Optimizing support and service delivery for problem gambling among persons with complex needs

In Progress

Homelessness and Housing

Substance Use, Harm Reduction and Addictions

Problem gambling disproportionately affects people living with poverty, homelessness and multimorbidity including mental health and substance use concerns. For example, our research shows that men who are homeless are nine times more likely than the general population to be addicted to gambling.

Because only one in 10 people experiencing problem gambling seek treatment, we hypothesized that self-management would be a useful addition to treatment to improve health outcomes for people with complex needs.

A first-of-its-kind Smartphone app built with – and for – people experiencing gambling and other concerns such as homelessness.

The SPRiNG app protoytpe will be accessible to everyone with a phone, and designed to be integrated into existing programming for people to use to self-manage their problem gambling. The app is meant to complement and supplement service delivery when problem-gambling programming or case workers are not available (e.g. nights, weekends). It was developed through several interrelated projects. A Community Advisory Committee guided all aspects of the research projects described below.


We started with a literature review, to find out what is already known about the potential of self-management strategies for problem gambling among people with complex needs. Little research has focused on self-help and self-management in gambling recovery, and even less has looked at self-management approaches for people with complex social and health histories (e.g. poverty, homelessness, multiple physical and mental health and substance concerns). Read a report on the review.


We consulted with people with lived experience of problem gambling and complex needs, to better understand their experiences and needs, and to identify useful functions and features for a self-management app. This project included a focus group with service providers and 21 in-person qualitative interviews with people with lived experience.


We collaborated with technology partners and people with lived experience to co-design and develop a problem-gambling self-management app prototype. The app’s development was guided by the feedback and information described above, along with a competitive analysis of available self-management apps, and continuous feedback from service providers and people with lived experience, through user testing sessions in the community. The goal was to develop a usable prototype that reflects the experiences, needs and values of the clients who will be using it.

Guiding solutions

To further address the paucity of research on interventions to support people experiencing problem gambling and complex needs, we conducted a concept mapping project with a variety of health and service providers. The goal was to find out what they need (e.g., knowledge, strategies, resources) to better serve this group. We identified five actionable recommendations to address the systematic gaps in knowledge among health-care and service providers with respect to screening and treating problem gambling. These recommendations are being disseminated to policy makers and professional associations within Ontario for uptake in practice.

Homelessness and Housing

Substance Use, Harm Reduction and Addictions

Dr. Flora Matheson

Dr. Flora Matheson is a medical sociologist and mental health and addictions specialist. Using a gender lens, she investigates the social determinants of mental health, substance and alcohol use, homelessness, problem gambling, and criminal justice involvement.

Dr. Sara Guilcher

MAP Affiliate Scientist


  • Aklilu Wendaferew (Good Shepherd Ministries)
    Principal Knowledge User
  • Dr. Nigel Turner (Centre for Addiction and Mental Health)
  • Dr. Wayne Skinner (University of Toronto)


  • Christopher Gruca, App Development
  • Sarah Hamilton-Wright, Research Program Manager
  • David Kryszajtys, Research Coordinator (formerly with MAP)
  • Igor Tomachevski, Design Consultant
  • Hamza Varvani, App Development
  • Dr. Jessica Wiese, Research Associate (formerly with MAP)
  • Kevin Wu, Research Assistant


  • Ontario Ministry of Health and Long Term Care


  • Good Shepherd Ministries
  • The Jean Tweed Centre
  • Fred Victor
  • Costi Immigrant Services
  • Gambling Research Exchange Ontario
  • Ontario Pharmacists Association
  • Public Health Ontario
  • YMCA Youth Gambling Awareness Program
  • Skylark
  • Black Youth Helpline
  • Gambling, Gaming and Technology Use, Centre for Addiction and Mental Health

Contact Info

Dr. Flora Matheson

Principal Investigator

(416) 864-6060 ext. 77482