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Research ArticleRegular Article

Extreme Risk Protection Orders in Connecticut, 2013-2020

Reena Kapoor, Bettina Viereck, Hsiu-Ju Lin, Jeffrey W. Swanson, Michele M. Easter, Madelon V. Baranoski, April M. Zeoli, Shannon Frattaroli and Michael A. Norko
Journal of the American Academy of Psychiatry and the Law Online May 2024, JAAPL.240022-24; DOI: https://doi.org/10.29158/JAAPL.240022-24
Reena Kapoor
Dr. Kapoor is an Associate Professor of Psychiatry and Dr. Baranoski and Dr. Norko are Professors of Psychiatry, Yale University School of Medicine, New Haven, CT. Dr. Viereck is a Research Analyst, Connecticut Department of Mental Health and Addiction Services, Hartford, CT, and a Lecturer at Yale University School of Medicine, New Haven, CT. Dr. Lin is an Associate Research Professor, School of Social Work, University of Connecticut, Hartford, CT. Dr. Swanson is a Professor of Psychiatry and Behavioral Sciences and Dr. Easter is an Assistant Professor of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC. Dr. Zeoli is an Associate Professor, Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, MI. Dr. Frattaroli is a Professor at the Center for Gun Violence Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
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Bettina Viereck
Dr. Kapoor is an Associate Professor of Psychiatry and Dr. Baranoski and Dr. Norko are Professors of Psychiatry, Yale University School of Medicine, New Haven, CT. Dr. Viereck is a Research Analyst, Connecticut Department of Mental Health and Addiction Services, Hartford, CT, and a Lecturer at Yale University School of Medicine, New Haven, CT. Dr. Lin is an Associate Research Professor, School of Social Work, University of Connecticut, Hartford, CT. Dr. Swanson is a Professor of Psychiatry and Behavioral Sciences and Dr. Easter is an Assistant Professor of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC. Dr. Zeoli is an Associate Professor, Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, MI. Dr. Frattaroli is a Professor at the Center for Gun Violence Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
PhD, Dipl-Psych
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Hsiu-Ju Lin
Dr. Kapoor is an Associate Professor of Psychiatry and Dr. Baranoski and Dr. Norko are Professors of Psychiatry, Yale University School of Medicine, New Haven, CT. Dr. Viereck is a Research Analyst, Connecticut Department of Mental Health and Addiction Services, Hartford, CT, and a Lecturer at Yale University School of Medicine, New Haven, CT. Dr. Lin is an Associate Research Professor, School of Social Work, University of Connecticut, Hartford, CT. Dr. Swanson is a Professor of Psychiatry and Behavioral Sciences and Dr. Easter is an Assistant Professor of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC. Dr. Zeoli is an Associate Professor, Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, MI. Dr. Frattaroli is a Professor at the Center for Gun Violence Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
PhD
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Jeffrey W. Swanson
Dr. Kapoor is an Associate Professor of Psychiatry and Dr. Baranoski and Dr. Norko are Professors of Psychiatry, Yale University School of Medicine, New Haven, CT. Dr. Viereck is a Research Analyst, Connecticut Department of Mental Health and Addiction Services, Hartford, CT, and a Lecturer at Yale University School of Medicine, New Haven, CT. Dr. Lin is an Associate Research Professor, School of Social Work, University of Connecticut, Hartford, CT. Dr. Swanson is a Professor of Psychiatry and Behavioral Sciences and Dr. Easter is an Assistant Professor of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC. Dr. Zeoli is an Associate Professor, Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, MI. Dr. Frattaroli is a Professor at the Center for Gun Violence Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
PhD
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Michele M. Easter
Dr. Kapoor is an Associate Professor of Psychiatry and Dr. Baranoski and Dr. Norko are Professors of Psychiatry, Yale University School of Medicine, New Haven, CT. Dr. Viereck is a Research Analyst, Connecticut Department of Mental Health and Addiction Services, Hartford, CT, and a Lecturer at Yale University School of Medicine, New Haven, CT. Dr. Lin is an Associate Research Professor, School of Social Work, University of Connecticut, Hartford, CT. Dr. Swanson is a Professor of Psychiatry and Behavioral Sciences and Dr. Easter is an Assistant Professor of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC. Dr. Zeoli is an Associate Professor, Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, MI. Dr. Frattaroli is a Professor at the Center for Gun Violence Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
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Madelon V. Baranoski
Dr. Kapoor is an Associate Professor of Psychiatry and Dr. Baranoski and Dr. Norko are Professors of Psychiatry, Yale University School of Medicine, New Haven, CT. Dr. Viereck is a Research Analyst, Connecticut Department of Mental Health and Addiction Services, Hartford, CT, and a Lecturer at Yale University School of Medicine, New Haven, CT. Dr. Lin is an Associate Research Professor, School of Social Work, University of Connecticut, Hartford, CT. Dr. Swanson is a Professor of Psychiatry and Behavioral Sciences and Dr. Easter is an Assistant Professor of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC. Dr. Zeoli is an Associate Professor, Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, MI. Dr. Frattaroli is a Professor at the Center for Gun Violence Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
PhD
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April M. Zeoli
Dr. Kapoor is an Associate Professor of Psychiatry and Dr. Baranoski and Dr. Norko are Professors of Psychiatry, Yale University School of Medicine, New Haven, CT. Dr. Viereck is a Research Analyst, Connecticut Department of Mental Health and Addiction Services, Hartford, CT, and a Lecturer at Yale University School of Medicine, New Haven, CT. Dr. Lin is an Associate Research Professor, School of Social Work, University of Connecticut, Hartford, CT. Dr. Swanson is a Professor of Psychiatry and Behavioral Sciences and Dr. Easter is an Assistant Professor of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC. Dr. Zeoli is an Associate Professor, Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, MI. Dr. Frattaroli is a Professor at the Center for Gun Violence Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
PhD, MPH
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Shannon Frattaroli
Dr. Kapoor is an Associate Professor of Psychiatry and Dr. Baranoski and Dr. Norko are Professors of Psychiatry, Yale University School of Medicine, New Haven, CT. Dr. Viereck is a Research Analyst, Connecticut Department of Mental Health and Addiction Services, Hartford, CT, and a Lecturer at Yale University School of Medicine, New Haven, CT. Dr. Lin is an Associate Research Professor, School of Social Work, University of Connecticut, Hartford, CT. Dr. Swanson is a Professor of Psychiatry and Behavioral Sciences and Dr. Easter is an Assistant Professor of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC. Dr. Zeoli is an Associate Professor, Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, MI. Dr. Frattaroli is a Professor at the Center for Gun Violence Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
PhD, MPH
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Michael A. Norko
Dr. Kapoor is an Associate Professor of Psychiatry and Dr. Baranoski and Dr. Norko are Professors of Psychiatry, Yale University School of Medicine, New Haven, CT. Dr. Viereck is a Research Analyst, Connecticut Department of Mental Health and Addiction Services, Hartford, CT, and a Lecturer at Yale University School of Medicine, New Haven, CT. Dr. Lin is an Associate Research Professor, School of Social Work, University of Connecticut, Hartford, CT. Dr. Swanson is a Professor of Psychiatry and Behavioral Sciences and Dr. Easter is an Assistant Professor of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC. Dr. Zeoli is an Associate Professor, Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, MI. Dr. Frattaroli is a Professor at the Center for Gun Violence Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
MD, MAR
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  • Figure 1.
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    Figure 1.

    Temporary ERPOs Issued in Connecticut from 1999 to 2020.a2020 data are from January 1 to June 30 only.

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    Table 1

    ERPO Respondents’ Demographics

    Characteristicsn (%)
    Gendera
     Male1,289 (92.5%)
     Female105 (7.5%)
     Age in years, mean; median (range)b47.6; 47.3 (16.3–98.4)
    Race and ethnicitya
     Not reported in police affidavit677 (48.6%)
     Reported in police affidavit717 (51.4%)
      White673 (93.9%)
      Black and African American34 (4.7%)
      Hispanic and Latinx5 (0.7%)
      Asian4 (0.6%)
      Native American and Alaskan Native2 (0.3%)
      Multiple Races2 (0.3%)
      Other1 (0.1%)
    • ↵aN = 1,394 unique respondents

    • ↵bN = 1,407 cases

    • View popup
    Table 2

    Reason for Gun Removal

    Type of riskn (%)
     Harm to self only785 (55.8%)
     Harm to others only350 (24.9%)
     Harm to self and others190 (13.5%)
     No Harm to self or others82 (5.8%)
    Harm to selfa975 (69.3%)
     Suicidal ideation, threats, plans, or aborted attempt840 (59.7%)
     Suicide attempt116 (8.2%)
     Self-harm that was not suicide attempta37 (2.6%)
    Harm to othersa540 (38.4%)
     Use of violence210 (14.9%)
     Threat of violence392 (27.9%)
     Mass shooting threat46 (3.3%)
    • Note. N = 1,407 cases.

    • ↵aMultiple choices possible within the category.

    • View popup
    Table 3

    Mental Health Concerns and Alcohol and Drug Use

    Characteristicsn (%)
    Respondents with mental health concerns (excluding alcohol and substance use disorders)1,148 (81.6%)
     Specific mental health diagnosis or psychotropic medication212 (15.1%)
     Vague statements about mental health936 (66.5%)
     Irrational or erratic behaviorsa94 (6.7%)
     Cognitive decline from dementia, TBI, or other causesa67 (4.8%)
    Respondents with no mental health concerns259 (18.4%)
    Respondents with alcohol or drug use637 (45.3%)
     Alcohol only401 (28.5%)
     Drugs only148 (10.5%)
     Alcohol and drugs88 (6.3%)
    Respondents with no alcohol or drug use770 (54.7%)
    Respondents with drug use236 (16.8%)
     Opioids, including heroina93 (39.4%)
     Marijuana149 (20.8%)
     Inhalants (e.g., huffing, whippits)a53 (22.5%)
     Stimulants, hallucinogens (e.g., methamphetamine, cocaine, LSD, PCP)138 (16.1%)
     Respondents with vague or unclear references to drugsa57 (24.2%)
    • Note. N = 1,407 subjects.

    • ↵aNot mutually exclusive.

    • View popup
    Table 4

    Action Taken by Police at the Scene

    Action Takenn (%)
    Transported involuntarily to a hospital for evaluation1,113 (79.1%)
    Arrested260 (18.5%)
     Arrested and involuntarily transported to a hospital for evaluation117 (8.3%)
     Arrested and not involuntarily transported to a to a hospital for evaluation143 (10.2%)
    Not Arrested but involuntarily transported to a hospital for evaluation996 (70.8%)
    Neither arrested nor involuntarily transported to a hospital for evaluation.151 (10.7%)
    • Note. N = 1,407 cases.

    • View popup
    Table 5

    Number of Firearms Removed per Case

    Characteristicsn (%)
    Number of firearms removed per case, mean (range; median)5.85 (1–150; 3.0)
    Total number of firearms removed8,087
    Type of firearms removeda
     Handguns1,068 (76.8%)
     Long guns951 (68.4%)
     Not described21 (1.5%)
    • Note. N = 1,407 cases.

    • ↵aNot mutually exclusive.

    • View popup
    Table 6

    Available Comparisons Reported in Three CT ERPO Study Publications

    Current study (2013–2020)Swanson et al. 20174 (1999–2013)Norko and Baranoski 20143 (1999–2013)
    Total (n)1,407762764
    Gender—
     Male92.5%92%—
     Female—
    Mean age47.6 years47 years—
    Who initiated ERPO
     Family44.7%41%—
     Healthcare providers8.3%8% (employer or clinician)—
    Type of risk
     Self-harm69.3%61% (based on n = 702)
     Harm to others38.4%32%
    Rural or suburban92.5%—76%
    Mental health treatment
     No DMHAS history57.2%—89.2%
     Active DMHAS treatment7.1%—<1%
    Substance use
     Alcohol use28.5%—30%
     Drug use10.5%—<5%
    Action taken by police
     Sent to ER78% male; 92.4% female—60% male; 80% female
     Arrested18.7%—20%
     Both8.3%—16%
    Weapons ordered held by court50.9% petitions granted (data available for 80% of cases)—68% (data available for < 30% of cases)
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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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Extreme Risk Protection Orders in Connecticut, 2013-2020
Reena Kapoor, Bettina Viereck, Hsiu-Ju Lin, Jeffrey W. Swanson, Michele M. Easter, Madelon V. Baranoski, April M. Zeoli, Shannon Frattaroli, Michael A. Norko
Journal of the American Academy of Psychiatry and the Law Online May 2024, JAAPL.240022-24; DOI: 10.29158/JAAPL.240022-24

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Extreme Risk Protection Orders in Connecticut, 2013-2020
Reena Kapoor, Bettina Viereck, Hsiu-Ju Lin, Jeffrey W. Swanson, Michele M. Easter, Madelon V. Baranoski, April M. Zeoli, Shannon Frattaroli, Michael A. Norko
Journal of the American Academy of Psychiatry and the Law Online May 2024, JAAPL.240022-24; DOI: 10.29158/JAAPL.240022-24
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