There have been lessons learned in how best to help those in need, but otherwise, only incremental gains have been made in responding to what many term the "silent addiction,'' according to today's team at the Vanguard program.

In terms of access to care for compulsive gambling, the country today is where it was in the early 1970s with treating chemical dependency, according to Mike Schiks, executive director and CEO of Project Turnabout, which also offers alcohol and drug recovery.

The Vanguard Center for Gambling Recovery in Granite Falls, an independent program within Project Turnabout, remains the only residential treatment program for compulsive gamblers in the state, and one of only a handful in the country, he said.

Most of those who arrive for care discover insurance companies do not cover their treatment costs, unlike the case for chemical dependency. Vanguard "stretches'' the funds made available by the state of Minnesota from unclaimed lottery prizes and its own fundraising efforts to make possible much of the care it offers, according to Schiks and Mark Sannerud, communications director for Project Turnabout.

Many other things remain the same as 25 years ago too. Only 1 to 10 percent of those who need help for compulsive gambling will obtain it, according to Sheryl Anderson, coordinator for Vanguard.

Their lives may be in a mess, but they put off getting help in the belief that it can all be solved with one big win.

"Just maybe I can get myself out of this,'' said Sherry Parker, director of residential services, of the thought pattern.

There's another, equally disturbing pattern with this disease: "It is pretty standard that people that have a gambling problem are seeking help for lots of other things way before they ever seek help for gambling specifically,'' Anderson said.

Anxiety; thoughts and attempts at suicide; financial, marital and family stress; and criminal behavior are among the issues that many will report as their problems. And yet, unless the question is directly asked, few will disclose that compulsive gambling is at the root of their troubles. "So much shame and stigma is associated with it,'' Anderson said.

The secret about this addiction that remains the most difficult to expose yet today is the toll that compulsive gambling takes on families and communities, according to Sannerud. Arrests of formerly law-abiding citizens. Divorces and broken families. Suicide attempts, ER visits. Bankruptcies.

Schiks believes more should be done to identify and steer those with gambling problems to the help they need. Every county has a designated professional whose job it is to assess people who may need chemical dependency treatment. Far harder to find are those trained to recognize problem gamblers.

"Most physicians, most social workers, most psychologists, most chaplains, get almost zero training in this area,'' Schiks said.

And in many ways, Minnesota is far ahead of other states. Some of those coming to Vanguard are from states where "zero" help is offered for this addiction, he said.

The Vanguard residential facility on the Project Turnabout campus in Granite Falls can care for 20 people at a time. There are usually 12 to 18 receiving treatment in any given week, Anderson said. Most patients remain for 30 days. Outpatient treatment and participation in Gamblers Anonymous or other programs is critical for recovery.

Obtaining continued care can be a challenge for those with this addiction, Schiks said. While virtually every small community has an Alcoholics Anonymous or Narcotics Anonymous group, Gamblers Anonymous groups are far fewer.

Men and women seem equally vulnerable to compulsive gambling. At Vanguard, it's been roughly a 53 percent to 47 percent split in terms of men and women receiving care, respectively.

Statistically, men are more likely to start gambling earlier in life, but they progress to the problem stage at a slower pace, Anderson said.

Women tend to start at a later age, but make up for the lost time quickly, she said. More so than men, they tend to gravitate toward video gaming machines, where the onset of compulsive gambling appears to have a faster progression.

Opportunities for gambling are never more than a smartphone away. The venues in Minnesota for gambling, whether it's sports betting, charitable gambling, or Indian casinos, have expanded greatly since Vanguard opened its doors.

Last year in the U.S., more than $9 billion was wagered during the "March Madness'' NCAA college basketball tournament, according to the NorthStar Gambling Alliance.

Schiks is quick to point out that there are many in the state's gaming industry who recognize the need to help compulsive gamblers. There is a certain portion of the population vulnerable to the addiction, while the majority of people can treat gaming as recreation without the adverse consequences, he explained.

"This isn't about good guys and bad guys. This is about certain folks desperately in need of help and they deserve it,'' he said.

Schiks said Vanguard's mission today remains exactly what it was 25 years ago: Giving those with the courage to walk through its doors hope to carry with them as they walk out.

Vanguard has met many challenges in its 25 years, including the need to rebuild after a tornado tore apart its then newly built facilities in 2000.

Schiks said the Project Turnabout board of directors remains committed to providing care for compulsive gamblers even though in many ways, the financial and societal challenges remain as daunting today as 25 years ago.

"At the bottom of it all is people are worth it,'' he said. "This population is worth it.''

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Minnesota's first residential gambling treatment center remains only one - Hastings Star Gazette