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✦EvidencePulse™by 2 Minute Medicine3 reportsYou askedtop stroke trials 2026Synthesizing medical evidence...Top 2026 stroke trial results:OCEANIC — ischemic stroke: 6.2% vs 8.4%OPTION* — mRS 0–1: 43.6% vs 34.2%ORIENTAL* — mRS 0–2: 58.6% vs 46.6%*Higher sICH in intervention armsParticipants randomizedNOCEANIC12,327OPTION570ORIENTAL564Ask about guidelines or landmark trials...↑Try EvidencePulse™Ask the evidence. Get the signal.Try it now →
Home All Specialties Psychiatry

Extreme risk protection orders protect individuals from firearm threats

byHarsh ShahandDeepti Shroff
June 29, 2020
in Psychiatry, Public Health
Reading Time: 3 mins read
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1. Extreme risk protection order (ERPO) laws were shown to protect respondents and family members from harming themselves or others with firearms.

2. The information within the ERPOs had large variations amongst the county jurisdictions in the state of Washington.

Evidence Rating Level: 3 (Average)

Study Rundown: Firearm-related injuries are a substantial threat to public health and safety in the United States. Certain states have enacted extreme risk protection order ERPO laws. ERPO laws enable a civil court process by which a petitioner requests firearm access restriction for individuals (the “respondent”) with threatening or violent behavior that poses a substantial danger to self or others. These laws make it illegal for the respondent to purchase and possess firearms, along with failing all subsequent background checks during an attempt to purchase firearms in the state. This study conducted the first statewide study of the ERPO laws passed in Washington in order to characterize the respondents and circumstances of the orders. The study determined ERPO laws protected patients and family members from self-harm and harming others with firearms. This descriptive study was limited by inconsistencies in provided information between jurisdictions. Some jurisdictions provided detailed descriptions of the incidents leading to filing the petition. However, other jurisdictions provided only the minimum information needed for the petition. The differences in the degree of information provided between the petition filings created a challenge for the completeness of the study. Nonetheless, the findings of this study are significant and it is the first statewide study of ERPOs detailing respondent characteristics and the circumstances surrounding the orders.

Click to read the study in Annals of Internal Medicine

Relevant Reading: Assessment of physician self-reported knowledge and use of Maryland’s extreme risk protection order law

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In-Depth [retrospective cohort]: This descriptive study analyzed 237 ERPO law records obtained from the Washington Administrative Office of the Courts. Inclusion criteria included all petitions filed from December 8, 2016, when the law went into effect, to May 10, 2019, when the data set was closed. Exclusion criteria included petitions without a stated reason for filing. In collaboration with the King County Regional Domestic Violence Firearms Enforcement Unit, the study was granted access to the private electronic court records. The information from the records were double-coded to improve data reliability for subsequent data abstraction. The study collected information on the following: reason for filing, mental health history, and ERPO petition outcome. Of the 237 petitions filed, the main concern for 67 petitions were the respondent’s risk for self-harm, the main reason for 86 petitions were harm to others, and the reason for filing the remaining 84 petitions were both harm to self and others. In regard to mental health history, 39% of respondents had an inpatient mental health encounter and 9% of respondents had an outpatient mental health encounter, as reported by the petitioner. Furthermore, 62% of respondents had a history of suicidal ideations and 24% of respondents were previous domestic violence perpetrators. Of all the respondents, 79% owned at least one firearm, and 54% of the respondents who did not own a firearm expressed the intent of obtaining a firearm. The ERPO filings resulted in 81% petitions being granted by the courts. Additionally, the courts ordered mental health evaluations in 30% of the cases. The ERPO resulted in the removal of 641 firearms from 64% of respondents. Taken together, the ERPO laws have been able to protect respondents and family members from firearm threats.

Image: PD

©2020 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.

Tags: extreme risk protection order (ERPO)firearm safetygun violencemental health
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