first step themselves. The Harrah's program is different, experts
say, because it requires workers such as dealers and cashiers to notify a
manager if they believe a person has a gambling problem. The manager then
calls the "ambassador" on duty to handle the touchy task of sitting down
with the customer.
Competitors say the responsibility to help gamblers already lies with every
rank-and-file employee on the casino floor as part of state-mandated
training programs.

In reality, problem gambling advocates say, workers are being told about the
disease but are rarely taking the initiative to intercept people on the
casino floor.

"Frankly, there's a lot of lip service at the corporate level that doesn't
get translated down to the employees," said Keith Whyte, executive director
of the National Council on Problem Gambling. "I can't tell you the number of
times I've gone into a casino and have found brochures tucked away and
employees who don't know what their responsibilities are. There's a
difference between having a program and making sure employees are
comfortable enough to take action."

Previously, workers didn't feel at ease approaching people who probably
needed help, said Andy Donato, a casino supervisor at Harrah's Reno and one
of about 700 "ambassadors" who have volunteered for the added responsibility
nationwide.

"This program reassures them ¦ that we really believe in this," Donato said.

The program requires employees to take action based on what a person says.
Casinos and some treatment experts believe that unless a gambler's behavior
is over the top, words are a more definitive indicator of a person's mental
state.

There aren't any specific "trigger" phrases - that's left to employees'
judgment. Workers receive several hours of training that includes watching
instructional videos with interactions between employees and distraught
customers.

"We don't want to shoehorn them into a box so that they're thinking, 'If I
don't hear this phrase then I don't need to help the person,' " said
Harrah's spokesman David Strow.

So far, about two to three such conversations have occurred at each Harrah's
property per month. Gamblers don't appear to be resisting efforts to strike
up a conversation, though in some cases, ambassadors find that the best time
to approach them is not right away but after the person has had time to cool
off from his last gambling session.

Some appreciate the information and concern but do not appear to need help,
while others have been referred to treatment as a result of the program,
Strow said.

Donato said he received input from outside problem gambling and human
resources experts on how to approach people in a friendly way without making
them feel defensive or combative.

For example, a Harrah's manager might approach a gambler and suggests a
"timeout" over a drink or a meal.

"I've been with Harrah's almost 30 years, and over the years you hear all
sorts of statements, like, 'My wife is going to kill me when I go home' to
'I'm having a bad day, I never should have come here,' " Donato said. "It's
not easy to evaluate without talking to the person directly whether the
person is serious."

Henry Lesieur, a staff psychologist at Rhode Island Hospital's gambling
treatment program and one of the nation's foremost treatment experts, calls
the effort "one of the most thought-out programs I've seen" from a casino
company.

Lesieur, who co-authored the first definition of problem gambling included
in the American Psychiatric Association's diagnostic manual, said discussing
self-help schemes with gamblers in the casino is an "improvement." However,
he questions Harrah's commitment to maintaining a growing "watch" list
documenting conversations and outcomes involving hundreds, even thousands of
gamblers for years to come.

The program also is not going to catch each gambler who tries to re-enter
casinos after requesting that they be excluded or refused service from
Harrah's properties, he added.

Some problem gambling experts are skeptical that the program will make a
difference for gamblers in the throes of addiction.

Robert Hunter, clinical director of the Problem Gambling Center in Las
Vegas, said Harrah's may have trouble reasoning with addicts in a gambling
environment.

"If someone at a bar has had too many drinks, that's not the time to talk to
someone about their drinking," Hunter said. "I see folks who've already
crossed the line into addiction. For them, this is not going to be much
help. That said, I support any efforts to get people into recovery."

Carol O'Hare, director of the Nevada Council on Problem Gambling, says the
program still represents a "big step" for the industry because it aims to
help people before they hit bottom.

Lesieur says the program is a sign that the industry is willing to face its
Achilles heel head-on rather than be pummeled by critics.

Strow said the effort resulted from a policy of continuous evaluation and
improvement based on new research. It is not a knee-jerk reaction or an
admission of inadequacy of past programs, he said.

Lesieur, though, said the program does not go far enough.

The responsibility to be more proactive lies with state governments, not
Harrah's, he said.

"Harrah's is in the business of making money," he said. "I don't expect them
to have a hard sell. If any education of gambling is to be done, it needs to
be done by the state."

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