Connecticut providers knowledge and attitudes towards use of extreme risk protection orders

Abstract

Background Extreme Risk Protection Orders (ERPOs) are a legislative tool that temporarily restrict firearm access in patients with higher suicide risk. ERPOs have reduced firearm suicide rates in Connecticut and are estimated to save one life per 10 orders filed. Connecticut medical providers can initiate this process, but less than 8% of 2020 ERPOs were filed by providers. This survey assesses provider knowledge and attitudes towards use of ERPOs. Methods This study electronically surveyed providers from six hospitals regarding their current knowledge of the Connecticut ERPO law, perceived barriers to the use of the law and procedures that might make use more likely. Results 114 providers completed the survey in 2022. 66 (57.8%) providers encountered more than 1 patient per year at risk for suicide with firearm access. Only 2 providers had ever initiated an ERPO, but both found it extremely helpful. Only 1 provider was extremely familiar with ERPO while 91 (83.4%) were not familiar. Barriers to using ERPO include negatively impacting the patient relationship, and not enough time to call and follow up. ERPO specific training, and trained on-site coordinators to help file and follow through were ways to encourage to ERPO utilization. Conclusion The majority of providers encounter at least one patient annually who may benefit from an ERPO. However, providers are largely unfamiliar with ERPO and the filing process. Time cost is the greatest barrier to its utilization. Provider training and trained coordinators to process ERPO were the two most requested supports to encourage providers to initiate ERPOs.