1
|
Rakshe S, Valek R, Teichman R, Freeman K, DeFrancesco S, Carlson KF. Five Years of Extreme Risk Protection Orders in Oregon: A Descriptive Analysis. Psychol Rep 2024:332941241248599. [PMID: 38676327 DOI: 10.1177/00332941241248599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2024]
Abstract
Extreme Risk Protection Order (ERPO) laws have received increasing attention as a tool to prevent firearm suicide and homicide, including mass shootings. However, important gaps remain in our understanding of ERPO usage and implementation. Using the Oregon Judicial Case Information Network database, we abstracted data from all ERPO petitions filed in Oregon from 2018 to 2022, the first five years after the law took effect (N = 649). ERPO petitions were filed in 29 of 36 counties (81%, range 0-105 per county, median 11), against respondents 17-96 years of age (median: 42). Of ERPOs filed, 78% were initially granted. While only 22% of respondents in initially-granted ERPOs requested a hearing, when a hearing was held, nearly half (44%) of ERPOs were dismissed. The majority of ERPO petitions were motivated by threats of harm to respondents and others (n = 327, 50%), followed by threats of harm to others-only (n = 220, 34%) or respondents-only (n = 81, 12%). During the 5-year period, 72 (11%) ERPO petitions cited threats of mass violence as a motivating factor, including 24 (4%) petitions citing threats to schools or college campuses. The majority of ERPOs were filed by law enforcement officers (60%), and these petitions were significantly more often granted than those filed by family/household members (96% vs. 67%, p < .0001). We also found evidence of important gaps in documentation, including of respondent race (unavailable for 191 respondents, 29%) and of weapon removal or disposition after the ERPO was granted (unavailable in 350 cases, 69%). This study of long-term patterns of ERPO petitions highlights trends in usage and suggests areas where improvement may be possible, with implications for other states that have adopted or are considering similar ERPO laws.
Collapse
Affiliation(s)
- Shauna Rakshe
- Oregon Health & Science University Knight Cancer Institute, Portland, OR, USA
| | - Rebecca Valek
- Oregon Health & Science University-Portland State University School of Public Health, Portland, OR, USA
| | - Rebecca Teichman
- Oregon Health & Science University-Portland State University School of Public Health, Portland, OR, USA
| | - Kathryn Freeman
- University of New Mexico Department of Emergency Medicine, Albuquerque, NM, USA
| | - Susan DeFrancesco
- Oregon Health & Science University-Portland State University School of Public Health, Portland, OR, USA
| | - Kathleen F Carlson
- Oregon Health & Science University-Portland State University School of Public Health, Portland, OR, USA
| |
Collapse
|
2
|
Nichter B, Hill ML, Fischer I, Panza KE, Kline AC, Na PJ, Norman SB, Rowcliffe M, Pietrzak RH. Firearm storage practices among military veterans in the United States: Findings from a nationally representative survey. J Affect Disord 2024; 351:82-89. [PMID: 38280567 DOI: 10.1016/j.jad.2024.01.179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 01/16/2024] [Accepted: 01/18/2024] [Indexed: 01/29/2024]
Abstract
BACKGROUND Unsafe storage of firearms is associated with increased risk of suicide.. However, contemporary population-based data on the prevalence and correlates of firearm storage practices among veterans are limited. METHODS Data were from the 2022 National Health and Resilience in Veterans Study, a nationally representative sample of 2441 veterans. Analyses examined: (1) the prevalence of firearm storage practices; (2) sociodemographic, psychiatric, and clinical characteristics associated with storing firearms loaded and/or in non-secure location; and (3) associations between types of potentially traumatic events and storage practices. RESULTS More than half of veterans reported owning one or more personal firearms (50.9%). Among firearm owners, 52.9% reported some form of unsafe firearm storage practice (i.e., loaded and/or non-secure location), with 39.9% reporting that they stored one or more firearms loaded. After adjusting for sociodemographic characteristics, major depressive, alcohol and drug use disorders, direct trauma exposures, future suicidal intent, and traumatic brain injury were associated with storing firearms loaded and/or in a non-secure location (ORs = 1.09-7.16). Veterans with a history of specific forms of direct trauma exposure (e.g., physical assault) were more likely to store firearms unsafely. LIMITATIONS Cross-sectional design precludes causal inference. CONCLUSIONS Half of U.S. veterans who own firearms store at least one personal firearm loaded and/or in a non-secure location, with approximately four-in-ten keeping a loaded firearm in the home. These high rates underscore the importance of nationwide training initiatives to promote safe firearm storage for all service members and veterans, regardless of risk status, as well as for healthcare professionals working with veterans.
Collapse
Affiliation(s)
- Brandon Nichter
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA.
| | - Melanie L Hill
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Ian Fischer
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; National Center for PTSD, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Kaitlyn E Panza
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA; VA San Diego Healthcare System, San Diego, CA, USA
| | - Alexander C Kline
- Naval Health Research Center, San Diego, CA, USA; Leidos, Reston, VA, USA
| | - Peter J Na
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; National Center for PTSD, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Sonya B Norman
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA; VA San Diego Healthcare System, San Diego, CA, USA; National Center for PTSD, White River Junction, VT, USA
| | - Mara Rowcliffe
- 321(st) Special Tactics Squadron, U.S. Air Force Special Operations Command, USA
| | - Robert H Pietrzak
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; National Center for PTSD, VA Connecticut Healthcare System, West Haven, CT, USA; Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
| |
Collapse
|
3
|
Asa N, Buchbinder SA, Bonnell T, Mills B, Littman A. Engagement with Preventive Health Behaviors and Safe Firearm Storage Practices Using the 2017 Behavioral Risk Factor Surveillance System. Am J Health Promot 2024; 38:167-176. [PMID: 37935039 DOI: 10.1177/08901171231214867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Abstract
PURPOSE "Behavioral bundling" is a theory that explains how some health behaviors reinforce one another. This study aims to investigate the relationship between preventive health behaviors (PHBs) and safe firearm storage. DESIGN This study used a cross-sectional design using 2017 Behavioral Risk Factor Surveillance Survey data. SETTING Survey participants resided in California, Idaho, Kansas, Oregon, Texas, and Utah. SUBJECTS There were 12,817 people living in households with a firearm included in this study. MEASURES We classified individuals' engagement in 5 PHBs: cholesterol screening, influenza immunization, physical activity, primary care, and seatbelt use. We defined safe firearm storage as storing a firearm unloaded, or loaded but locked. ANALYSIS Using Poisson regression models, we calculated adjusted prevalence ratios (aPRs) to estimate the association between engagement in the five PHBs with safe firearm storage. RESULTS Most firearm owners reported safe firearm storage (80.3%). The prevalence of safe firearm storage was 3% higher for each additional PHB engaged in (aPR = 1.03 [1.01, 1.05]). There was a higher prevalence of safe firearm storage among those who always wore a seatbelt while driving or riding in a car compared to those who did not (aPR = 1.12 [1.05, 1.18]). CONCLUSION This study found preliminary evidence to suggest that engagement in seatbelt usage may be bundled with safe firearm storage, though we are not able to determine causality.
Collapse
Affiliation(s)
- Nicole Asa
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | | | - Tyler Bonnell
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Brianna Mills
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Alyson Littman
- Department of Epidemiology, University of Washington, Seattle, WA, USA
- Department of Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA
| |
Collapse
|
4
|
Hullenaar KL, Rowhani-Rahbar A, Morgan ER, Hicks CD, Rivara FP. Mental Health Comorbidities, Household Firearm Ownership, and Firearm Access Among Children. Pediatrics 2023; 151:e2022060610. [PMID: 37212029 PMCID: PMC10233734 DOI: 10.1542/peds.2022-060610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/21/2023] [Indexed: 05/23/2023] Open
Abstract
OBJECTIVES To examine how youth and their caregivers' mental health risk factors for suicide are associated with youth firearm access inside and outside the home. METHODS This study examines a cross-section of the Adolescent Brain and Cognitive Development Social Development study data collected from 2016 to 2021. The sample included 2277 children aged 10 to 15 years from 5 study sites across the United States. We estimated multilevel generalized linear models of household firearm ownership and the child's reported firearm access (hard access or easy access). The primary exposures were the child's and their caregivers' mental health risk factors for suicide. RESULTS In the Adolescent Brain and Cognitive Development Social Development study sample, approximately 20% of children lived in a firearm-owning household and 5% of all children reported easy firearm access. In non-firearm-owning households, children with diagnosed lifetime suicidality were 2.48 times more likely (95% confidence interval [CI], 1.50-4.10) than their counterparts to report easy firearm access. In firearm-owning households, children of caregivers who self-reported any mental health history or externalizing problems were 1.67 times (95% CI, 1.10-2.54) and 2.28 times (95% CI, 1.55-3.37) more likely than their counterparts to report easy firearm access. CONCLUSIONS Youths with mental health risk factors for suicide may be just as likely or more likely to report firearm access as those without such risk factors. Youth suicide prevention efforts should address youths' firearm access outside the home and caregiver mental health.
Collapse
Affiliation(s)
- Keith L. Hullenaar
- Harborview Injury Prevention and Research Center
- Departments ofEpidemiology
| | - Ali Rowhani-Rahbar
- Harborview Injury Prevention and Research Center
- Departments ofEpidemiology
| | - Erin R. Morgan
- Harborview Injury Prevention and Research Center
- Departments ofEpidemiology
| | - Chelsea D. Hicks
- Harborview Injury Prevention and Research Center
- Pediatrics, University of Washington, Seattle, Washington
| | | |
Collapse
|
5
|
Donnelly M, Kuza C, Sargent B, Swentek L, de Virgilio C, Grigorian A, Schubl S, Nahmias J. Firearm Violence Surrounding the COVID-19 Pandemic: A Reopening Phenomenon. J Surg Res 2023; 285:168-175. [PMID: 36680877 PMCID: PMC9808419 DOI: 10.1016/j.jss.2022.12.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 10/15/2022] [Accepted: 12/24/2022] [Indexed: 01/04/2023]
Abstract
INTRODUCTION Past research has demonstrated a "reopening phenomenon" of increased firearm violence associated with the initial lifting of coronavirus disease 2019 (COVID-19) pandemic-related restrictions after the first wave. Now, with widespread societal reemergence from stay-at-home measures, we hypothesize another spike in firearm violence in the United States (US). Thus, the purpose of this study was to evaluate the trends in firearm violence before and after extensive community reopenings during the COVID-19 pandemic. METHODS The Gun Violence Archive was utilized to collect data on daily firearm violence incidents, injuries, and deaths as well as on types of firearm violence. Mann-Whitney U-tests were performed for trends and types of firearm violence "before" (12/14/20-4/9/21) versus "after" (4/10/21-7/31/21) widespread societal reopening in the US. Additional analyses also sought to compare the after reopening time-period to historical data (2017-2020) of similar calendar dates, to better control for possible annual/seasonal variation. RESULTS Median daily firearm violence incidents (153 versus 176, P < 0.001), injuries (89 versus 121, P < 0.001) and deaths (54 versus 58, P < 0.001) increased from before versus after reopening. Compared to all historical years, in the after reopening time-period there were consistent increases in total as well as mass shooting incidents/injuries/deaths (all P < 0.05). CONCLUSIONS Firearm violence incidents, injuries, and deaths increased after societal reemergence from the COVID-19 pandemic. In addition, there has been an increase in mass shootings despite a relative lull initially brought on by the pandemic. This suggests the "reopening phenomenon" has worsened an already substantial national firearm epidemic.
Collapse
Affiliation(s)
- Megan Donnelly
- Division of Trauma, Department of Surgery, University of California, Irvine, Burns and Surgical Critical Care, Orange, California
| | - Catherine Kuza
- Department of Anesthesiology, University of Southern California, Los Angeles, California
| | - Brynn Sargent
- Division of Trauma, Department of Surgery, University of California, Irvine, Burns and Surgical Critical Care, Orange, California
| | - Lourdes Swentek
- Division of Trauma, Department of Surgery, University of California, Irvine, Burns and Surgical Critical Care, Orange, California
| | | | - Areg Grigorian
- Department of Surgery, University of Southern California, Los Angeles, California
| | - Sebastian Schubl
- Division of Trauma, Department of Surgery, University of California, Irvine, Burns and Surgical Critical Care, Orange, California
| | - Jeffry Nahmias
- Division of Trauma, Department of Surgery, University of California, Irvine, Burns and Surgical Critical Care, Orange, California.
| |
Collapse
|
6
|
Richards JE, Kuo E, Stewart C, Bobb JF, Mettert KD, Rowhani-Rahbar A, Betz ME, Parrish R, Whiteside U, Boggs JM, Simon GE. Self-reported Access to Firearms Among Patients Receiving Care for Mental Health and Substance Use. JAMA HEALTH FORUM 2021; 2:e211973. [PMID: 35977197 PMCID: PMC8796974 DOI: 10.1001/jamahealthforum.2021.1973] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Accepted: 06/14/2021] [Indexed: 12/03/2022] Open
Abstract
Question Did patients respond to a standard question about firearm access on a mental health questionnaire, and, if so, how did they respond? Findings In this cross-sectional study of 128 802 patients receiving care for mental health and substance use, 83% of primary care patients answered a standard question about firearm access and 21% reported access. In mental health clinics, 92% of patients answered the question and 15% reported access. Meaning In this study, most patients reported firearm access on standard questionnaires; this screening practice may improve efforts to identify and engage patients at risk of suicide in discussions about securing firearms. Importance Firearms are the most common method of suicide, one of the “diseases of despair” driving increased mortality in the US over the past decade. However, routine standardized questions about firearm access are uncommon, particularly among adult populations, who are more often asked at the discretion of health care clinicians. Because standard questions are rare, patterns of patient-reported access are unknown. Objective To evaluate whether and how patients self-report firearm access information on a routine mental health monitoring questionnaire and additionally to examine sociodemographic and clinical associations of reported access. Design, Setting, and Participants Cross-sectional study of patients receiving care for mental health and/or substance use in primary care or outpatient mental health specialty clinics of Kaiser Permanente Washington, an integrated health insurance provider and care delivery system. Main Outcomes and Measures Electronic health records were used to identify patients who completed a standardized self-reported mental health monitoring questionnaire after a single question about firearm access was added from January 1, 2016, through December 31, 2019. Primary analyses evaluated response (answered vs not answered) and reported access (yes vs no) among those who answered, separately for patients seen in primary care and mental health. These analyses also evaluated associations between patient characteristics and reported firearm access. Data analysis took place from February 2020 through May 2021. Results Among patients (n = 128 802) who completed a mental health monitoring questionnaire during the study period, 74.4% (n = 95 875) saw a primary care clinician and 39.3% (n = 50 631) saw a mental health specialty clinician. The primary care and mental health samples were predominantly female (63.1% and 64.9%, respectively) and White (75.7% and 77.0%), with a mean age of 42.8 and 51.1 years. In primary care, 83.4% of patients answered the question about firearm access, and 20.9% of patients who responded to the firearm question reported having access. In mental health, 91.8% of patients answered the question, and 15.3% reported having access. Conclusions and Relevance In this cross-sectional study of adult patients receiving care for mental health and substance use, most patients answered a question about firearm access on a standardized mental health questionnaire. These findings provide a critical foundation to help advance understanding of the utility of standardized firearm access assessment and to inform development of practice guidelines and recommendations. Responses to standard firearm access questions used in combination with dialogue and decision-making resources about firearm access and storage may improve suicide prevention practices and outcomes.
Collapse
Affiliation(s)
- Julie E. Richards
- Health Research Institute, Kaiser Permanente Washington, Seattle
- Department of Health Services, University of Washington, Seattle
| | - Elena Kuo
- Health Research Institute, Kaiser Permanente Washington, Seattle
| | | | - Jennifer F. Bobb
- Health Research Institute, Kaiser Permanente Washington, Seattle
| | - Kayne D. Mettert
- Health Research Institute, Kaiser Permanente Washington, Seattle
| | - Ali Rowhani-Rahbar
- Department of Epidemiology, University of Washington School of Public Health, Seattle
- Harborview Injury Prevention and Research Center, Seattle, Washington
| | - Marian E. Betz
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora
| | - Rebecca Parrish
- Department of Mental Health & Wellness, Kaiser Permanente Washington, Seattle
| | - Ursula Whiteside
- NowMattersNow.org, Seattle, Washington
- Psychiatry and Behavioral Sciences, University of Washington, Seattle
| | | | - Gregory E. Simon
- Health Research Institute, Kaiser Permanente Washington, Seattle
- Department of Mental Health & Wellness, Kaiser Permanente Washington, Seattle
- Psychiatry and Behavioral Sciences, University of Washington, Seattle
| |
Collapse
|
7
|
Teplin LA, Meyerson NS, Jakubowski JA, Aaby DA, Zheng N, Abram KM, Welty LJ. Association of Firearm Access, Use, and Victimization During Adolescence With Firearm Perpetration During Adulthood in a 16-Year Longitudinal Study of Youth Involved in the Juvenile Justice System. JAMA Netw Open 2021; 4:e2034208. [PMID: 33538822 PMCID: PMC7862991 DOI: 10.1001/jamanetworkopen.2020.34208] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE Preventing firearm violence requires understanding its antecedents. Yet no comprehensive longitudinal study has examined how involvement with firearms during adolescence-use, access, and victimization (defined as threatened with a weapon or gunshot injury)-is associated with the perpetration of firearm violence in adulthood. OBJECTIVE To examine the association between firearm involvement during adolescence and subsequent firearm perpetration and ownership in adulthood among youth involved in the juvenile justice system. DESIGN, SETTING, AND PARTICIPANTS This cohort study analyzed interview responses of 1829 randomly selected participants as part of the Northwestern Juvenile Project, a longitudinal study of health needs and outcomes of youth sampled from a temporary juvenile detention center in a large US city. Youth aged 10 to 18 years were interviewed in detention from November 1995 through June 1998. Participants were reinterviewed up to 13 times over 16 years through February 2015, for a total of 17 776 interviews. The sample was stratified by sex, race/ethnicity, age, and legal status (juvenile or adult court). Data were analyzed from April 2017, when data preparation began, through November 2020. EXPOSURES Firearm involvement during adolescence: use (ie, threaten, shoot), access (ownership, ease of access, firearm in household, membership in gang that carries firearms), and victimization (gunshot injury, threatened with a weapon). MAIN OUTCOMES AND MEASURES Firearm involvement during adulthood: perpetration of firearm violence (ie, threatening with or using a firearm) and firearm ownership. RESULTS Among the 1829 participants, 1388 had a 16-year follow-up interview: 860 males, 528 females; 809 were African American, 203 were non-Hispanic White; 374 were Hispanic; and 2 were other race/ethnicity; median (interquartile range) age of 32 (30-32) years. Eighty-five percent of males and 63.2% of females were involved with firearms as adolescents. Compared with females, males had significantly higher odds of every type of involvement except having a firearm in the home. In adulthood, 41.3% of males and 10.5% of females perpetrated firearm violence. Adolescents who had been threatened with a weapon or injured by firearms had 3.1 (95% CI, 2.0-4.9) and 2.4 (95% CI, 1.2-4.9) times the odds of perpetrating violence during adulthood. Similar associations were found for firearm ownership. CONCLUSIONS AND RELEVANCE Involvement with firearms during adolescence-including victimization-is a significant risk factor for firearm perpetration and ownership during adulthood.
Collapse
Affiliation(s)
- Linda A. Teplin
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
- Department of Medicine, Infectious Disease, Northwestern University Feinberg School of Medicine, Chicago, Illinois
- Institute for Policy Research, Northwestern University, Evanston, Illinois
- Department of Sociology, Weinberg College of Arts & Sciences, Northwestern University, Evanston, Illinois
- School of Education and Public Policy, Northwestern University, Evanston, Illinois
| | - Nicholas S. Meyerson
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Jessica A. Jakubowski
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - David A. Aaby
- Department of Medicine, Infectious Disease, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Nanzi Zheng
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Karen M. Abram
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Leah J. Welty
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| |
Collapse
|