Extreme Risk Protection Orders in Washington : A Statewide Descriptive Study

Ann Intern Med. 2020 Sep 1;173(5):342-349. doi: 10.7326/M20-0594. Epub 2020 Jun 30.


Background: In 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.

Objective: To characterize respondents and circumstances of ERPOs.

Design: Descriptive study.

Setting: State of Washington.

Participants: All ERPO respondents during 8 December 2016 to 10 May 2019.

Measurements: Reason 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).

Results: The 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.

Limitation: Filing of the forms was inconsistent.

Conclusion: Laws 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 source: State of Washington.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Firearms / legislation & jurisprudence*
  • Gun Violence / legislation & jurisprudence
  • Gun Violence / prevention & control*
  • Gun Violence / psychology
  • Humans
  • Male
  • Middle Aged
  • Risk Assessment
  • Suicide / psychology
  • Suicide Prevention
  • Washington
  • Young Adult