• Ali Rowhani-Rahbar, M Alex Bellenger, Lauren Gibb, Heather Chesnut, Madison Lowry-Schiller, Emma Gause, Miriam J Haviland, and Frederick P Rivara.
• School of Public Health and Firearm Injury & Policy Research Program, Harborview Injury Prevention & Research Center, University of Washington, Seattle, Washington (A.R., M.L., E.G.).
• Ann. Intern. Med. 2020 Sep 1; 173 (5): 342-349.

BackgroundIn the United States, 74% of homicides and 51% of suicides involve firearms. Using extreme risk protection order (ERPO) laws, petitioners can request restricting firearm access for individuals (known as "respondents") who pose a risk to themselves or others.ObjectiveTo characterize respondents and circumstances of ERPOs.DesignDescriptive study.SettingState of Washington.ParticipantsAll ERPO respondents during 8 December 2016 to 10 May 2019.MeasurementsReason for filing the ERPO; characteristics of respondents; respondent's reported history of domestic violence perpetration, mental illness, substance misuse, and suicide ideation or attempt; number and type of firearms removed; and ERPO petition outcome (granted or not granted).ResultsThe ERPOs were filed for concerns about harm to self (n = 67), harm to others (n = 86), or harm to both self and others (n = 84). Of all ERPOs, 87% were filed by law enforcement and 81% were granted. At least 1 firearm was removed from 64% of respondents, with a total of 641 firearms removed. The petitioner reported prior domestic violence perpetration by the respondent in 24% of cases, and a prior diagnosis of a mental health condition and substance misuse for the respondent in 40% and 47% of cases, respectively. Of all respondents, 62% had a history of suicidal ideation or attempt according to the petitioner. As part of the ERPO process, the court ordered mental health evaluation in 30% of cases.LimitationFiling of the forms was inconsistent.ConclusionLaws regarding ERPOs are a potential tool to help protect patients or family members from harming themselves or others by restricting firearm possession and purchase. Further studies are needed to determine the long-term effects of these laws and identify approaches to increase their use.Primary Funding SourceState of Washington.

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