Problem gambling is a social issue that increasingly involves women; however, research into gambling and gambling problems amongst women has not kept pace with the feminization of gambling. The aims of this paper are to review relevant literature, discuss research findings on distinctive features of women's gambling, and consider various explanations for gender differences in gambling. While minimal gendered gambling research has been conducted over the past decade, gender differences are apparent in relation to progression to problem gambling, gambling preferences and motivations. Drawing on literature including social capital theory, gender role theory, socialization and cultural geography helps to illuminate why, for instance, for some older women, their gambling increases as their gendered caring role decreases. A better understanding of women's experiences of gambling will allow practical prevention, harm-minimization and treatment strategies to be implemented, and for women's concerns and needs to be accommodated in gambling policy.

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Partners can be especially vulnerable to the negative effects of gambling problems, but little research has sought to understand partners' experiences from their own unique perspectives. This qualitative interpretive study explored the impacts of gambling problems on partners. In-depth interviews were conducted with 18 partners and ex-partners of people with gambling problems to understand their experiences of gambling problems from their perspectives. The findings showed that partners experienced a wide range of negative effects, especially on their financial security, their emotional, mental and physical health, and on their relationships. The financial impacts of gambling problems on partners were substantial and far-reaching. Some partners were forced to take up extra employment to cover household expenses and pay off gambling-related debts. Others lost their savings, homes, belongings and established ways of life. While these impacts were extensive, partners also experienced a range of emotional impacts that were equally devastating. Their gambling partner's lies, dishonesty and concealment of problems and gambling behaviour created considerable distress, loss of trust and a sense of betrayal. These experiences undermined these partners' sense of self-identity, and created additional conflicts within their relationships. Along with accumulating mental and physical health impacts, these challenges lead to separation and/or divorce for many participants. These findings point to the need for greater understanding of partners' experiences and public health initiatives that protect partners and their families from the harmful effects of gambling problems.

BackgroundWith the move to community care and increased involvement of generalist health care providers in mental health, the need for health service partnerships has been emphasised in mental health policy. Within existing health system structures the active strategies that facilitate effective partnership linkages are not clear. The objective of this study was to examine the evidence from peer reviewed literature regarding the effectiveness of service linkages in primary mental health care.MethodsA narrative and thematic review of English language papers published between 1998 and 2009. Studies of analytic, descriptive and qualitative designs from Australia, New Zealand, UK, Europe, USA and Canada were included. Data were extracted to examine what service linkages have been used in studies of collaboration in primary mental health care. Findings from the randomised trials were tabulated to show the proportion that demonstrated clinical, service delivery and economic benefits.ResultsA review of 119 studies found ten linkage types. Most studies used a combination of linkage types and so the 42 RCTs were grouped into four broad linkage categories for meaningful descriptive analysis of outcomes. Studies that used multiple linkage strategies from the suite of "direct collaborative activities" plus "agreed guidelines" plus "communication systems" showed positive clinical (81%), service (78%) and economic (75%) outcomes. Most evidence of effectiveness came from studies of depression. Long term benefits were attributed to medication concordance and the use of case managers with a professional background who received expert supervision. There were fewer randomised trials related to collaborative care of people with psychosis and there were almost none related to collaboration with the wider human service sectors. Because of the variability of study types we did not exclude on quality or attempt to weight findings according to power or effect size.ConclusionThere is strong evidence to support collaborative primary mental health care for people with depression when linkages involve "direct collaborative activity", plus "agreed guidelines" and "communication systems".