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Research ArticleRegular Article

Criminal Justice and Suicide Outcomes with Indiana's Risk-Based Gun Seizure Law

Jeffrey W. Swanson, Michele M. Easter, Kelly Alanis-Hirsch, Charles M. Belden, Michael A. Norko, Allison G. Robertson, Linda K. Frisman, Hsiu-Ju Lin, Marvin S. Swartz and George F. Parker
Journal of the American Academy of Psychiatry and the Law Online April 2019, JAAPL.003835-19; DOI: https://doi.org/10.29158/JAAPL.003835-19
Jeffrey W. Swanson
Dr. Swanson is Professor and Associate Director, Division of Social and Community Psychiatry, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina. Dr. Easter is Assistant Professor in Psychiatry and Behavioral Sciences, Duke University School of Medicine. Dr. Belden is Research Scholar, Duke Global Health Institute, Duke University, Durham, North Carolina. Dr. Norko is Professor of Psychiatry, Yale University School of Medicine, New Haven, Connecticut and Director of Forensic Services, Connecticut Department of Mental Health and Addiction Services, Hartford. Dr. Robertson is Assistant Professor in Psychiatry and Behavioral Sciences, Duke University School of Medicine. Dr. Frisman is Research Professor and Dr. Lin is Associate Research Professor, University of Connecticut School of Social Work, Hartford. Dr. Swartz is Professor and Head, Division of Social and Community Psychiatry, Duke University School of Medicine. Dr. Parker is Professor of Clinical Psychiatry and Director of Forensic Psychiatry, Indiana University School of Medicine, Indianapolis. Some of the authors are involved in the editorial leadership of The Journal. The authors did not participate in any aspect of this article's review and acceptance, however, which were managed by an ad hoc editor who is not a member of the Editorial Board. Dr. Norko acknowledges the support of the Connecticut Department of Mental Health and Addiction Services. The views and opinions expressed are those of the authors. The research presented in this article was supported by The Fund for a Safer Future, The Elizabeth K. Dollard Trust, and The Brain and Behavior Foundation.
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Michele M. Easter
Dr. Swanson is Professor and Associate Director, Division of Social and Community Psychiatry, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina. Dr. Easter is Assistant Professor in Psychiatry and Behavioral Sciences, Duke University School of Medicine. Dr. Belden is Research Scholar, Duke Global Health Institute, Duke University, Durham, North Carolina. Dr. Norko is Professor of Psychiatry, Yale University School of Medicine, New Haven, Connecticut and Director of Forensic Services, Connecticut Department of Mental Health and Addiction Services, Hartford. Dr. Robertson is Assistant Professor in Psychiatry and Behavioral Sciences, Duke University School of Medicine. Dr. Frisman is Research Professor and Dr. Lin is Associate Research Professor, University of Connecticut School of Social Work, Hartford. Dr. Swartz is Professor and Head, Division of Social and Community Psychiatry, Duke University School of Medicine. Dr. Parker is Professor of Clinical Psychiatry and Director of Forensic Psychiatry, Indiana University School of Medicine, Indianapolis. Some of the authors are involved in the editorial leadership of The Journal. The authors did not participate in any aspect of this article's review and acceptance, however, which were managed by an ad hoc editor who is not a member of the Editorial Board. Dr. Norko acknowledges the support of the Connecticut Department of Mental Health and Addiction Services. The views and opinions expressed are those of the authors. The research presented in this article was supported by The Fund for a Safer Future, The Elizabeth K. Dollard Trust, and The Brain and Behavior Foundation.
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Kelly Alanis-Hirsch
Dr. Swanson is Professor and Associate Director, Division of Social and Community Psychiatry, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina. Dr. Easter is Assistant Professor in Psychiatry and Behavioral Sciences, Duke University School of Medicine. Dr. Belden is Research Scholar, Duke Global Health Institute, Duke University, Durham, North Carolina. Dr. Norko is Professor of Psychiatry, Yale University School of Medicine, New Haven, Connecticut and Director of Forensic Services, Connecticut Department of Mental Health and Addiction Services, Hartford. Dr. Robertson is Assistant Professor in Psychiatry and Behavioral Sciences, Duke University School of Medicine. Dr. Frisman is Research Professor and Dr. Lin is Associate Research Professor, University of Connecticut School of Social Work, Hartford. Dr. Swartz is Professor and Head, Division of Social and Community Psychiatry, Duke University School of Medicine. Dr. Parker is Professor of Clinical Psychiatry and Director of Forensic Psychiatry, Indiana University School of Medicine, Indianapolis. Some of the authors are involved in the editorial leadership of The Journal. The authors did not participate in any aspect of this article's review and acceptance, however, which were managed by an ad hoc editor who is not a member of the Editorial Board. Dr. Norko acknowledges the support of the Connecticut Department of Mental Health and Addiction Services. The views and opinions expressed are those of the authors. The research presented in this article was supported by The Fund for a Safer Future, The Elizabeth K. Dollard Trust, and The Brain and Behavior Foundation.
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Charles M. Belden
Dr. Swanson is Professor and Associate Director, Division of Social and Community Psychiatry, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina. Dr. Easter is Assistant Professor in Psychiatry and Behavioral Sciences, Duke University School of Medicine. Dr. Belden is Research Scholar, Duke Global Health Institute, Duke University, Durham, North Carolina. Dr. Norko is Professor of Psychiatry, Yale University School of Medicine, New Haven, Connecticut and Director of Forensic Services, Connecticut Department of Mental Health and Addiction Services, Hartford. Dr. Robertson is Assistant Professor in Psychiatry and Behavioral Sciences, Duke University School of Medicine. Dr. Frisman is Research Professor and Dr. Lin is Associate Research Professor, University of Connecticut School of Social Work, Hartford. Dr. Swartz is Professor and Head, Division of Social and Community Psychiatry, Duke University School of Medicine. Dr. Parker is Professor of Clinical Psychiatry and Director of Forensic Psychiatry, Indiana University School of Medicine, Indianapolis. Some of the authors are involved in the editorial leadership of The Journal. The authors did not participate in any aspect of this article's review and acceptance, however, which were managed by an ad hoc editor who is not a member of the Editorial Board. Dr. Norko acknowledges the support of the Connecticut Department of Mental Health and Addiction Services. The views and opinions expressed are those of the authors. The research presented in this article was supported by The Fund for a Safer Future, The Elizabeth K. Dollard Trust, and The Brain and Behavior Foundation.
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Michael A. Norko
Dr. Swanson is Professor and Associate Director, Division of Social and Community Psychiatry, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina. Dr. Easter is Assistant Professor in Psychiatry and Behavioral Sciences, Duke University School of Medicine. Dr. Belden is Research Scholar, Duke Global Health Institute, Duke University, Durham, North Carolina. Dr. Norko is Professor of Psychiatry, Yale University School of Medicine, New Haven, Connecticut and Director of Forensic Services, Connecticut Department of Mental Health and Addiction Services, Hartford. Dr. Robertson is Assistant Professor in Psychiatry and Behavioral Sciences, Duke University School of Medicine. Dr. Frisman is Research Professor and Dr. Lin is Associate Research Professor, University of Connecticut School of Social Work, Hartford. Dr. Swartz is Professor and Head, Division of Social and Community Psychiatry, Duke University School of Medicine. Dr. Parker is Professor of Clinical Psychiatry and Director of Forensic Psychiatry, Indiana University School of Medicine, Indianapolis. Some of the authors are involved in the editorial leadership of The Journal. The authors did not participate in any aspect of this article's review and acceptance, however, which were managed by an ad hoc editor who is not a member of the Editorial Board. Dr. Norko acknowledges the support of the Connecticut Department of Mental Health and Addiction Services. The views and opinions expressed are those of the authors. The research presented in this article was supported by The Fund for a Safer Future, The Elizabeth K. Dollard Trust, and The Brain and Behavior Foundation.
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Allison G. Robertson
Dr. Swanson is Professor and Associate Director, Division of Social and Community Psychiatry, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina. Dr. Easter is Assistant Professor in Psychiatry and Behavioral Sciences, Duke University School of Medicine. Dr. Belden is Research Scholar, Duke Global Health Institute, Duke University, Durham, North Carolina. Dr. Norko is Professor of Psychiatry, Yale University School of Medicine, New Haven, Connecticut and Director of Forensic Services, Connecticut Department of Mental Health and Addiction Services, Hartford. Dr. Robertson is Assistant Professor in Psychiatry and Behavioral Sciences, Duke University School of Medicine. Dr. Frisman is Research Professor and Dr. Lin is Associate Research Professor, University of Connecticut School of Social Work, Hartford. Dr. Swartz is Professor and Head, Division of Social and Community Psychiatry, Duke University School of Medicine. Dr. Parker is Professor of Clinical Psychiatry and Director of Forensic Psychiatry, Indiana University School of Medicine, Indianapolis. Some of the authors are involved in the editorial leadership of The Journal. The authors did not participate in any aspect of this article's review and acceptance, however, which were managed by an ad hoc editor who is not a member of the Editorial Board. Dr. Norko acknowledges the support of the Connecticut Department of Mental Health and Addiction Services. The views and opinions expressed are those of the authors. The research presented in this article was supported by The Fund for a Safer Future, The Elizabeth K. Dollard Trust, and The Brain and Behavior Foundation.
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Linda K. Frisman
Dr. Swanson is Professor and Associate Director, Division of Social and Community Psychiatry, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina. Dr. Easter is Assistant Professor in Psychiatry and Behavioral Sciences, Duke University School of Medicine. Dr. Belden is Research Scholar, Duke Global Health Institute, Duke University, Durham, North Carolina. Dr. Norko is Professor of Psychiatry, Yale University School of Medicine, New Haven, Connecticut and Director of Forensic Services, Connecticut Department of Mental Health and Addiction Services, Hartford. Dr. Robertson is Assistant Professor in Psychiatry and Behavioral Sciences, Duke University School of Medicine. Dr. Frisman is Research Professor and Dr. Lin is Associate Research Professor, University of Connecticut School of Social Work, Hartford. Dr. Swartz is Professor and Head, Division of Social and Community Psychiatry, Duke University School of Medicine. Dr. Parker is Professor of Clinical Psychiatry and Director of Forensic Psychiatry, Indiana University School of Medicine, Indianapolis. Some of the authors are involved in the editorial leadership of The Journal. The authors did not participate in any aspect of this article's review and acceptance, however, which were managed by an ad hoc editor who is not a member of the Editorial Board. Dr. Norko acknowledges the support of the Connecticut Department of Mental Health and Addiction Services. The views and opinions expressed are those of the authors. The research presented in this article was supported by The Fund for a Safer Future, The Elizabeth K. Dollard Trust, and The Brain and Behavior Foundation.
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Hsiu-Ju Lin
Dr. Swanson is Professor and Associate Director, Division of Social and Community Psychiatry, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina. Dr. Easter is Assistant Professor in Psychiatry and Behavioral Sciences, Duke University School of Medicine. Dr. Belden is Research Scholar, Duke Global Health Institute, Duke University, Durham, North Carolina. Dr. Norko is Professor of Psychiatry, Yale University School of Medicine, New Haven, Connecticut and Director of Forensic Services, Connecticut Department of Mental Health and Addiction Services, Hartford. Dr. Robertson is Assistant Professor in Psychiatry and Behavioral Sciences, Duke University School of Medicine. Dr. Frisman is Research Professor and Dr. Lin is Associate Research Professor, University of Connecticut School of Social Work, Hartford. Dr. Swartz is Professor and Head, Division of Social and Community Psychiatry, Duke University School of Medicine. Dr. Parker is Professor of Clinical Psychiatry and Director of Forensic Psychiatry, Indiana University School of Medicine, Indianapolis. Some of the authors are involved in the editorial leadership of The Journal. The authors did not participate in any aspect of this article's review and acceptance, however, which were managed by an ad hoc editor who is not a member of the Editorial Board. Dr. Norko acknowledges the support of the Connecticut Department of Mental Health and Addiction Services. The views and opinions expressed are those of the authors. The research presented in this article was supported by The Fund for a Safer Future, The Elizabeth K. Dollard Trust, and The Brain and Behavior Foundation.
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Marvin S. Swartz
Dr. Swanson is Professor and Associate Director, Division of Social and Community Psychiatry, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina. Dr. Easter is Assistant Professor in Psychiatry and Behavioral Sciences, Duke University School of Medicine. Dr. Belden is Research Scholar, Duke Global Health Institute, Duke University, Durham, North Carolina. Dr. Norko is Professor of Psychiatry, Yale University School of Medicine, New Haven, Connecticut and Director of Forensic Services, Connecticut Department of Mental Health and Addiction Services, Hartford. Dr. Robertson is Assistant Professor in Psychiatry and Behavioral Sciences, Duke University School of Medicine. Dr. Frisman is Research Professor and Dr. Lin is Associate Research Professor, University of Connecticut School of Social Work, Hartford. Dr. Swartz is Professor and Head, Division of Social and Community Psychiatry, Duke University School of Medicine. Dr. Parker is Professor of Clinical Psychiatry and Director of Forensic Psychiatry, Indiana University School of Medicine, Indianapolis. Some of the authors are involved in the editorial leadership of The Journal. The authors did not participate in any aspect of this article's review and acceptance, however, which were managed by an ad hoc editor who is not a member of the Editorial Board. Dr. Norko acknowledges the support of the Connecticut Department of Mental Health and Addiction Services. The views and opinions expressed are those of the authors. The research presented in this article was supported by The Fund for a Safer Future, The Elizabeth K. Dollard Trust, and The Brain and Behavior Foundation.
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George F. Parker
Dr. Swanson is Professor and Associate Director, Division of Social and Community Psychiatry, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina. Dr. Easter is Assistant Professor in Psychiatry and Behavioral Sciences, Duke University School of Medicine. Dr. Belden is Research Scholar, Duke Global Health Institute, Duke University, Durham, North Carolina. Dr. Norko is Professor of Psychiatry, Yale University School of Medicine, New Haven, Connecticut and Director of Forensic Services, Connecticut Department of Mental Health and Addiction Services, Hartford. Dr. Robertson is Assistant Professor in Psychiatry and Behavioral Sciences, Duke University School of Medicine. Dr. Frisman is Research Professor and Dr. Lin is Associate Research Professor, University of Connecticut School of Social Work, Hartford. Dr. Swartz is Professor and Head, Division of Social and Community Psychiatry, Duke University School of Medicine. Dr. Parker is Professor of Clinical Psychiatry and Director of Forensic Psychiatry, Indiana University School of Medicine, Indianapolis. Some of the authors are involved in the editorial leadership of The Journal. The authors did not participate in any aspect of this article's review and acceptance, however, which were managed by an ad hoc editor who is not a member of the Editorial Board. Dr. Norko acknowledges the support of the Connecticut Department of Mental Health and Addiction Services. The views and opinions expressed are those of the authors. The research presented in this article was supported by The Fund for a Safer Future, The Elizabeth K. Dollard Trust, and The Brain and Behavior Foundation.
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Article Figures & Data

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    Table 1

    Characteristics of Firearm Seizure Cases in Indiana

    Characteristicn (%)
    Gender
        Male318 (80.5)
        Female77 (19.5)
    Age, y, mean (range)42.8 (17–86)
    Race/ethnicity
        White301 (76.2)
        Other94 (23.8)
    Reason for gun seizure (not mutually exclusive)
        Suicidal ideation269 (68.1)
        Homicidal ideation83 (21.0)
        Domestic disturbance112 (28.4)
        Acute mental illness, cognitive impairment67 (17.0)
        Drug or alcohol intoxication104 (26.3)
        Other14 (3.5)
    Number of firearms removed per case, mean (range)2.7 (1–82)
    Number of firearms removed, by type
        Handguns548 (50.8)
        Long guns or not described531 (49.2)
        Total1,079 (100.0)
    Action taken by police at the scene of firearm removal
        Not arrested
            Transported involuntarily to a hospital for evaluation273 (69.1)
            Transported voluntarily to a hospital for evaluation38 (9.6)
            Not transported to a hospital or arrested52 (13.2)
        Arrested
            Transported involuntarily to a hospital for evaluation, and arrested19 (4.8)
            Arrested at the scene of gun removal and transported to jail13 (3.3)
    • N = 395 subjects.

    • View popup
    Table 2

    Documented Reason for Gun Risk Concern Among Gun Seizure Respondents

    Arrested* (n = 99)Not Arrested* (n = 296)Statistical Significance
    Suicidal ideation (n = 269)55 (55.6)214 (72.3)†
    Homicidal ideation (n = 83)33 (33.3)50 (16.9)†
    Domestic violence (n = 112)34 (34.3)78 (26.4)
    Substance involvement (n = 104)28 (28.3)76 (25.7)
    Mental/cognitive health (n = 67)15 (15.2)52 (17.6)
    Other (n = 14)6 (6.1)14 (4.7)
    • N = 395 subjects. Data are shown as n (%). Sum of columns exceeds 100% because more than one reason may be noted.

    • ↵* Defined as arrested or not arrested at the time of gun seizure, the year before, or the year after.

    • ↵† Statistical significance: P < .01

    • View popup
    Table 3

    Severity of and Gun Involvement in Most Serious Charge Among Gun Seizure Respondents

    Uniform Crime Report Tier 1: Index Crimes*Uniform Crime Report Tier 2: Other Crimes†Non-Gun ChargeGun ChargeAny Arrest
    Arrested
        No367 (92.9)309 (78.2)314 (79.5)381 (96.5)296 (74.9)
        At seizure‡7 (1.8)13 (3.3)15 (3.8)5 (1.3)20 (5.1)
        Year before7 (1.8)33 (8.4)35 (8.9)3 (0.8)38 (9.6)
        Year after15 (3.8)49 (12.4)51 (12.9)8 (2.0)58 (14.7)
    Convicted
        No386 (97.7)336 (85.1)345 (87.3)390 (98.7)332 (84.1)
        At seizure§2 (0.5)9 (2.3)9 (2.3)2 (0.5)11 (2.8)
        Year before0 (0.0)20 (5.1)19 (4.8)1 (0.3)20 (5.1)
        Year after7 (1.8)32 (8.1)34 (8.6)2 (0.5)36 (9.1)
    • N = 395 subjects. Data are shown as n (%). Sum of columns exceeds 100% people may have been arrested before, during, and after gun seizure.

    • ↵* FBI Uniform Crime Report index crimes: criminal homicide, forcible rape, robbery, aggravated assault, burglary, larceny, motor vehicle theft, arson.

    • ↵† FBI Uniform Crime Report other: other assaults (simple, non-aggravated), forgery and counterfeiting, fraud, embezzlement, stolen property offenses (buying, receiving, possessing), vandalism, weapons violations (carrying, possessing), prostitution and commercialized vice, other sex offenses, drug law violations, gambling, offenses against the family and children, driving under the influence, liquor law violations, drunkenness, disorderly conduct, vagrancy, suspicion, loitering, all other offenses.

    • ↵‡ Arrest occurred within 4 days before or after the gun seizure event.

    • ↵§ Conviction connected to an arrest that occurred within 4 days before or after the gun seizure event.

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Journal of the American Academy of Psychiatry and the Law Online: 53 (1)
Journal of the American Academy of Psychiatry and the Law Online
Vol. 53, Issue 1
1 Mar 2025
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Criminal Justice and Suicide Outcomes with Indiana's Risk-Based Gun Seizure Law
Jeffrey W. Swanson, Michele M. Easter, Kelly Alanis-Hirsch, Charles M. Belden, Michael A. Norko, Allison G. Robertson, Linda K. Frisman, Hsiu-Ju Lin, Marvin S. Swartz, George F. Parker
Journal of the American Academy of Psychiatry and the Law Online Apr 2019, JAAPL.003835-19; DOI: 10.29158/JAAPL.003835-19

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Criminal Justice and Suicide Outcomes with Indiana's Risk-Based Gun Seizure Law
Jeffrey W. Swanson, Michele M. Easter, Kelly Alanis-Hirsch, Charles M. Belden, Michael A. Norko, Allison G. Robertson, Linda K. Frisman, Hsiu-Ju Lin, Marvin S. Swartz, George F. Parker
Journal of the American Academy of Psychiatry and the Law Online Apr 2019, JAAPL.003835-19; DOI: 10.29158/JAAPL.003835-19
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