Extreme Risk Protection Orders Among Military Service Members and Veterans

Importance: Service members and veterans who die by suicide disproportionately use firearms. Extreme risk protection orders (ERPOs) temporarily restrict firearm access for individuals deemed at risk of harming themselves or others. Despite elevated firearm-suicide risk among service members and veterans, no research has examined ERPO use within this population. Objective: To characterize how often ERPOs are applied to service member and veteran populations compared with civilians, and under what circumstances they are filed in Colorado. Design, Setting, and Participants: This cross-sectional study included all ERPO respondents from petitions filed in Colorado between January 1, 2020, and December 31, 2024. Exposure: Service member or veteran status. Main Outcomes and Measures: Petitions involving service members and veterans vs civilians were compared using χ2 and Fisher exact tests. Narrative summaries for service member and veteran cases were qualitatively analyzed to identify themes. Results: Of 692 ERPO petitions, 68 (9.8%) involved service members or veterans, and 624 (90.2%) involved civilians. Temporary ERPOs were granted in 47 service member or veteran cases (69.1%), and 36 of these (76.6%) were extended to full 365-day orders. Compared with civilian respondents, service member or veteran respondents were more likely to be male (66 [97.1%] vs 504 [80.8%]), older (mean [SD] age, 40.0 [14.4] vs 36.0 [15.4] years), have documented mental health concerns (48 [70.9%] vs 358 [57.2%]), and have a history of involuntary mental health holds (26 [38.2%] vs 166 [26.6%]). No significant differences were found in reasons for filing, likelihood of ERPO granting, or documented firearm access. Five petitions (7.4%) were filed by military superior officers for active-duty members; all were denied due to lack of legal standing. Qualitative analysis identified themes of multiple co-occurring threats, PTSD, substance misuse, homelessness, and threats of suicide with firearm access. Conclusions and Relevance: In this cross-sectional study of ERPO petitions filed in Colorado from 2020 to 2024, service members and veterans were slightly overrepresented among ERPO respondents relative to their share of Colorado's population, suggesting ERPOs may be an important tool for mitigating suicide and violence risks in this group. The presence of multiple overlapping threat types highlights the complex risk profiles encountered among service members and veterans. Enhanced training for law enforcement, military, and other petitioners may improve appropriate ERPO use for this population.