States that legalized online sports betting saw increases in the use of mental health medications and outpatient care.
Researchers analyzed nearly 62 million insurance enrollee-years to examine the potential connection.
The findings suggest that expanding access to online betting could create additional demand for mental health services.
Online sports betting has become more widely available across the United States, making it easier for people to place wagers from their phones and computers. But as access to these platforms grows, researchers are taking a closer look at the potential effects on people's health.
A new study published in JAMA Psychiatry found that states legalizing online sports betting experienced increases in the use of treatment for depression and anxiety. The findings suggest that the effects of expanded gambling access may extend beyond financial losses, potentially creating additional needs for mental healthcare.
The research, conducted by investigators affiliated with the Johns Hopkins Bloomberg School of Public Health, examined whether legalizing online sports betting was associated with changes in how often people sought treatment for behavioral health conditions.
How researchers studied the connection
To investigate the relationship, researchers analyzed health insurance claims covering nearly 62 million enrollee-years between January 2016 and December 2023. The data included adults ages 18 to 64 with employer-sponsored health insurance.
Rather than simply comparing people who gambled with those who did not, the researchers looked at what happened in states before and after online sports betting became legal. They compared those changes with states that had not legalized the activity by the end of the study period.
This approach allowed researchers to examine whether changes in access to legal sports betting coincided with changes in mental healthcare use.
The team tracked prescription fills for antidepressant and anti-anxiety medications, along with outpatient, emergency room, and hospital visits involving diagnoses of depression, anxiety, or substance use disorders.
What the findings mean for consumers
The results showed that legalizing online sports betting was associated with increased use of antidepressants and anti-anxiety medications, as well as more outpatient visits related to depression and anxiety.
The researchers also found that the associations were generally more consistent for men than women. However, the study did not find a measurable increase in medication use or treatment visits related to substance use disorders. Nor did it identify increases in behavioral health diagnoses in emergency rooms or hospitals.
“I hope these results will increase awareness among psychiatrists and primary care doctors who treat mental health, as well as online sports bettors themselves, that these online apps can lead to harms beyond financial risks,” researcher Mark Meiselbach, Ph.D., said in a news release.
It's important to understand that these findings show an association, not proof that legal sports betting directly causes depression or anxiety. The study also relied on insurance claims, meaning its findings reflect people with employer-sponsored coverage rather than every person who bets online.
Still, the results highlight a potential consequence of making sports betting more accessible. For consumers, it's worth remembering that gambling can affect more than a bank account. Paying attention to changes in mood, stress, and overall well-being can be just as important as keeping track of how much money is being wagered.