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036 Washington clinicians’ willingness and preferences related to extreme risk protection orders for their patients
  1. Emma L Gause1,
  2. Kelsey M Conrick1,2,
  3. Megan Moore1,2,3,
  4. Ali Rowhani-Rahbar4,
  5. Frederick P Rivara1
  1. 1Firearm Injury and Policy Research Program, University of Washington, Seattle, WA, USA
  2. 2School of Social Work, University of Washington, Seattle, WA, USA
  3. 3Harborview Injury Prevention and Research Center, University of Washington, Seattle, WA, USA
  4. 4University of Washington, Seattle, USA


Statement of Purpose Extreme Risk Protection Orders (ERPO) are civil court orders that allow for the temporary restriction of firearm possession for individuals at substantial risk of harming themselves or others. Currently Washington clinicians can 1). counsel a patient or patient’s family to file a petition, or 2). contact law enforcement to file the petition, but some states allow clinicians to 3). file an ERPO petition independently. We surveyed clinicians on their familiarity, willingness, and preferences to use ERPOs by these three initiation approaches.

Methods/Approach All MDs, ARNPs, and social workers (SWs) licensed in Washington were emailed an electronic survey and three email follow ups between May 10 and June 14, 2021.

Results 23,051 MDs, 8,049 ARNPs, and 6,910 SWs were sent the survey link. Response rates were 10.2%-MDs, 13.4%-ARNPs and 22.1%-SWs. Of respondents, 9.1%-MDs, 7.2%-ARNPs and 19.9%-SWs reported being familiar with ERPO laws. Many clinicians reported discussing firearms with their patients, particularly when concerned about suicidal ideation (40.2%-MDs, 40.4%-ARNPs, 60.6%-SWs). All three initiation approaches were acceptable to most respondents with 70% or more being willing to use each; counseling the patient or family about ERPOs was most commonly reported as the first choice (67.9%- MDs, 62.9%- ARNPs, 72.7%-SWs). The most commonly reported barriers for all approaches were the lack of knowledge about the process, uncertainty about what threats or behavior qualified for an EPRO, and concerns about working with law enforcement.

Conclusion Most healthcare providers surveyed were willing to use ERPOs but desired more training. Many providers would be willing to file ERPO petitions independently if this were available, but most reported counseling the patient or family as their preferred initiation approach.

Significance Understanding healthcare providers’ willingness and barriers to ERPO use could help promote this injury prevention tool for patients at substantial risk of harm to themselves or others.

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