Legal sports wagering is coming to Missouri, and betting platforms and state officials alike are preparing.
So are those who help people addicted to gambling.
Missouri Gaming Commission Chair Jan Zimmerman said many people are eagerly anticipating the start on Dec. 1 since voters approved it by a narrow margin last November.
"The people who will engage in sports wagering, they're anxious," Zimmerman said. "They want to get it going. They wish that we were going to have it live before Dec. 1, for sure."
Others are concerned about the effect that easily accessible mobile betting will have on gambling addiction in the state.
"With sports betting, you'll be able to place a bet from your bedroom, your living room chair, your car in the parking lot, on break at work, literally anytime of the day or night," said Keith Spare, chair of the Missouri Alliance to Curb Problem Gambling.
Spare said he is not as concerned about huge increases in the number of gamblers as he is about the increased speed and severity of consequences. The consequences of problem gambling include bankruptcy, family and relationship problems and even suicide.
More than 60% of Missouri adults gamble, and Spare said 1 in 5 meet the criteria for a gambling disorder, according to a 2022 study.
The study, conducted by a Kansas City government problem gambling committee, also found that among disordered gamblers, 27.5% either attempted or considered suicide.
Sparse mental health resources for gamblers
Gambling-specific mental health treatment in Missouri is hard to come by.
In 2021, one of the last state-funded compulsive gambling treatment programs ended. Daniel Smith was the clinical director for the BetNoMore Gambling Programs at Assessment and Counseling Solutions in St. Louis. The program, offered at no cost to Missouri residents, ended when he retired. He said it was the last of about six similar programs in Missouri.
"The biggest problem that occurs with someone seeking help is that they go to a well meaning counselor who doesn't know anything about gambling," Smith said. "The state of treatment in Missouri, I hope, will change."
He said there are state-funded counselors available who are trained in gambling counseling, but none specialized in gambling.
One provider that does offer gambling-specific services is nationwide online therapy company Kindbridge. Founder and CEO Daniel Umfleet said he started the company because he found a lack of problem gambling treatment across the country.
Kindbridge provides services in all 50 states, Canada and Puerto Rico. Umfleet said it has three licensed clinicians in Missouri, along with a handful of certified gambling counselors.
Kindbridge has seen 30 Missouri residents in the past year. For individuals, the cost per appointment is $195, which some insurance companies will cover.
Umfleet, who is originally from St. Louis, said he is concerned that Missouri isn't creating new programs to deal with an influx of problem gamblers and relying on existing resources.
"It kind of seems like there's not a really solid plan on what to do when this goes live, and then six months, nine months, 12 months later, when people start reaching out in more volume," Umfleet said.
Similarly to Spare, Umfleet said it is hard to say whether there will be a major increase of gamblers in Missouri. Many people are already betting illegally or driving across state lines to Kansas or Illinois to place bets.
"I think you're going to see more visibility and more volume of people migrating over to the legal market," Umfleet said.
He said that similarly to other states that have legalized sports betting, there has been an "onslaught of advertising activity" in Missouri that exposes more people of a variety of demographics to sports betting.
A new market
Recently, advertisements for sportsbooks from companies like DraftKings and FanDuel have emerged on Missouri billboards, TVs and social media feeds.
This is in part because Google updated its policy to allow for companies to advertise their sportsbooks starting Aug. 15.
Additionally, the announcement that DraftKings and Circa Sports received the two coveted untethered licenses from the Missouri Gaming Commission stirred up renewed attention on the topic. The licenses allow the companies to operate their sportsbooks without partnering with a casino or sports team.
FanDuel, which was expected by many to receive the second license over the smaller Circa Sports, announced its partnership with St. Louis City SC on the same day the untethered licenses were announced.
Zimmerman said the commission decided to award Circa the second license because it offered a different betting experience.
"We just felt that it was going to be offering our citizens something different, instead of FanDuel and DraftKings, which we felt were virtually the same," Zimmerman said.
Circa offers a higher bet limit. It puts its focus on high-spending gamblers.
Spare, of the Missouri Alliance to Curb Problem Gambling, said there should be more ads promoting gambling treatment.
"I think people are more aware of the gambling advertising for where you can gamble than they are of where you can get help," Spare said.
Kindbridge collaborates with betting platforms in hopes of more directly providing help to problem gamblers. Umfleet said that if a user self-excludes from a platform like DraftKings or reaches out to customer service with concerns, they will be directly referred to Kindbridge and go through a diagnostic process.
Zimmerman said she was impressed that online gambling platforms have features like this built in.
"I was really pleased to hear that the industry pays a lot of attention to folks who may feel like they have an issue or they have a problem," Zimmerman said.
But Smith said in his experience with clients, the gambling industry does not have the consumer's best interest at heart.
"The prevention activities that both casinos and online platforms have are put there to give the illusion of good citizenship," Smith said. "They really don't do much. There's always a backdoor around."
In addition to counseling problem gamblers, Smith is a former gambler himself. He said the ease of being able to place a bet at home would likely have worsened the severity of his gambling.
"The ease of placing a bet at home, on the internet, which I use daily, and most people do these days, or placing a bet on my phone would certainly make it easier for the progression of the condition to worsen quickly," Smith said.
People who are concerned about their gambling can reach out to 1-800-GAMBLER, or 1-888-BETS-OFF, the statewide hotline.
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