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Suicide Prevention Effects of Extreme Risk Protection Order Laws in Four States
Jeffrey W Swanson1, April M Zeoli2, Shannon Frattaroli2
1Dr. Swanson is a Professor and Dr. Easter is an Assistant Professor in Psychiatry and Behavioral Sciences, Duke University School of Medicine, and both are faculty affiliates of the Wilson Center for Science and Justice, Duke University School of Law, Durham, NC. Dr. Zeoli is an Associate Professor in the Institute for Firearm Injury Prevention and the Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, MI. Dr. Frattaroli is a Professor, Health Policy and Management, and Core Faculty, Center for Gun Violence Solutions at the Johns Hopkins Bloomberg School of Public Health. Dr. Kapoor is an Associate Professor of Psychiatry and Dr. Norko is a Professor of Psychiatry, Yale School of Medicine, New Haven, CT. Dr. Kapoor is Director of Forensic Services and Dr. Norko is a Forensic Policy Advisor, Connecticut Department of Mental Health and Addiction Services, Hartford, CT. Dr. Betz is a Professor and Director of the Firearm Injury Prevention Initiative, Department of Emergency Medicine and Dr. Knoepke is an Assistant Professor of Cardiology and Law Enforcement Lead, Firearm Injury Prevention Initiative, University of Colorado School of Medicine, Aurora, CO, Dr. Pear is Assistant Professor in Residence, Violence Prevention Research Program, Department of Emergency Medicine and Dr. Wintemute is a Professor and the Susan P. Baker-Stephen P. Teret Chair in Violence Prevention, University of California, Davis, Davis, CA. Dr. Rowhani- Rahbar is the Bartley Dobb Professor for the Study and Prevention of Violence, Professor of Epidemiology and Pediatrics, and Director of the Firearm Injury & Policy Research Program and Ms. Schleimer is a PhD Candidate, Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, and a Research Data Analyst at the Violence Prevention Research Program, Department of Emergency Medicine, University of California, Davis. jeffrey.swanson@duke.edu.
Abstract:
More than half of suicide deaths in the United States result from self-inflicted firearm injuries. Extreme risk protection order (ERPO) laws in 21 states and the District of Columbia temporarily limit access to firearms for individuals found in a civil court process to pose an imminent risk of harm to themselves or others. Research with large multistate study populations has been lacking to determine effectiveness of these laws. This study assembled records pertaining to 4,583 ERPO respondents in California, Connecticut, Maryland, and Washington. Matched records identified suicide decedents and self-injury method. Researchers applied case fatality rates for each suicide method to estimate nonfatal suicide attempts corresponding to observed deaths. Comparison of counterfactual to observed data patterns yielded estimates of the number of lives saved and number of ERPOs needed to avert one suicide. Estimates varied depending on the assumed probability that a gun owner who attempts suicide will use a gun. Two evidence-based approaches yielded estimates of 17 and 23 ERPOs needed to prevent one suicide. For the subset of 2,850 ERPO respondents with documented suicide concern, comparable estimates were 13 and 18, respectively. This study's findings add to growing evidence that ERPOs can be an effective and important suicide prevention tool.
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