How Gambling Can Turn Addictive For Refugees From Southeast Asia
Quyen Truong still gets a cozy feeling when she sees a hand of cards.
It reminds her of family and traditions as a refugee from Vietnam who arrived in the U.S. in late 1990. Aunts, uncles and cousins in Connecticut 鈥� among the Southeast Asian refugees who resettled here in waves after the Vietnam War 鈥� would get together on weekends with rolls of quarters, nickels, pennies and dimes.
Card games lasted late into the night over several courses of traditional Vietnamese food. Children rooted for their parents.
And it was an honor, 鈥渁 big deal,鈥� said Truong, 35, a health care advocate in Hartford, 鈥渨hen your grandmother says, 鈥楬ey, do you want to play a hand with me?鈥欌��
The role of fortune and luck is big in some Asian cultures. Cards and dice games get woven into memories of baby showers, birthdays, weddings and funerals. As refugees in the U.S., Truong and others said, some of the most thrilling outings as a family are day trips to glitzy casinos that cater to Asian patrons with Asian cuisine, entertainment, translated signs and native Asian-speaking workers.
The downside of gambling is what Truong鈥檚 father warned her about. The former South Vietnamese soldier 鈥� jailed for seven years in a re-education camp after his American allies left Vietnam 鈥� cautioned his daughter against playing cards 鈥渢oo much鈥� and 鈥済etting into trouble with it,鈥� Truong recalled.
Southeast Asian refugees are among the groups that are especially vulnerable to falling into gambling addiction, experts say. One groundbreaking study more than a decade ago in Connecticut examined a sample group of refugees from Vietnam, Cambodia and Laos 鈥� and reported their rate of gambling addiction was almost 30 times the national average.
Yet Southeast Asian refugees are often overlooked in the public policy debate over the expansion of legalized gambling, as states across the nation push for new sources of revenue to fill holes in government budgets.
Advocates in the Asian community and gambling experts say this feeling of invisibility helps fuel the 鈥渉idden鈥� addiction. A tradition passed through generations, they say, can spiral out of control for some refugees who then find it difficult to get help.
鈥淕ambling is seen as an opportunity out of poverty,鈥� said Dr. Timothy Fong, a professor of addiction psychiatry and co-director of . 鈥淲hen you have tremendous amounts of poverty, especially in the Southeast Asian refugee population, that tends to be a very tempting idea.鈥�
Seeking Comfort
Howard Phengsomphone, 70, a Laotian elder in the Hartford area, has been trying to coax people in his community to talk about problem gambling.
鈥淚t鈥檚 not easy,鈥� he said. Although gambling is socially accepted in his culture, and is perceived by some refugees as a way to make fast money, gambling addiction is considered taboo 鈥� part of a bigger cultural stigma in Asian communities over mental health and addiction issues.
National data show that Asians are least likely among ethnic groups in the U.S. . Among Southeast Asians in Connecticut, community health advocates say the stigma becomes another hurdle to accessing the American health care system, on top of language barriers and skepticism of traditional Western methods of treatment.
Mental health needs often go unmet, Phengsomphone said, despite the reality that many Southeast Asians of his generation bear the trauma and scars of 鈥渢he war-torn country.鈥�
鈥淲e came as political refugees,鈥� he said, and 鈥渃arry a lot of stress 鈥� It鈥檚 very difficult to heal.鈥�
From a clinical perspective, experts say that the high level of trauma for Southeast Asian refugees is one of the reasons why the odds may be stacked against them. The high of gambling becomes 鈥渁 way of seeking comfort,鈥� as Fong put it.
Why is Gambling Addictive? Gambling can stimulate the brain's reward system much like drugs or alcohol can, leading to addiction. Exactly what causes someone to gamble compulsively isn't well-understood. Like many problems, compulsive gambling may result from a combination of biological, genetic and environmental factors.Mayo Clinic
A 2003 study that examined gambling habits of 96 Vietnamese, Laotian and Cambodian refugees in Connecticut found that nearly 60 percent met the criteria for gambling addiction 鈥� compared to a national average of about 2 percent.
Led by UConn Health Center, that 42 percent of the refugees had wagered at least $500 in the past two months, and that their choice of games ranged from the lottery and cards to slot machines and scratch tickets. The study noted that many of those interviewed at Southeast Asian community centers said they had been physically tortured in their home countries.
Add in that tap into Asian culture and concepts of luck, and 鈥渟uddenly you have what we call a cauldron of risk factors,鈥� said Fong of UCLA.
鈥淵ou can imagine the experience of a refugee coming all the way from Southeast Asia and landing in a place like Connecticut that鈥檚 really far away. It鈥檚 cold 鈥� and all their peers are gambling,鈥� Fong said in an interview. 鈥淭hey鈥檙e struggling with acculturation. They鈥檙e struggling with language. Poverty-stricken. And suddenly you walk into Foxwoods or the Mohegan Sun,鈥� Connecticut鈥檚 two tribal casinos that are among the biggest casinos in the U.S.
National studies have estimated the prevalence of problem gambling among Asians in the U.S. to be less than 5 percent. But experts say pinpointing the rate is difficult, in part, because larger phone surveys can overlook immigrants and others wary of exposing their private struggles to a stranger who may not speak their language.
Problem-Gambling Rates 鈥� Asian Americans 2.3%; Native Americans 2.3%; African-Americans 2.2%; White Americans 1.2%; Hispanic Americans 1%National Epidemiologic Survey on Alcohol and Related Conditions
鈥楾he Crazy Clinic鈥�
As a Laotian refugee who came to Connecticut as a toddler in the late 1980s, Sou Thammavong said the casinos鈥� bright lights can glimmer like beacons of hope. Illegal card games are common in her community, she said, but casinos are 鈥渢he escape.鈥�
鈥淚f you鈥檙e working in a factory, or you don鈥檛 necessarily see that you have a future for yourself, you can change your fortune,鈥� said Thammavong, an outreach coordinator at North Central Regional Mental Health Board, a community advocacy group in Hartford. 鈥淵ou can change your destiny.鈥�
The Mohegan Tribe of Connecticut owns Mohegan Sun. A spokesman for the casino did not respond to requests for comment on the extent of its Asian clientele.
Mashantucket Pequot Tribal Nation owns and operates Foxwoods Resort Casino, which said in a statement: 鈥淲e pride ourselves on having multilingual team members and signage to provide superior service to those visiting from around the globe, including all parts of Asia (with Southeastern Asia representing a small percentage of that group).鈥�
Both tribal casinos are partners of the and give funding for awareness and prevention programs. 鈥淭his issue can affect anyone, regardless of gender, age, social, ethnic or economic group, and we remain committed to providing resources for those who may need help,鈥� a Foxwoods spokesman said.
But especially within Asian communities, advocates and health care workers say a gambling addict may go unnoticed in society until the stress of heavy debts manifests into broken families, bankruptcy and physical pain.
That鈥檚 because problems are kept 鈥渉ush-hush 鈥� within the family, within the community,鈥� said Sabrina Chau, a domestic-violence outreach specialist in Hartford who works with Asian families.
Asians represent five percent of the Connecticut population, but only about three percent of the callers who have sought help from the state鈥檚 problem-gambling hotline since 2015, according to data from the Connecticut Department of Mental Health & Addiction Services.
鈥淭hey just don鈥檛 think services exist, or they鈥檙e so ashamed that they can鈥檛 bear to expose themselves,鈥� said Truong, the health care advocate originally from Vietnam. She also works at North Central Regional Mental Health Board in Hartford. 鈥淭hey might say, 鈥極h, I lost my job.鈥� Or, 鈥業 got unlucky, and so I don鈥檛 have any money anymore; I have to find more work.鈥� But they鈥檙e never going to say, 鈥業 went to the casino and gambled away all my money.鈥欌��
At in Hartford 鈥� a clinic that counsels Asians struggling with issues that include problem gambling 鈥� employees said clients rarely come in until there鈥檚 a crisis. The lead case manager is Tuyen Long, a survivor of the 鈥淜illing Fields鈥� in Cambodia who arrived in the U.S. as a refugee in 1983.
Sometimes, clients show up because child-protection services got involved and made it mandatory, Long said, or doctors referred them to the clinic after they landed in the hospital.
鈥淚t鈥檚 a stigma,鈥� Long said. 鈥溾�榊ou鈥檙e going to the crazy clinic!鈥� No, it鈥檚 not a crazy clinic. This is the mental health services so it can help you to resolve your issues in order for you to move forward and also have a quality of life.鈥�
Gambling experts say that shame can lead to a snowball effect with potentially devastating consequences.
鈥淪o this may lead to people gambling for longer periods of time and experiencing greater problems before they share or disclose some of their struggles and seek help,鈥� said Dr. Marc Potenza, a Yale psychiatry professor and director of the .
鈥淪ome of this can lead to tragic outcomes,鈥� Potenza said. 鈥淪uicidality related to gambling is a significant concern, and may be particularly concerning amongst Asian individuals with gambling problems.鈥�
Asian Ambassadors
Mari Merwin, an immigrant from Japan, used to work with Long as a clinician at Asian Family Services. Several years ago, she said, one Vietnamese woman came into the clinic feeling suicidal after her husband gambled away all their money at the casino and skipped town, saddling her with two mortgages she couldn鈥檛 afford.
鈥淪he wanted to end her life because she was evicted,鈥� Merwin recalled. 鈥淣o one in the Vietnamese community wanted to really help this woman. And even if they wanted to, the money she owed to the banks was so enormous.鈥�
The bank foreclosed, and the woman received treatment and case management from the clinic. Eventually, she moved in with her sister.
Merwin later joined Asian Ambassadors, a pilot program seen as a potential national model on how to reach Asians 鈥� and other minority groups 鈥� on the sensitive topic of problem gambling. The Asian Pacific American Problem Gambling initiative is a partnership with , a state program largely funded with revenue from the Connecticut Lottery.
The ambassadors are Asian immigrants who hold sessions tailored to their communities on the warning signs and how to get help. They include Merwin, Truong, Thammavong and Phengsomphone, the Laotian elder. He speaks Lao at the community sessions that are sometimes held at a Buddhist temple, and said he is careful not to offend anyone when broaching the subject of problem gambling.
鈥淕ambling is very personal,鈥� Phengsomphone said. 鈥淯sually, they don鈥檛 like to talk about it.鈥�
The ambassadors also give presentations to employees of the Connecticut court system and others who may come in contact with Asian problem gamblers 鈥� the initiative isn't limited to the Southeast Asian community. But in talks within their community, Truong and Thammavong said they prefer using the phrase 鈥渇inancial literacy.鈥� Gradually, they ease into gambling.
鈥淵ou can鈥檛 say 鈥榩roblem gambling,鈥欌�� Thammavong said. 鈥淏ecause if you say 鈥榩roblem gambling,鈥� people are gonna be like, 鈥楴ope, not a problem; I鈥檓 out.鈥� 鈥�
Mui Mui Hin-McCormick, an advocate in the Asian American community in Connecticut, recruited the ambassadors a few years ago. One of the difficulties they face, she said, is that concepts of mental health and addiction don鈥檛 have a direct translation in many Asian languages. And because casino gambling is legal here, some immigrants and refugees wonder: If gambling is legal, why is it a problem?
Those cultural nuances are why it was important to choose gatekeepers in the Asian community who can try to break down barriers that have prevented problem gamblers from seeking help, said Miriam Delphin-Rittmon, commissioner of the Connecticut Department of Mental Health & Addiction Services.
鈥淭he ambassadors end up being individuals who are trusted,鈥� Delphin-Rittmon said.
Marlene Warner, board president of the , said putting time into a community and 鈥済etting the language right鈥� can lead to a culturally sensitive treatment model, because 鈥渋t鈥檚 not one-size-fits-all.鈥�
Recovery for Southeast Asian refugees might look more family-oriented, for example, 鈥渨here the family is going to have to provide some of the care, and it鈥檚 not showing up in a very Western way, in traditional treatment with a clinician,鈥� Warner said. 鈥淲e really need to adapt our approaches and options to the population.鈥�
Community sessions for Asian-American college students have brought another revelation: The younger generation is 鈥渘ot necessarily going to the casinos anymore,鈥� Thammavong said. 鈥淚t鈥檚 the online sports betting. It鈥檚 the fantasy football. Fantasy leagues.鈥�
Connecticut is one of the states that is after last year鈥檚 Supreme Court ruling.
The ambassadors said they do not discourage gambling. Their point, they said, is giving people enough information to make decisions for themselves, and giving them a chance to hear it from folks who speak and look like them.
鈥淭he only way to do community work is to have your foot halfway in the door,鈥� Thammavong said. 鈥淲e can鈥檛 go out into communities that we don鈥檛 have a connection with 鈥� and to offer these things 鈥� because then people are you going to be like, 鈥榃ho are you?鈥欌��
Listen to a Conversation
Listen to a conversation about problem gambling and people of color, featuring Dr. Timothy Fong of UCLA's Gambling Studies Program.
