Extreme risk protection orders issued under red flag laws can be an effective tool for preventing suicide, a recent study found.
The research, published in the September issue of the Journal of the American Academy of Psychiatry and the Law, found that one potential suicide was likely prevented for every 17 times an order removed guns from people who showed a risk of harming themselves or others.
Extreme risk protection orders (ERPOs) empower families and law enforcement to petition to temporarily restrict access to firearms for individuals at an elevated risk of harming themselves or others. These laws can also be called red flag laws, firearm restraining orders and gun violence restraining orders.
The study, which analyzed over 4,500 ERPO respondents in four states, also determined that when an order involved someone with a known risk for suicide, an estimated one suicide was prevented for every 13 orders.
Reporting on ERPOs and red flag laws is a great opportunity to explore methods to prevent suicides and homicides and to report on whether or not they’re effective. As this study points out, if the health care field had a better grasp on these laws, maybe they could be used to prevent more deaths.
Over the last two decades, more than 800,000 lives were lost to suicide in the U.S., more than half of which involved firearms, according to the study.
“Interventions that can effectively keep guns out of the hands of people at imminent risk of harm to themselves or others should be a key component of an effective public health effort to reduce the number of these preventable tragedies,” authors wrote.
A preventive method
The study, funded by a grant from the National Collaborative on Gun Violence Research, examined risk orders in California, Connecticut, Maryland and Washington.
The researchers acknowledge that the application of the law varies across those four states and other states with ERPOs. Currently, 21 states and the District of Columbia have some version of an ERPO.
The study’s authors also note that eight people in their sample died by gun suicide while under an active order and 12 did so at the end of their order.
But their findings do show that ERPOs can be a preventive method, especially given how lethal a firearm suicide is. Nine out of 10 people survive a non-firearm suicide attempt and are unlikely to attempt again, according to the study. But only one in 10 people survive a firearm suicide attempt, and the survivors live with severe disabilities.
“For such a person at a time of high risk, an ERPO is designed to foreclose the most lethal method of injury,” the authors wrote. “ERPOs are designed as a public health-oriented law that does not restrict the rights of law-abiding gun owners unless they are deemed to be a danger to themselves or others.”
When a person experiences suicidal thoughts within a health care setting, providers have an opportunity to intervene, such as encouraging the person to voluntarily reduce access to firearms, according to the study. But health care providers aren’t always aware of high-risk individuals or those people aren’t open to voluntarily turning over their guns. That’s where red flag laws can be effective, the study points out.
The researchers outlined several ways to make ERPOs a more effective tool. One way is reducing the supply of guns that an ERPO respondent can still access, such as guns sold and resold on secondary or illegal markets.
Another is better education on what ERPOs are and how to use them, especially for people like clinicians and law enforcement who are on the frontlines of responding to situations where people are behaving dangerously.
A little more on ERPOs
ERPOs are a civil court order that an individual or a law enforcement agency can petition for before a judge under red flag laws. If the judge agrees that the person is a danger to themselves or others, law enforcement will then temporarily remove their firearms and prevent them from purchasing new ones during the course of the order.
There are usually two types of ERPOs, according to the Johns Hopkins Center for Gun Violence Solutions. The first is an ex-parte, meaning temporary, ERPO that is made available quickly and usually lasts only one to two weeks. The second, a final ERPO, typically lasts up to a year and may only be issued after a hearing notice is given and the respondent has a chance to appear and be heard by the judge.
Mental health diagnosis alone should not be a reason to grant an ERPO, according to Hopkins. Courts should consider whether the risk of violence is imminent. The evidence a judge can consider does vary state to state. But it’s generally limited to: recent acts or threats of violence toward self or others; a history of threatening or dangerous behavior; a history of or current risky usage of alcohol and/or drugs; a recent violation of a domestic violence protective order; unlawful or reckless use of a firearm; or cruelty to animals.
“Further research is needed to assess more directly the impact of ERPOs and the effectiveness of different approaches to their implementation, as ERPOs are increasingly being brought to scale in a number of states and local jurisdictions,” study authors concluded.
Resources
- The Safer Homes Collaborative is a great source and example of how to employ a credible messenger model when talking about firearm suicide prevention and safe gun storage. It’s a joint effort between firearm owners and and suicide prevention advocates to raise awareness that suicide can be prevented through safe firearm storage.
- Contact: Katie Ellison, katie.ellison@mimh.edu.
- Katie is an excellent source on firearm suicide prevention. She also is the program director for the lethal means safety and firearm suicide prevention initiatives at the University of Missouri–St. Louis Institute of Mental Health.
- Contact: Katie Ellison, katie.ellison@mimh.edu.
- Reporting on Suicide is a great resource for the best practices for covering suicide. Their recommendations are developed by experts in suicide prevention and in collaboration with several international suicide prevention and public health organizations, schools of journalism, media organizations, journalists and internet safety experts.
- The BulletPoints Project was established in 2019 by the California Firearm Violence Research Center at UC Davis through a California State Assembly bill. The project was created to teach medical and mental health care providers how to reduce the risk of firearm injury in their patients.
