The Gambling Harms Severity Index (GHSI) provides a set of innovative, evidence-based tools for measuring gambling-related harm and recovery. These tools go beyond identifying whether someone gambles “too much”—they capture the real impacts that gambling can have on people’s lives, in ways that are meaningful to individuals, practitioners, researchers, and policymakers alike.
Why we needed a new approach
Most existing measures of gambling – such as the Problem Gambling Severity Index (PGSI) focus on financial loss or behavioural symptoms. But harm isn’t just about money or frequency—it’s about the broader consequences for a person’s health, relationships, and everyday wellbeing. The GHSI tools were created to fill this gap.
The GHSI measures were developed through a multi-stage process that combined:
- Lived experience – Our tools were shaped by in-depth interviews and co-production with people affected by gambling (both directly and indirectly) and people delivering services to reduce gambling harms.
- Rigorous psychometrics – A large-scale national survey was used to refine and test items statistically, ensuring the tools are valid, reliable, and sensitive to change.
- Iterative design – Items were tested, revised, and scored using modern measurement theory (including Rasch Measurement Theory) to create high-quality, interval-level measures.
The GHSI tools assess gambling-related harm across three domains:
- Health – including mental and physical wellbeing
- Resources – including financial hardship, and work or study disruption
- Relationships – including conflict, breakdown, and social isolation
- Recovery - we also have a tool to measure recovery, which captures progress through four core areas: control, insight, ownership, and behaviour change.
- Each harm domain is scored on an interval-level scale, allowing meaningful comparisons between people and over time.
- Scores are calibrated to reflect both the severity and personal significance of the harm experienced.
- The scoring enables tracking of change, making it suitable for use in both clinical and community settings.
- A key advantage of the GHSI is that it allows the calculation of decrements to wellbeing, using standardised utility measures.
This means that gambling harms can be interpreted with the same approach used in wider public health and economic evaluations.
To support continuity in the field:
- GHSI score can be inter-converted with the Problem Gambling Severity Index (PGSI), making it possible to compare data or transition smoothly from older tools.
- This enables services and researchers to bridge between traditional “risk” assessments and more holistic harm-based approaches.
- In support services – To assess clients’ starting points, track recovery, and guide tailored support.
- In research – To provide robust, person-centred data on gambling harms and their impact.
- In policy – To inform public health approaches, economic modelling, and evaluation of interventions or regulatory changes.
- In population surveys – To measure gambling harm and wellbeing impact at a national or regional level.
