Structural gaps in referral and treatment pathways for gambling-related harm: a systematic review of health system responses using the antecedents–decision–outcomes framework

Introduction Gambling-related harm is increasingly recognized as a public mental health concern, yet referral pathways into formal treatment and support services remain poorly understood. Weak or absent referral structures may delay engagement with care and limit coordination across health and support systems. This review aimed to map structural and system-level factors shaping referral and treatment pathways for gambling-related harm. Particular attention was given to mechanisms influencing hel