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Extreme Risk Protection Orders (ERPOs) significantly reduced firearm suicides in four states without increasing suicides by other methods. This study supports ERPOs as effective public health interventions for suicide prevention.

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Area of Science:

  • Public Health
  • Epidemiology
  • Criminology

Background:

  • Firearm suicides are a major public health crisis in the US, comprising over half of all suicide deaths.
  • Extreme Risk Protection Orders (ERPOs), or red flag laws, allow temporary firearm removal from high-risk individuals.
  • The effectiveness of ERPOs in reducing overall suicide deaths versus merely shifting methods is an unresolved question.

Purpose of the Study:

  • To assess the association between ERPOs and firearm suicides.
  • To determine if ERPOs are linked to an increase in non-firearm suicides.
  • To evaluate ERPO effectiveness in states with clear legislative data.

Main Methods:

  • A cohort study using county-level data from 2012-2022.
  • Difference-in-differences event study analysis comparing states with and without ERPOs.
  • Analysis focused on states that passed ERPO laws without concurrent firearm legislation changes.

Main Results:

  • ERPO passage was linked to a significant reduction in firearm suicides (3.79 per 100,000 population after one year).
  • This reduction is equivalent to an estimated 675 fewer firearm suicides.
  • No association was found between ERPOs and non-firearm suicides in the year of passage or the following year.

Conclusions:

  • ERPO laws in four states were associated with substantial decreases in firearm suicides.
  • There was no evidence that ERPOs led to an increase in suicides by other methods.
  • ERPOs are supported as targeted public health interventions to reduce firearm suicides effectively.