Abstract
Policy Points Risk-based firearm removal laws are an effective policy tool to reduce firearm-related suicides. Unlike 21 other states with such laws, Maine's firearm removal statute applies only to persons who have been detained by law enforcement in a short-term mental health hold, and it requires an assessment for dangerousness by a medical provider. Maine's approach illuminates barriers to implementation and use of risk-based firearm removal policies. Legislative changes are necessary to bring Maine's program in line with 21 other states for which evidence shows that risk-based firearm removal laws can save lives. CONTEXT: Extreme Risk Protection Orders (ERPOs) are an effective legal tool for reducing firearm suicide by temporarily removing access to firearms for certain individuals who exhibit dangerous behavior. Unlike most state laws restricting access to firearms based on status, ERPOs are predicated on the assessment of future risk of harm to self or other, as determined by civil court file finding. Emerging research indicates that separating those in crisis from lethal means reduces firearm mortality. We assess Maine's unique approach and consider whether it is a replicable policy option for other states or should be modified to comport with other states' more broadly applicable model. METHODS: We conducted semistructured interviews with stakeholders in Maine and in three comparison states-Connecticut, Maryland, and Vermont. Interviewees included law enforcement officers, prosecutors, mental health practitioners, medical practitioners, and educational leaders and researchers. We utilized qualitative analysis software and grouped results into themes, concepts, and recommendations that addressed implementation barriers and facilitators. FINDINGS: Maine's statutory approach to risk-based firearm removal provides an opportunity for comparison with other ERPO states. Maine's requirement that a person be deemed mentally ill excludes other dangerous people from involuntary firearm seizure. Additionally, Maine's mandated provider evaluation promotes tension between law enforcement and the medical community, as many providers are disinclined to perform the required evaluations. Maine's efforts to separate those at risk of self-harm or harm to others could be improved through adoption of more traditional ERPO policies. CONCLUSIONS: No policy alone can eliminate gun violence in the United States. However, many lives can be saved by a state law that authorizes time-limited, civil court-ordered removal of firearms. Maine's narrower version, a risk-based firearm removal law, could be amended to comport with other states' ERPO laws, which have been shown to prevent many suicides.