Extreme Risk Protection Orders (ERPOs)
ERPOs, sometimes referred to as red flag laws, are civil court orders that temporarily restrict firearm access for an individual who is behaving dangerously or presents a high risk of harm to self or others.
The Issue
In many incidents of gun violence, warning signs are present that an individual is at risk of harming themselves or others. Family members are often the first to know when loved ones are in a suicidal crisis or threatening interpersonal violence. In many high-profile shootings and firearm suicides, family members saw their loved ones engage in risky behaviors and grew concerned about their risk of harming themselves or others. These warning signs present an opportunity to proactively intervene rather than wait for a tragedy to occur.
The Solution
An Extreme Risk Protection Order (ERPO) is a civil court order that temporarily restricts firearm access for an individual who is behaving dangerously or presents a high risk of harm to self or others. By authorizing the temporary removal of firearms and prohibiting the individual from purchasing, possessing, or accessing firearms while the order is in effect, ERPOs provide a critical opportunity to intervene to prevent gun violence, including mass violence, homicide, and suicide. Law enforcement, and, depending on the state’s ERPO law, others such as family or household members, may petition the court to temporarily restrict a person’s access to firearms when they are at elevated risk of harming themselves or others. ERPOs grant law enforcement clear authority to temporarily remove firearms from ERPO respondents and prevent them from purchasing new guns for the duration of the order.
When deciding whether to issue an ERPO, courts should consider evidence-based criteria, not a mental health diagnosis alone, and whether the risk of violence is imminent. The evidence a judge may consider when issuing an order for firearm removal varies among states. It generally includes, but is not limited to:
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Recent acts or threats of violence towards self or others.
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History of threatening or dangerous behavior.
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History of, or current, risky alcohol or controlled substance use.
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Recent violation of a domestic violence protective order.
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Unlawful or reckless use, display, or brandishing of a firearm.
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Cruelty to animals.
There are usually two types of ERPOs:
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An ex parte, or temporary, ERPO that is available quickly and typically only lasts for one to two weeks.
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A final ERPO, which typically lasts up to one year and may only be issued after a notice of hearing at which the respondent has the opportunity to appear and be heard. Both temporary and final ERPOs are civil, not criminal, orders.
How do ERPOs encompass due process?
ERPO laws are consistent with the rights afforded under the United States Constitution. Funding for ERPO implementation under BSCA must also be consistent with the due process protections of the U.S. Constitution, including the 5th and 14th Amendments. Rights articulated under BSCA include the rights to:
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Notice
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An in-person hearing
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An unbiased adjudicator
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Know opposing evidence
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Present evidence
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Confront adverse witnesses
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Counsel (at no expense to the government)
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Penalties for abuse of the program
The Evidence
Extreme Risk Protection Orders Prevent Suicides
Researchers examined 762 ERPO-style orders issued in Connecticut from 1999–2013. They found that ERPOs were used to prevent suicides among a population that had an annual suicide rate 40 times higher than the general public. In 99% of cases, police recovered firearms removing an average of seven guns per subject. The researchers calculated that for every 10–20 orders issued, one suicide was prevented. 1
Extreme Risk Protection Orders Are Used in Efforts to Prevent Mass Shootings
Researchers analyzed nearly 6,800 cases from six states (CA, CO, CT, FL, MD, WA) and identified 662 cases, or 10%, of ERPOs were issued in response to a threat to shoot at least three people.2
Increased Awareness of ERPOs is Critical
Researchers found most physicians in one Maryland hospital were unfamiliar with the state’s ERPO law. After being informed about the law, a majority showed a willingness to use it. Emergency medicine physicians in the sample reported the potential to use it more often compared to psychiatrists and pediatricians who responded.3
ERPO: Preventing Gun Violence and Saving Lives
In this video, made in partnership with the Bloomberg American Health Initiative, Professor Shannon Frattaroli, PhD '99, MPH '94, shares the power and potential of ERPO laws to save lives.
Our Work
Extreme Risk Protection Orders were developed by the Consortium for Risk-Based Firearm Policy in 2013 after the shooting at Sandy Hook Elementary School. Center faculty and staff are among the founding members of the Consortium and continue to lead ERPO implementation efforts nationwide.
The Center has participated in advocacy efforts to pass and fund ERPO in 21 states and the District of Columbia since 2014. Today, more than half of all Americans live in a state that has an ERPO, and this is the direct result of the work of the Center, the Consortium, and gun violence prevention advocates across the country.
The National ERPO Resource Center
The Johns Hopkins Center for Gun Violence Solutions, in partnership with the U.S. Department of Justice, Bureau of Justice Assistance (BJA), established the National ERPO Resource Center (ERC) in 2023. The ERC is a training and technical assistance (TTA) hub designed to support states and localities with the implementation of their ERPO programs to reduce gun violence and save lives.
Training and Technical Assistance through the ERC includes:
- Development and dissemination of trainings for ERPO stakeholders.
- Support for states and local jurisdictions to implement ERPO programs.
- Facilitation of peer-to-peer engagements with model ERPO learning sites.
- Delivery of presentations and webinars to advance states’ and localities’ knowledge on key ERPO topics.
The ERC will also support states and local jurisdictions to ensure that funding received through the Bipartisan Safer Communities Act (BSCA) is effectively utilized and that all ERPO activities include the law’s required constitutional and due process protections.
Successful ERPO implementation requires the collaboration of a variety of stakeholders, including law enforcement, prosecutors, attorneys, judicial officers, clinicians, educators, veterans’ organizations, victim service providers, community organizations, and behavioral health and social service providers. Each of these partners plays an important role in the ERPO process, from the initiation of the order to the return of firearms (where appropriate). In collaboration with BJA, the ERC will support these ERPO implementers and partners nationwide by providing TTA.
Contact the National ERPO Resource Center at erpo@jhu.edu.
ERPO Guides & Factsheets
The National ERPO Resource Center [ERC]
ERPO.org will offer original and curated resources, including specific information about each state’s ERPO law, ERPO toolkits, implementation guides, a training and technical assistance request form, and a calendar of events designed to support states to implement their ERPO laws.
VISIT ERPO.ORG
“The public health approach to gun violence prevention tells us that we need to look upstream and prevent violence before it occurs. Extreme risk protection orders do just that. ERPO data from around the country shows us that ERPOs are a promising tool to curb our gun violence epidemic.”
Lisa Geller, MPH
Senior Advisor for Implementation and Co-Lead of the National ERPO Resource Center
Journal Articles and Reports
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Extreme Risk Protection Orders: What Clinicians Need to Know (YouTube)
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New: Research on Extreme Risk Protection Orders: An Evidence-Based Policy that Saves Lives
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Webinar: Extreme Risk Protection Orders: New Recommendations for Policy and Implementation
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Extreme Risk Protection Orders and Domestic Violence Restraining Orders: How Do They Differ?
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Policies that Work to Reduce Gun Violence: Extreme Risk Protection Order Laws
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Extreme risk protection orders in King County, Washington: The epidemiology of dangerous behaviors and an intervention response. Frattaroli S, Omaki EC, Molocznik A, Allchin A, Hopkins R, Shanahan S, Levinson A. Injury Epidemiology, 2020 July 22..
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Assessment of Extreme Risk Protection Order Use in California From 2016 to 2019. Pallin R, Schleimer JP, Pear VA, Wintemute GJ. JAMA Netw Open. 2020;3(6):e207735.
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Extreme risk protection orders intended to prevent mass shootings: A case series. Wintemute, G. J., Pear, V. A., Schleimer, J. P., Pallin, R., Sohl, S., Kravitz‐Wirtz, N., & Tomsich, E. A. Annals of Internal Medicine. 2019.
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Assessment of Physician Self-reported Knowledge and Use of Maryland’s Extreme Risk Protection Order Law. Frattaroli S, Hoops K, Irvin NA, McCourt A, Nestadt PS, Omaki E, Shields WC, Wilcox HC. JAMA Netw Open. 2019;2(12):e1918037.
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Guns, public health, and mental illness: an evidence-based approach for state policy: Consortium for Risk-Based Firearms Policy. 2013; 7–8, 22.
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Using research evidence to reframe the policy debate around mental illness and guns: process and recommendations. McGinty EE, Frattaroli S, Appelbaum PS, Bonnie RJ, Grilley A, Horwitz J, Swanson JW, Webster DW. American Journal of Public Health. 2014.
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Gun violence restraining orders: alternative or adjunct to mental health-based restrictions on firearms? Frattaroli S, McGinty EE, Barnhorst A, Greenberg S. Behavioral Sciences and the Law. 2015; 33: 290-307.
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Beyond the academic journal: unfreezing misconceptions about mental illness and gun violence through knowledge translation to decision makers. Horwitz J, Grilley A, Kennedy O. Behavioral Sciences and the Law. 2015; 33: 356-365.
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Circumstances and outcomes of a firearm seizure law: Marion County, Indiana, 2006–2013. Parker GF. Behavioral Sciences and the Law. 2015; 33: 308-322.
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The gun violence restraining order: an opportunity for common ground in the gun violence debate. Roskam K, Chaplin V. Developments in Mental Health Law. 2017; 36: 1.
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Implementation and effectiveness of Connecticut’s risk-rased gun removal law: does it prevent suicides? Law and Contemporary Pro. Swanson JW, Norko MA, Lin HJ, Alanis-Hirsch K, Frisman LK, Baranoski MV, Easter MM, Robertson AG, Swartz MS, Bonnie RJ (2017).
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Background checks for all gun buyers and gun violence restraining orders: state efforts to keep guns from high-risk persons. Vernick JS, Alcorn T, Horwitz J (2017). The Journal of Law, Medicine & Ethics. 2017; 45: 98-102.
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Extreme risk protection orders - effective tools for keeping guns out of dangerous hands. Bonnie RJ, Swanson JW. Developments in Mental Health Law. 2018; 37: 2-6.
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Effects of risk-based firearm seizure laws in Connecticut and Indiana on suicide rates, 1981–2015. Kivisto AJ, Phalen PL. Psychiatric Services. 69: 855-862.
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Extreme risk protection orders to reduce firearm violence. Frizzell W, Chien J. Psychiatric Services. 2019; 70: 75-77.
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Elderly gun ownership and the wave of state red flag laws: an unintended consequence that could help many. Sklar T. The Elder Law Journal. 2019; 27: 100-115.
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Analysis of the Strength of Legal Firearms Restrictions for Perpetrators of Domestic Violence and Their Associations With Intimate Partner Homicide.
Zeoli AM, McCourt A, Buggs S, Frattaroli S, Lilley D, Webster DW. Am J Epidemiol. 2018 Nov 1;187(11):2365-2371. -
Removing Firearms From Those Prohibited From Possession by Domestic Violence Restraining Orders: A Survey and Analysis of State Laws.
Zeoli AM, Frattaroli S, Roskam K, Herrera AK. Trauma Violence Abuse. 2017 Jan 1:1524838017692384. -
Effects of policies designed to keep firearms from high-risk individuals.
Webster DW, Wintemute GJ. Annu Rev Public Health. 2015 Mar 18;36:21-37. -
Identifying armed respondents to domestic violence restraining orders and recovering their firearms: process evaluation of an initiative in California.
Wintemute GJ, Frattaroli S, Claire BE, Vittes KA, Webster DW. Am J Public Health. 2014 Feb;104(2):e113-8. -
Removing guns from batterers: findings from a pilot survey of domestic violence restraining order recipients in California.
Vittes KA, Webster DW, Frattaroli S, Claire BE, Wintemute GJ. Violence Against Women. 2013 May;19(5):602-16. -
Women with protective orders report failure to remove firearms from their abusive partners: results from an exploratory study.
Webster DW, Frattaroli S, Vernick JS, O'Sullivan C, Roehl J, Campbell JC. J Women’s Health (Larchmt). 2010 Jan;19(1):93-8. -
Risk factors for femicide within physically abusive intimate relationships: Results from a multi-site case control study.
Campbell JC, Webster D, Koziol-McLain J, Block C, Campbell D, Curry MA, Gary F, Glass N, McFarlane J, Sachs C, Sharps P, Ulrich Y, Wilt SA, Manganello J, Xu X, Schollenberger J, Frye V, Laughon K. Am J Public Health. 2003 Jul;93(7):1089-97. -
Use of extreme risk protection orders to reduce gun violence in Oregon.
Zeoli AM, Paruk J, Branas CC, Carter PM, Cunningham R, Heinze J, & Webster DW. (2021). Criminology & Public Policy, 20(2), 243-261. https://doi.org/10.1111/1745-9133.12544. -
Implementation and enforcement of restrictions on gun possession by domestic violence offenders in four U.S. localities.
Frattaroli S, Zeoli AM, Webster DW. Armed, Prohibited and Violent at Home: Journal of Family Violence, 2021;36:573-586.
References
1. Swanson JW et al. (2017). Implementation and effectiveness of Connecticut’s risk-based gun removal law: Does it prevent suicides? Law and Contemporary Problems.
2. Zeoli AM, Frattaroli S, Barnard L, Bowen A, Christy A, Easter M, Kapoor R, Knoepke C, Ma W, Molocznik A, Norko M, Omaki E, Paruk JK, Pear VA, Rowhani-Rahbar A, Schleimer JP, Swanson JW, & Wintemute GJ. (2022). Extreme risk protection orders in response to threats of multiple victim/mass shooting in six U.S. states: A descriptive study. Preventive Medicine.
3. Frattaroli S, Hoops K, Irvin NA, et al. (2019). Assessment of Physician Self-reported Knowledge and Use of Maryland’s Extreme Risk Protection Order Law. JAMA Network Open.