Q&A With Nick Vega Puente
Supervisor, Prevention/Compulsive Gambling Services
Department of Human Services

Q: Do you have specific goals to address the issue of problem gambling in Minnesota?

A: In 2012, the Department of Human Services Adult Mental Health Division worked with the Problem Gambling Advisory Committee in a discussion seeking recommendations for short- and long-range goals and strategies for Minnesota’s compulsive gambling program. The following represents recommendations from the committee:

  • Help individuals with problem gambling behavior and their families become self-sufficient through individualized attention to multi-cultural factors;
  • Reduce the negative consequences of problem gambling on families, employers and the community at large;
  • Inform the general public about the warning signs of problem gambling to minimize the progression to pathological states;
  • Develop policy and procedures that support a recovery oriented, person-centered system of care;
  • Expand the knowledge base regarding problem gambling with focus on evidenced-based techniques and best practices.

So we will pick up where we left off in 2012 and set our sights on these goals into 2013 and 2014.

One of the things that I am conducting during the transition of this program to the Alcohol and Drug Abuse Division is an assessment of the program’s strengths and where we might need to shore up some resources. Organization is very important to me, so one of my goals is to focus my early attention to how this program is organized internally within DHS, including understanding the legislation that mandates these services and ensure we establish the measures to comply with these mandates.

Another goal is getting to know our external partners, including the members of our advisory committee and providers and what each brings to strengthen the program.

Q: What are some of the opportunities you see for improving problem gambling diagnosis and treatment in Minnesota?

A: As I learn about the program and engage in discussions with the DHS Compulsive Gambling Advisory Committee members and as well as treatment providers, this is one question that has come up early. Together we are looking at ways to get the word out that treatment works. We are looking at data we currently collect, which brings up other questions, specifically about what needs to be in place to ensure we develop paths to the appropriate level of care from assessment, referral, treatment and recovery. Data is important to have to inform our decision making going forward to building a sound compulsive gambling services continuum, from prevention to early intervention, treatment and recovery. We need to find doors to compulsive gambling services via outreach efforts, to referral processes and opportunities to treatment and on-going recovery services. Are currently using technology to conduct outreach efforts and we know there is a connection between effective outreach efforts and events to calls to our helpline. So looking at these opportunities and being creative in the strategies we use will be challenging and fun. The other thing that comes to mind is that there are other systems, such as the mental health and chemical dependency treatment systems that can help us identify diagnosis and referral treatment points. These systems can help improve on gambling diagnosis and referral to treatment. We need to tap into what these systems can contribute to this goal, which means establishing and maintaining effective relationships and collaborations with these two systems.

Q: The state’s oversight of problem gambling recently moved from the Adult Mental Health Division to the Chemical Dependency Division. Why was that switch made?

A: Nationally and in Minnesota, there is increased understanding of what works. The American Psychiatric Association’s latest Diagnostic and Statistical Manual of Mental Disorders (DSM-V) has proposed a new category of “behavioral addictions,” which contains gambling addiction. Research supports that pathological gambling and substance use disorders have similar effects on the brain and neurological reward system. There is continued need for empirically-supported, evidence-based treatment standards, including research on the impact of online gambling.

Given this national trend and research around gambling addiction, DHS Adult Mental Health Division transitioned administrative oversight of the Compulsive Gambling Program to the DHS Alcohol and Drug Abuse Division effective May 2013. As director of the Alcohol and Drug Abuse Division, Kevin Evenson assumed leadership for administration of the compulsive gambling program. The two divisions will continue to work in partnership to promote and support this program whenever possible.

Q: What has surprised you the most since you became involved with the gambling program?

A: I have been not so much surprised, but impressed with the passion that exists among the DHS Compulsive Gambling Advisory Committee members and treatment providers. Since I have become involved, I have been amazed by the great work accomplished by the advisory committee and our contractors. For example, Minnesota received the “outstanding website” award at the National Conference on Problem Gambling this year- July 2013. This is a great accomplishment and a reflection of the great work of the committee, our contractors and partners. It is my hope that we continue to be creative in improving the compulsive gambling program in DHS and better meet the needs of people with gambling problems and addiction and their families. This is a great note on which to assume oversight of this program.

Q: What are the key areas of the program that you feel are working well, and what areas need attention?

A: The DHS Compulsive Gambling program is a great example of how we can make counseling and treatment available both through program-based providers and individual providers. This was established while this program was housed within the Mental Health Division. We need to strengthen and nurture this system. I think we can build on this foundation. What needs attention? We need to improve utilization of our treatment programs. We know not all who need counseling and treatment are getting the needed services. So we have to find ways to ensure we create effective access points and process to these services.

Q: What immediate action items do you see as priorities in the next 6-12 months?

A: Since I have been involved with the program, I have heard from our advisory committee members that they want a work plan that sets clear goals and direction for the program. I hope to work with our partners to develop this plan for the next 12-24 months. The most immediate need within the next 6-12 months is to ensure that all aspects of the program are in place and to have as little interruption to services during the transition of the program to the Alcohol and Drug Abuse Division.

Q: What would be the “ideal operation” for the DHS as it pertains to its role in problem gambling treatment and awareness?

A: I think the “ideal operations” is having an effective continuum of care system for compulsive gambling services. A system of care that is integrated with other systems, such as the mental health and chemical dependency system and the primary care system. The Affordable Care Act will present some opportunities to enhance the DHS Compulsive Gambling program and I hope to work with our partners to take advantage of these opportunities when they present themselves.

Q: Is there anything else you’d like to share?

A: First of all, I would like to thank the partners I have met so far for their warm welcome. As I mentioned earlier, I am impressed with the work they have accomplished. Assuming oversight of this program has opened my eyes to a whole new world I knew little about. The Advisory Committee members and providers are teaching me a lot about problem gambling and the pain this causes in people’s lives. I am excited about their passion, their work and the possibilities we have together to make this a great program.