Qualitative exploration of gambling harm among UK veterans : normalisation, stigma and postservice escalation

dc.contributor.authorDekel, Dana
dc.contributor.authorEkenna, Adanma
dc.contributor.authorEngward, Hillary
dc.contributor.authorGodier-McBard, Lauren R.
dc.contributor.authorKay, Chris
dc.contributor.authorKersey, Thomas
dc.contributor.authorFossey, Matt
dc.contributor.authorDymond, Simon
dc.contributor.departmentDepartment of Psychology
dc.date.accessioned2026-09-11T14:40:06Z
dc.date.available2026-09-11T14:40:06Z
dc.date.issued2026-03
dc.descriptionPublisher Copyright: © Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY. Published by BMJ Group.. This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.en
dc.description.abstractObjectiveThis study explored the lived experiences of UK Armed Forces veterans affected by gambling-related harm. It examined how military culture, institutional practices and life transitions shaped gambling behaviours, barriers to help-seeking and the long-term impact on well-being. While quantitative research has documented elevated gambling-related harm among veterans, little qualitative work has examined how veterans themselves understand, experience and navigate gambling harm across military and post-military contexts.DesignReflexive thematic analysis of one-to-one semistructured interviews, covering topics such as the nature of participants’ gambling activities, the impact on their lives, pathways to gambling behaviours and help-seeking.ParticipantsParticipants were UK veterans (n=14), aged 31–60, including one female, from three service branches, all of whom self-identified as having experienced gambling-related harm.ResultsFour interrelated themes were generated: (1) Gambling as normalised in both civilian and military contexts, reinforced by institutional routines and downtime activities; (2) Gambling as an emotional coping mechanism, shaped by institutional norms of stoicism and emotional control; (3) Stigma, silence and structural barriers to help-seeking, including fears of professional repercussions and (4) Escalation postdischarge, driven by isolation, unstructured time, digital gambling access and difficulties adjusting to civilian life. Participants reported concealment, debt and relational breakdowns, with some disclosing suicidal ideation linked to gambling harm.ConclusionsGambling harm among UK veterans is shaped by a complex interplay of cultural, emotional and institutional factors. While gambling opportunities are embedded in military life, systems of support remain inconsistent and often punitive. Gambling remains under-recognised as a serious mental health issue within military and veteran care pathways. Findings highlight the need for stigma-free, culturally informed interventions across the military life cycle, including routine screening, gambling harm education and trauma-informed care.en
dc.description.versionPeer revieweden
dc.format.extent367261
dc.format.extent
dc.identifier.citationDekel, D, Ekenna, A, Engward, H, Godier-McBard, L R, Kay, C, Kersey, T, Fossey, M & Dymond, S 2026, 'Qualitative exploration of gambling harm among UK veterans : normalisation, stigma and postservice escalation', BMJ Open, vol. 16, no. 3. https://doi.org/10.1136/bmjopen-2025-109458en
dc.identifier.doi10.1136/bmjopen-2025-109458
dc.identifier.issn2044-6055
dc.identifier.other250818680
dc.identifier.other0347772c-a0ed-498a-8b55-dc9c56deae3d
dc.identifier.other105034366683
dc.identifier.other41881538
dc.identifier.urihttps://hdl.handle.net/20.500.11815/8251
dc.language.isoen
dc.relation.ispartofseriesBMJ Open; 16(3)en
dc.relation.urlhttps://www.scopus.com/pages/publications/105034366683en
dc.rightsinfo:eu-repo/semantics/openAccessen
dc.subjectBehavioren
dc.subjectMENTAL HEALTHen
dc.subjectQUALITATIVE RESEARCHen
dc.subjectGeneral Medicineen
dc.titleQualitative exploration of gambling harm among UK veterans : normalisation, stigma and postservice escalationen
dc.type/dk/atira/pure/researchoutput/researchoutputtypes/contributiontojournal/articleen

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