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Zeoli AM, Molocznik A, Paruk J, Omaki E, Frattaroli S, Betz ME, Christy A, Kapoor R, Knoepke C, Ma W, Norko MA, Pear VA, Rowhani-Rahbar A, Schleimer JP, Swanson JW, Wintemute GJ. A multi-state evaluation of extreme risk protection orders: a research protocol. Inj Epidemiol 2024; 11:49. [PMID: 39252094 PMCID: PMC11382528 DOI: 10.1186/s40621-024-00535-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Accepted: 08/29/2024] [Indexed: 09/11/2024] Open
Abstract
BACKGROUND Extreme Risk Protection Orders (ERPOs) are civil court orders that prohibit firearm purchase and possession when someone is behaving dangerously and is at risk of harming themselves and/or others. As of June 2024, ERPOs are available in 21 states and the District of Columbia to prevent firearm violence. This paper describes the design and protocol of a six-state study of ERPO use. METHODS The six states included are California, Colorado, Connecticut, Florida, Maryland, and Washington. During the 3-year project period (2020-2023), ERPO case files were obtained through public records requests or through agreements with agencies with access to these data in each state. A team of over four dozen research assistants from seven institutions coded 6628 ERPO cases, abstracting 80 variables per case under domains related to respondent characteristics, events and behaviors leading to ERPO petitions, petitioner types, and court outcomes. Research assistants received didactic training through an online learning management system that included virtual training modules, quizzes, practice coding exercises, and two virtual synchronous sessions. A protocol for gaining strong interrater reliability was used. Research assistants also learned strategies for reducing the risk of experiencing secondary trauma through the coding process, identifying its occurrence, and obtaining help. DISCUSSION Addressing firearm violence in the U.S. is a priority. Understanding ERPO use in these six states can inform implementation planning and ERPO uptake, including promising opportunities to enhance safety and prevent firearm-related injuries and deaths. By publishing this protocol, we offer detailed insight into the methods underlying the papers published from these data, and the process of managing data abstraction from ERPO case files across the multi-state and multi-institution teams involved. Such information may also inform future analyses of this data, and future replication efforts. REGISTRATION This protocol is registered on Open Science Framework ( https://osf.io/kv4fc/ ).
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Affiliation(s)
- April M Zeoli
- Institute for Firearm Injury Prevention, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA.
| | - Amy Molocznik
- The Johns Hopkins Bloomberg School of Public Health, 415 N. Washington, Baltimore, MD, 21205, USA
| | - Jennifer Paruk
- New Jersey Gun Violence Research Center, School of Public Health, Rutgers University, 683 Hoes Lane, Piscataway, NJ, 08854, USA
| | - Elise Omaki
- The Johns Hopkins Bloomberg School of Public Health, 415 N. Washington, Baltimore, MD, 21205, USA
| | - Shannon Frattaroli
- The Johns Hopkins Bloomberg School of Public Health, 415 N. Washington, Baltimore, MD, 21205, USA
| | - Marian E Betz
- Department of Emergency Medicine, University of Colorado, 12505 E. 16th Ave, Aurora, CO, 80045, USA
| | - Annette Christy
- College of Behavioral and Community Sciences, University of South Florida, 4202 E. Fowler Avenue, Tampa, FL, 33612, USA
| | - Reena Kapoor
- Department of Mental Health and Addiction Services, School of Medicine, Yale University, 333 Cedar Street, New Haven, CT, 06510, USA
| | - Christopher Knoepke
- University of Colorado Anschutz Medical Campus, 13001 East 17th Place, Aurora, CO, 80045, USA
| | - Wenjuan Ma
- College of Social Science, Michigan State University, 509 East Circle Drive, East Lansing, MI, 48824, USA
| | - Michael A Norko
- Department of Mental Health and Addiction Services, School of Medicine, Yale University, 333 Cedar Street, New Haven, CT, 06510, USA
| | - Veronica A Pear
- Davis School of Medicine, University of California, 2315 Stockton Blvd., Sacramento, CA, 95817, USA
| | - Ali Rowhani-Rahbar
- School of Public Health, University of Washington, 3980 15th Avenue NE, Box 351616, Seattle, WA, 98195, USA
| | - Julia P Schleimer
- Davis School of Medicine, University of California, 2315 Stockton Blvd., Sacramento, CA, 95817, USA
| | - Jeffrey W Swanson
- Duke University School of Medicine, 2400 Pratt Street, Box 102505, Durham, NC, 27705, USA
| | - Garen J Wintemute
- Davis School of Medicine, University of California, 2315 Stockton Blvd., Sacramento, CA, 95817, USA
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Barnard LM, Batta N, McCarthy M, Thies K, Robinson C, Schultze M, Betz ME, Knoepke CE. Implementation of Extreme Risk Protection Orders in Colorado from 2020 to 2022: Firearm relinquishment and return and petitioner characteristics. Prev Med Rep 2024; 44:102800. [PMID: 39035359 PMCID: PMC11260331 DOI: 10.1016/j.pmedr.2024.102800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 06/13/2024] [Accepted: 06/13/2024] [Indexed: 07/23/2024] Open
Abstract
Introduction Firearm injury remains a public health problem, with nearly 50,000 firearm-related deaths in the US in 2021. Extreme risk protection orders (ERPOs) are civil restraining orders that intend to reduce firearm deaths by temporarily removing firearms from individuals who are threatening violence to themselves or others. We described ERPO use by petitioner type and implementation including firearm removal. Methods All ERPO petitions filed in Colorado (1/1/2020-12/31/2022) were analyzed using an established abstraction tool and team-based approach. Case data abstracted from petitions and court documents were analyzed descriptively. Results Over three years, there were 353 ERPO petitions filed in Colorado. Only 39 % percent of granted petitions had documentation of firearms being relinquished. The average number firearms relinquished was 1.8 with a range of 1 to 31 firearms. One third (37.7 %) of petitions mentioned a mental health issue, 10 % had a renewal request, and half (54.6 %) of petitions were filed by law enforcement (LE). LE petitions filed were more likely to be granted temporary ERPOs (94.3 % vs 35.0 %, p < 0.0001) and full year ERPOs (79.7 % vs 39.3 %, p < 0.0001) compared to non-LE petitions. Conclusion Results from these analyses shed light on data gaps surrounding ERPO use and implementation. Differences in LE vs others' ERPO outcomes suggest a need for additional research and training. ERPOs' efficacy hinges on removing access to firearms among those at risk, and a lack of documentation limits the ability to evaluate these policies. This suggests a need to standardize reporting to ensure ERPO utilization and impact can be evaluated.Mini abstract: This descriptive study assessed use, implementation and data gaps surrounding Extreme Risk Protection Orders in Colorado.Abbreviations: Extreme risk protection orders (ERPOs) are civil restraining orders that intend to reduce firearm deaths by temporarily removing firearms from individuals who are threatening violence to themselves or others.
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Affiliation(s)
- Leslie M Barnard
- Firearm Injury Prevention Initiative, University of Colorado School of Medicine, Aurora, CO, USA
- Department of Epidemiology, University of Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Nisha Batta
- Department of Emergency Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Megan McCarthy
- Injury and Violence Prevention Center, University of Colorado, School of Medicine and University of Colorado, School of Public Health, Aurora, CO, USA
| | - Kimberly Thies
- Department of Emergency Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Caitlin Robinson
- Department of Emergency Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Marcus Schultze
- Injury and Violence Prevention Center, University of Colorado, School of Medicine and University of Colorado, School of Public Health, Aurora, CO, USA
| | - Marian E. Betz
- Firearm Injury Prevention Initiative, University of Colorado School of Medicine, Aurora, CO, USA
- Department of Emergency Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Christopher E. Knoepke
- Firearm Injury Prevention Initiative, University of Colorado School of Medicine, Aurora, CO, USA
- Adult and Child Center for Outcomes Research & Delivery Science, University of Colorado School of Medicine, Aurora, CO, USA
- Division of Cardiology, University of Colorado School of Medicine, Aurora, CO, USA
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Betz ME, Frattaroli S, Knoepke CE, Johnson R, Christy A, Schleimer JP, Pear VA, McCarthy M, Kapoor R, Norko MA, Rowhani-Rahbar A, Ma W, Wintemute GJ, Swanson JW, Zeoli AM. Extreme Risk Protection Orders in Older Adults in Six U.S. States: A Descriptive Study. Clin Gerontol 2024; 47:536-543. [PMID: 37688772 PMCID: PMC11229607 DOI: 10.1080/07317115.2023.2254279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/11/2023]
Abstract
OBJECTIVES Extreme Risk Protection Orders (ERPOs) allow a court to restrict firearm access for individuals ("respondents") at imminent risk of harm to self/others. Little is known about ERPOs use for older adults, a population with higher rates of suicide and dementia. METHODS We abstracted ERPO cases through June 30, 2020, from California, Colorado, Connecticut, Florida, Maryland, and Washington. We restricted our analysis to petitions for older (≥65 years) respondents, stratified by documented cognitive impairment. RESULTS Among 6,699 ERPO petitions, 672 (10.0%) were for older adults; 13.7% (n = 92) of these noted cognitive impairment. Most were white (75.7%) men (90.2%). Cognitively impaired (vs. non-impaired) respondents were older (mean age 78.2 vs 72.7 years) and more likely to have documented irrational/erratic behavior (30.4% vs 15.7%), but less likely to have documented suicidality (33.7% vs 55.0%). At the time of the petition, 56.2% of older adult respondents had documented firearm access (median accessible firearms = 3, range 1-160). CONCLUSIONS Approximately 14% of ERPO petitions for older adults involved cognitive impairment; one-third of these noted suicide risk. Studies examining ERPO implementation across states may inform usage and awareness. CLINICAL IMPLICATIONS ERPOs may reduce firearm access among older adults with cognitive impairment, suicidality, or risk of violence.
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Affiliation(s)
- Marian E Betz
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
- Firearm Injury Prevention Initiative, University of Colorado School of Medicine, Aurora, Colorado, USA
- VA Eastern Colorado Geriatric Research Education and Clinical Center, Aurora, Colorado, USA
| | - Shannon Frattaroli
- Center for Gun Violence Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Christopher E Knoepke
- Firearm Injury Prevention Initiative, University of Colorado School of Medicine, Aurora, Colorado, USA
- Adult & Child Consortium for Outcomes Research & Delivery Science, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Division of Cardiology, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Rachel Johnson
- Center for Innovative Design & Analysis, Department of Biostatistics & Informatics, Colorado School of Public health, Aurora, Colorado, USA
| | - Annette Christy
- Department of Mental Health Law and Policy at the de la Parte Florida Mental Health Institute, College of Behavioral and Community Sciences, University of South Florida, Tampa, Florida, USA
| | - Julia P Schleimer
- Violence Prevention Research Program, University of California Davis School of Medicine, Sacramento, California, USA
- Firearm Injury & Policy Research Program, University of Washington, Seattle, Washington, USA
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington, USA
| | - Veronica A Pear
- Violence Prevention Research Program, University of California Davis School of Medicine, Sacramento, California, USA
| | - Megan McCarthy
- Firearm Injury Prevention Initiative, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Reena Kapoor
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Michael A Norko
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Ali Rowhani-Rahbar
- Firearm Injury & Policy Research Program, University of Washington, Seattle, Washington, USA
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington, USA
| | - Wenjuan Ma
- Center for Statistical Training and Consulting, Michigan State University, Lansing, Michigan, USA
| | - Garen J Wintemute
- Violence Prevention Research Program, University of California Davis School of Medicine, Sacramento, California, USA
| | - Jeffrey W Swanson
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - April M Zeoli
- Department of Health Management and Policy, University of Michigan, School of Public Health, Ann Arbor, Michigan, USA
- Institute for Firearm Injury Prevention, University of Michigan, Ann Arbor, Michigan, USA
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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.
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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
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Knoepke CE, Barnard LM, Batta N, McCarthy M, Thies K, Olivencia C, Robinson C, Kettering S, Huss S, Betz ME. Petitions for Extreme Risk Protection Orders and Second Amendment Sanctuary Status in Colorado. JAMA Netw Open 2024; 7:e244381. [PMID: 38558140 PMCID: PMC10985551 DOI: 10.1001/jamanetworkopen.2024.4381] [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] [Received: 09/21/2023] [Accepted: 02/02/2024] [Indexed: 04/04/2024] Open
Abstract
Importance Extreme risk protection orders (ERPOs) temporarily bar individuals adjudicated as being at risk of violence (including suicide) from buying or possessing firearms. In protest, many US jurisdictions have declared themselves "Second Amendment sanctuaries" (2A sanctuaries). Many 2A sanctuaries continue to use ERPOs in low numbers, suggesting a poorly defined risk threshold at which they are acceptable. Objective To characterize circumstances under which ERPOs are used in 2A sanctuaries, highlighting their most broadly acceptable applications. Design, Setting, and Participants This cross-sectional study of civil court documents analyzed petitions for ERPOs filed in Colorado from January 2020 to December 2022. All petitions during the study period were included following de-duplication. These include petitions filed by law enforcement and family members against adults allegedly at risk of firearm violence across the state. Data were analyzed on a rolling basis between January 2020 and June 2023. Exposure ERPO petition filed in Colorado. Main Outcomes and Measures Seventy-seven data elements defined a priori were abstracted from all petitions and case files, including respondent demographics, petitioner types (family or law enforcement), types of threats (self, other, mass violence, combination), violence risk factors, and case outcomes (granted, denied). Results Of a total 338 ERPOs filed in Colorado, 126 (37.3%) occurred in 2A sanctuaries. Sixty-one of these 2A petitions were granted emergency orders, and 40 were full 1-year ERPOs after a hearing. Forty ERPOs (31.7%) were petitioned for by law enforcement. Petitions in non-2A counties were more likely to have been filed by law enforcement (138 of 227 [64.9%] vs 40 of 126 [31.7%]; P < .001) and to have had an emergency order granted (177 of 227 [78.0%] vs 61 of 126 [48.4%]; P < .001) than in 2A sanctuaries. Qualitative analysis of cases in 2A sanctuaries revealed common aggravating risk characteristics, including respondents experiencing hallucinations, histories of police interaction, and substance misuse. ERPOs have been granted in 2A sanctuaries against individuals threatening all forms of violence we abstracted for (themselves, others, and mass violence). Conclusions and Relevance In this examination of ERPO petitions across Colorado, more than a third of filings occurred in 2A sanctuaries. Nonetheless, law enforcement represent proportionately fewer petitions in these areas, and petitions are less likely to be granted. Serious mental illness, substance misuse, and prior interactions with law enforcement featured prominently in 2A sanctuary petitions. These case circumstances highlight dangerous situations in which ERPOs are an acceptable risk-prevention tool, even in areas politically predisposed to opposing them.
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Affiliation(s)
- Christopher E. Knoepke
- Firearm Injury Prevention Initiative, University of Colorado School of Medicine, Aurora
- Division of Cardiology, University of Colorado School of Medicine, Aurora
- Adult and Child Center for Outcomes Research & Delivery Science, University of Colorado School of Medicine, Aurora
| | - Leslie M. Barnard
- Firearm Injury Prevention Initiative, University of Colorado School of Medicine, Aurora
- Department of Epidemiology, University of Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora
- Injury and Violence Prevention Center, University of Colorado School of Medicine and University of Colorado School of Public Health, Aurora
| | - Nisha Batta
- Injury and Violence Prevention Center, University of Colorado School of Medicine and University of Colorado School of Public Health, Aurora
| | - Megan McCarthy
- Firearm Injury Prevention Initiative, University of Colorado School of Medicine, Aurora
- Department of Epidemiology, University of Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora
- Injury and Violence Prevention Center, University of Colorado School of Medicine and University of Colorado School of Public Health, Aurora
| | - Kimberly Thies
- Injury and Violence Prevention Center, University of Colorado School of Medicine and University of Colorado School of Public Health, Aurora
| | - Christian Olivencia
- Adult and Child Center for Outcomes Research & Delivery Science, University of Colorado School of Medicine, Aurora
| | - Caitlin Robinson
- Injury and Violence Prevention Center, University of Colorado School of Medicine and University of Colorado School of Public Health, Aurora
| | | | - Sheila Huss
- School of Public Affairs, University of Colorado, Denver
| | - Marian E. Betz
- Firearm Injury Prevention Initiative, University of Colorado School of Medicine, Aurora
- Injury and Violence Prevention Center, University of Colorado School of Medicine and University of Colorado School of Public Health, Aurora
- Department of Emergency Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora
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Pear VA, De Biasi A, Charbonneau A. Law Enforcement Officer Knowledge of, Attitudes Toward, and Willingness to Use Extreme Risk Protection Orders. JAMA Netw Open 2023; 6:e2338455. [PMID: 37856122 PMCID: PMC10587793 DOI: 10.1001/jamanetworkopen.2023.38455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 09/03/2023] [Indexed: 10/20/2023] Open
Abstract
Importance Understanding knowledge of, attitudes toward, and willingness to use extreme risk protection order (ERPO) laws among law enforcement officers (LEOs) can inform efforts to improve implementation of this underused firearm violence prevention strategy. Objective To characterize LEOs' knowledge of, attitudes toward, and willingness to use ERPOs across a range of scenarios. Design, Setting, and Participants A cross-sectional online survey, fielded from April 5 to August 30, 2021, was conducted in all 19 states and the District of Columbia with an ERPO law in 2021. A nonprobability sample of active-duty LEOs was used. Exposure Being a LEO in a state with an ERPO law. Main Outcomes and Measures Survey participants answered questions about their familiarity with and opinions on ERPO laws, as well as whether they would agree with using an ERPO in a variety of specific case scenarios. The analysis included an exploration of whether within-scenario differences, such as ERPO respondent race or gender, affected agreement by randomly assigning survey participants to 1 of 2 versions of each scenario. Results A total of 600 eligible individuals started the survey, and 283 survey participants were included in the analysis. The analytic sample consisted mostly of cisgender men (85.2%) and non-Hispanic White (71.4%) LEOs. Participants represented 14 states and the District of Columbia, with 53.7% living in California. Most participants (81.3%) were very or somewhat familiar with ERPO laws and 56.2% had received ERPO training. Opinions about ERPO laws were generally favorable but varied by self-identified political ideology. Across all scenarios, most participants supported using an ERPO; however, support was highest in cases involving intimate partner violence (71.4%-78.6%) and lowest in cases involving suicidality (54.2%-73.3%). Across all scenarios, LEOs with ERPO training or experience were substantially more likely to agree with using ERPOs than those without. None of the randomly assigned within-scenario differences were associated with differences in ERPO support. Conclusions and Relevance In this survey study of LEOs in states with ERPO laws, many officers had not received training on their use. Additionally, while conservative political ideology was associated with less favorable views of ERPOs, training and experience with ERPOs was associated with greater support for their use across a range of scenarios. These findings suggest that LEO training on ERPOs may promote their uptake and improve implementation.
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Affiliation(s)
- Veronica A. Pear
- Violence Prevention Research Program, Department of Emergency Medicine, University of California, Davis, Davis
| | - Alaina De Biasi
- Department of Criminology & Criminal Justice, Wayne State University, Detroit, Michigan
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Pear VA, Pallin R, Schleimer JP, Tomsich E, Kravitz-Wirtz N, Shev AB, Knoepke CE, Wintemute GJ. Gun violence restraining orders in California, 2016-2018: case details and respondent mortality. Inj Prev 2022; 28:465-471. [PMID: 35654574 PMCID: PMC9510437 DOI: 10.1136/injuryprev-2022-044544] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 04/01/2022] [Indexed: 11/22/2022]
Abstract
Background Gun violence restraining orders (GVROs), implemented in California in 2016, temporarily prohibit individuals at high risk of violence from purchasing or possessing firearms and ammunition. We sought to describe the circumstances giving rise to GVROs issued 2016–2018, provide details about the GVRO process and quantify mortality outcomes for individuals subject to these orders (‘respondents’). Methods For this cross-sectional description of GVRO respondents, 2016–2018, we abstracted case details from court files and used LexisNexis to link respondents to mortality data through August 2020. Results We abstracted information for 201 respondents with accessible court records. Respondents were mostly white (61.2%) and men (93.5%). Fifty-four per cent of cases involved potential harm to others alone, 15.3% involved potential harm to self alone and 25.2% involved both. Mass shooting threats occurred in 28.7% of cases. Ninety-six and one half per cent of petitioners were law enforcement officers and one-in-three cases resulted in arrest on order service. One-year orders after a hearing (following 21-day emergency/temporary orders) were issued in 53.5% of cases. Most (84.2%) respondents owned at least one firearm, and firearms were removed in 55.9% of cases. Of the 379 respondents matched by LexisNexis, 7 (1.8%) died after the GVRO was issued: one from a self-inflicted firearm injury that was itself the reason for the GVRO and the others from causes unrelated to violence. Conclusions GVROs were used most often by law enforcement officers to prevent firearm assault/homicide and post-GVRO firearm fatalities among respondents were rare. Future studies should investigate additional respondent outcomes and potential sources of heterogeneity.
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Affiliation(s)
- Veronica A Pear
- Department of Emergency Medicine, University of California Davis School of Medicine, Sacramento, California, USA
| | - Rocco Pallin
- Department of Emergency Medicine, University of California Davis School of Medicine, Sacramento, California, USA
| | - Julia P Schleimer
- Department of Emergency Medicine, University of California Davis School of Medicine, Sacramento, California, USA
| | - Elizabeth Tomsich
- Department of Emergency Medicine, University of California Davis School of Medicine, Sacramento, California, USA
| | - Nicole Kravitz-Wirtz
- Department of Emergency Medicine, University of California Davis School of Medicine, Sacramento, California, USA
| | - Aaron B Shev
- Department of Emergency Medicine, University of California Davis School of Medicine, Sacramento, California, USA
| | - Christopher E Knoepke
- Adult and Child Consortium for Outcomes Research and Delivery Science, University of Colorado Denver School of Medicine, Aurora, Colorado, USA.,Division of Cardiology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Garen J Wintemute
- Department of Emergency Medicine, University of California Davis School of Medicine, Sacramento, California, USA
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Wortzel HS, Simonetti JA, Ryan AT, Matarazzo BB. Firearm Injury Prevention and Extreme Risk Protection Orders. J Psychiatr Pract 2022; 28:240-243. [PMID: 35511101 DOI: 10.1097/pra.0000000000000631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Extreme risk protection orders (ERPOs) represent a potential mechanism to facilitate firearm-related lethal means safety. ERPOs are a legal mechanism that enables law enforcement to temporarily remove firearms from, and prevent firearm purchase by, an individual who presents a significant danger to self or others, as determined by a court of law. While few jurisdictions currently allow mental health professionals to initiate ERPO petitions, it nonetheless seems important that clinicians be familiar with ERPOs, as clinicians may still serve an important role in disseminating information and facilitating judicious petitions. However, ERPO laws remain quite new, and the implications for mental health professionals when participating (directly or indirectly) in ERPOs remain unclear. This column introduces readers to ERPOs and offers resources to learn more about how ERPOs work across various jurisdictions.
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