Case studies of individuals threatening mass violence suggest that extreme risk protection orders (ERPOs), colloquially known as ‘red flag’ orders, may play a role in preventing mass shootings. An aggregate summary and individual histories for a preliminary series of 21 cases are published in Annals of Internal Medicine.
Nearly 80 percent of perpetrators of mass violence in public places make explicit threats or behave in a manner “indicative of their intent to carry out an attack.” For example, the shooters in the infamous Parkland, Aurora, and Tucson events, among others, were known by family members, acquaintances, law enforcement, and in some cases, health care professionals, to be at high risk for violence. ERPOs provide a rapid, focused response when risk of imminent firearm violence is high. Studies suggest that these interventions are effective at preventing suicide, but their efficacy in preventing mass shootings is not known. To date, there have been only two reported cases of ERPO use in efforts to prevent mass shootings. California enacted the nation’s first ERPO statue, which took effect in January 2016.
Researchers from the Violence Prevention Research Program at UC Davis School of Medicine sought to evaluate the California statute’s implementation and effectiveness by reviewing court cases for persons subject to the orders. Of 414 cases, the authors received 159 and developed an aggregate summary and individual histories for a preliminary series of 21 cases. Their research showed that most subjects were male and non-Hispanic white and the mean age was 35. Most subjects made explicit threats and owned firearms. Four cases arose primarily in relation to medical or mental health conditions, and such conditions were noted in four others. Fifty-two firearms were recovered. The researchers conducted print, broadcast, and Internet media Google searches using the subjects’ names and locations to determine if they were the perpetrators of any violent events from the date of the order. As of early August 2019, none of the threatened shootings had occurred, and no other homicides or suicides by persons subject to the orders were identified. According to the authors, these cases suggest that this urgent, individualized intervention has a role to play in efforts to prevent mass shootings, in healthcare settings and elsewhere. They believe that further research would be helpful in determining definitively the effectiveness of such orders.