An idyllic country lifestyle raising kids on a sheep farm came to an end for Michaela Settle after her former husband’s gambling addiction spiralled out of control.

He eventually sought help to address his addiction to betting on horse racing, “but it was once he’d hit rock bottom and the damage had been done”, she told Guardian Australia.

Settle, now a Victorian state Labor MP, said it took her a long time to understand the link between her husband’s gambling and mental health.

“When it was all exploding and we were discussing it together, I was saying ‘why weren’t you thinking of me and the kids at the ATM?’… He at the time said this is a mental health issue,” Settle said.

“Is it chicken or egg? Are you so depressed that you go to gambling or had he done so much harm with gambling that it made him depressed?”

Settle is now one of many people calling for problem gambling to be treated as a public health issue. In a submission to the royal commission into the state’s mental health system, Settle has called for GPs to play a greater role in early intervention. She wants increased training for doctors and mental health workers on treatment options and ways to identify those at risk.

Michaela Settle, Victorian Labor member for Buninyong. Photograph: Eddy Khayat/Parliament of Victoria

Doctors should be asking patients about their gambling habits, just as they would ask about alcohol and drug use.

Research showed health professionals often struggled to broach the subject and often don’t know which services to refer people to, Settle said.

“For our entire relationship, I knew that he bet on horses,” she said. “There would be crunch points all the way through. And those crunch points escalated in severity. I wonder if he had been screened [by a GP] could we have gotten intervention earlier?”

The couple had been managing a family farm at Ararat, in western Victoria, at the time of the crisis. Settle is also calling for a boost in counselling and support services to help families grappling with a loved one’s addiction, particularly in rural areas.

Victoria’s Responsible Gambling Foundation says 39% of Victorians with a gambling problem have a diagnosed mental illness.

“A mental health condition can impair a person’s impulse control and decision making abilities,” the foundation said in its submission to the royal commission.

“This lack of recognition of problem gambling as a public health and mental health issue contributes to the stigma felt by those struggling with gambling and undermines efforts to prevent gambling harm and treat problem gambling.”

Problem gambling also has a hidden death toll. Analysis of Victorian coroners court data identified 128 suicides linked to problem gambling between 2000 and 2012.

Business analyst Ian, from Melbourne’s western suburbs, said he had suicidal thoughts for a decade and had made three attempts on his life before he was able to finally turn a corner in 2014.

His mental health began to suffer once his gambling caused relationship problems and major financial strain. He had been betting on horses since the early 1980s but most of his losses were to the pokies once they were introduced to Victoria in the early 1990s.

The father of three had to leave his family’s home in 2007 and had raked up $100,000 in credit card debt.

“I ended up being homeless, living on the streets,” he told the Guardian.

“I started to have panic attacks, which I’d never had before. My depression was severe.”

In 2010, he tallied up more than $1m of pokies losses and then continued gambling for another four years and lost count.

Ian saw eight or nine counsellors over many years but most ignored gambling as a “root cause” and tried to fix his other problems such as homelessness, depression, financial and relationship problems.

Pokies clubs become a haven because it’s acceptable to go there alone. Photograph: Paul Jeffers/AAP

“That was a real failing that I found in the mental health system,” he said.

“It’s like an octopus, they try to cut one leg off, but the octopus is still going to be an octopus.”

Within three months of starting counselling sessions with Gamblers Help, he stopped playing the pokies. He now runs a peer support program to help others get their addictions under control and urges authorities to boost funding to such groups.

“It doesn’t help to speak to family members … it’s very hard for them to understand. They’ll say things like ‘just stop’. If it was that easy I would have. It’s like you’re in a clothes dryer. You keep going round and round and round.”

A 2017 research report found 70% of Victorians gamble, 0.8% are problem gamblers and 2.8% are at moderate risk of becoming problem gamblers.

For some a gambling addiction stems from the need for an evening activity, particularly if they are recently divorced or widowed. Pokies clubs become a haven because it’s acceptable to go there alone. Some Melbourne libraries have been staying open later as an alternative under a trial.

Former pokies addict Anna Bardsley, 70, recalls the first time she went to play poker machines on her own one night. She felt safe, staff were friendly to her as a woman alone and she stayed longer than intended.

“The machines did what they are designed to do, which was calm me down and settle me into a zone,” Bardsley told Guardian Australia.

She went on to “shred” every ounce of her self-esteem during her decade of compulsive gambling and lost tens of thousands of dollars. It’s taken years of counselling, music, art and theatre therapy groups to rebuild her life.

“It was a deadly spiral into an ocean of shame,” Bardsley said.

She said GPs should be asking people what they do to relax and in their spare time, as part of health consultations.

The Alliance for Gambling Reform’s submission to the royal commission recommends $1 bet limits, a ban on cash withdrawals in poker machine venues, greater power for local councils to veto new gaming venues and reduce pokies numbers as well as shorter operating hours for clubs.

One Melbourne mother was forced to move interstate after years of struggling to help her compulsive gambler son Ben who also suffers bipolar disorder.

The mother, who doesn’t want to be named, spent a fortune on a psychiatrist who had no specialist training in addiction. She said she met with “closed door after another” in the mental health system.

She characterised it as a “desperate battle to save our drowning child, who fights you as you try to get his head above water”.

* Gamblers Help: 1800 858 858. Other crisis support services can be reached 24 hours a day: Lifeline 13 11 14; Suicide Call Back Service 1300 659 467; Kids Helpline 1800 55 1800; MensLine Australia 1300 78 99 78; Beyond Blue 1300 22 4636. In the UK and Ireland, Samaritans can be contacted on 116 123 or email jo@samaritans.orgor jo@samaritans.ie. In the US, the National Suicide Prevention Lifeline is 1-800-273-8255. Other international suicide helplines can be found at befrienders.org