Consider referring a patient with gambling disorder to specialist services when they have a greater severity of gambling-related harms or a greater severity of co-occurring needs, such as mental health conditions, suicidality, trauma, neurodiversity, learning disabilities, or substance dependence, and when assessment indicates the need for specialist intervention NICE NG248.
Referral should also be considered if the severity of gambling varies over time, including recent onset or short periods of less intense gambling that still cause severe harms, even after abstinence NICE NG248.
Additionally, if a patient presents with immediate or considerable risk to themselves or others, urgent referral to specialist mental health services or a crisis team is indicated NICE NG248.