CSTS podcast series
Let’s Talk About Your Guns
Episode 108: Extreme Risk Protection Orders
1.
2.

AUDIO

NOTES

DOROTHY PAUGH: I was nine years old on the
day my dad died.

3.

DOROTHY PAUGH: It was a warm August day.
He had asked my mother to take all the kids to theswimming pool.
So my mother loaded all five of us kids into thestation wagon to take us to the officer’s club.

4.

DOROTHY PAUGH: I remember playing Marco
Polo and then hearing my mother's name over the
loudspeaker.
We didn't know what was going on.

5.

DOROTHY PAUGH: A military policeman cameand took her away for a few minutes.

6.

DOROTHY PAUGH: A few minutes later the MPcame back and we were rounded up and got in thecar.
He was driving because they didn't want my mom
to drive.

7.

DOROTHY PAUGH: She was white. You could tellwith one look at her face that something was bad.
1

8.

DOROTHY PAUGH: They took us to the hospitalwhere we were herded into this room.
And I just remember that as we were walking down
the halls, people were looking at us.
And I remember a sensation of why is everyone
looking at us? Stop looking at us.
We just knew that there was something that was
terrible.

9.

DOROTHY PAUGH: It was the family priest that
did the talking to tell us that our dad was dead.
My father shot himself in our basement. And before
he did so, he called 911 so that my mother wouldn't
find his body.

10.

DOROTHY PAUGH: My mother was aware thatmy father was struggling.
He had set out his life insurance paperwork and his
will, and he had gone to a gun store and bought a
handgun.
And that was enough to clue my mother that things
were bad and she wanted help.

11.

DOROTHY PAUGH: She called in our priest to talkto him. I just remember that they sat outside underthe mimosa tree and drank beer and talked.

2

12.

DOROTHY PAUGH: But the priest didn’t ask ifthey could take the gun out of the home so that it
wouldn't be within easy reach.

13.

DOROTHY PAUGH: I'm not sure it occurred tothem that the availability of so lethal a weapon
might tempt my father in the midst of his despair.

14. Transition to new beat
15.

DR WEST: More than fifty years after Dorothy
Paugh’s father took his life, the memory still stings.

16.

DR WEST: She believes that if there had been alaw that allowed her mother to remove the gun
from the home, her father may have survived.

17.

DOROTHY PAUGH: I think that the ability forsomeone to take that gun away in that moment,
like right away, not five days from now, that thatmight have given him the time to get help.

18. Transition to new beat
19.

DR WEST: I’m Curt West: Associate Professor of
Psychiatry and Scientist at the Center for the Studyof Traumatic Stress at the Uniformed Services
University. Today, in Let’s Talk about Your Guns
we’ll talk about Extreme Risk Protective Orders.

3

20.

DR WEST: Extreme Risk Protective Orders – or
ERPOs - let law enforcement temporarily takefirearms away from a person in crisis. An ERPO
also stops that person from purchasing guns.

21.

DR WEST: Taking advantage of these laws may
save the life of someone you care about whenthings are really bad.

22.

DR WEST: Today, we’ll learn what motivatedDorothy Paugh to become such a strong advocate
for ERPO laws.
We’ll talk to Dr. Shannon Frattaroli about the
research behind them.
And we’ll talk to Sheriff Darren Popkin from
Montgomery County Maryland about how theselaws actually work.

23.

DR WEST: This final episode of our podcast isabout what you can do when conversations about
safe storage break down. Circumstances are truly
unsafe, and you’re concerned that ready access tofirearms may put someone you care about at risk tothemselves or others.
It’s not about whether you are for or against
guns. So now… Let’s Talk about Your Guns.

24. Transition to new beat

4

25.

DR WEST: Dorothy, to your knowledge, was there
any discussion about taking your father’s gun awaywhen he was having this crisis?

26.

DOROTHY PAUGH: Not that I know. And I'm also
not sure if my father would have been open tohanding over the gun.
My father was fairly headstrong, so he didn't wantsomeone telling him what to do. And I think that hewould have just felt as if this was a plan or this waswhat he saw as his best release from what he wasgoing through from his crisis.

27.

DR WEST: Your father’s suicide had a big impact
on you. How did it affect your mother?

28.

DOROTHY PAUGH: Oh, my father’s suicide had atremendous impact on my mother. After it first
happened, the five of us kids were sort of sent tostay with neighbors in the area just so she would
have some time. And it was just a day or two andshe was like, no, no bring them back. And I
remember that because we felt like we were sort ofexiled, like, you know, we had done something
because now my father's gone and, you know, mymother has to not be around us. So she, she's she
stood up to the challenge and years later said that's
what kept her going, was knowing that there were
five children between five and 15 that needed her

5to be strong. And she was a strong Irish woman.
And she did raise all five of us.
29.

DR WEST: What difference do you think it would
have made had there been a law in place to keep
him from purchasing a gun while he was in thiscrisis?

30.

DOROTHY PAUGH: I believe that had there beena law that empowered my mother to have law
enforcement come and ask for that gun and thenfor him to get help, that our lives would have been
completely different.
Instead of growing up feeling abandoned andwondering whether there was anything we could
have done or anything we had done to make thishappen, you know, we would have just had moredays of fun in the sun.

31.

DR WEST: Your experience has led you to
become a powerful advocate for ERPO laws inMaryland. Can you tell me what these Extreme
Risk Protection Orders do?

32.

DOROTHY PAUGH: What an extreme risk
protection order does is give family members andlaw enforcement the opportunity to petition a court
to remove temporarily firearms and ammunition
from the house, from the home. And it also
prohibits that person from purchasing a firearm
while that order is in effect. It doesn't require a6diagnosis of mental illness, and it's strictly basedon behaviors that indicate that the person might
hurt themselves or someone else. So it has aprocess where a person, a family member can go
to a court. It's a civil case. It doesn't require alawyer. It doesn't involve criminal charges. It's justto keep this person and those around that person
safe. We need to get the firearm out of their reach
until they are better able to cope.
33.

DR WEST: Your father’s story was not the only
event that led to your interest in gun safety forsuicide prevention. Can you tell me about the more
recent incident?

34.

DOROTHY PAUGH: It was April the 13th, theFriday the 13th in 2012, and I got a phone call andit was a Baltimore County detective, and he asked
my name and then he said my son's name andasked if I was his mother. And I said yes. And hesaid, There's been an acc… and he stopped andsaid incident. And he said, Why would he do this?
And I said, Why would he do what? And he saidshoot himself. My son had bought his gun legally
the summer before and. He one morning, forreasons I'll never know, he called in sick to his job
and he walked to the woods about a block from his
house. And when he got in the woods, he called
the police and said where he was and that theyneeded to come and pick up the gun because hedidn't want any kids to find it for him.
7So he actually waited until he saw the sirens up on
the hill just above him and that the police hadarrived and they heard the gunshot.
35.

DR WEST: Had he given any indication prior to his
suicide that anything was wrong?

36.

DOROTHY PAUGH: We knew he was unhappy on
the job. But, you know, I never thought it rose tothat level. I think he had to know that he could
have asked any one of us for help if he wasthinking of taking his life. But I don't think hebelieved that he would be respected if he sought
help, that that was an avenue that he could be
proud of.
It was actually about at least a year after my son's
death, before I felt I was even functional and could
try to do something about it.
What I did was read as much as I could on whatmade a difference, what actually worked to stopsuicide. And the more I read, the more I concluded
that what one individual, what one person can do iseverything they can to separate that person from afirearm in their moment of crisis.
It's not something that necessarily requires a law,
but there's a lot of instances where if someone isn't
going to be open to just giving the gun away, eventemporarily, that it's necessary to have an authority

8

to step in to save that person's life because they
can't see the value in their life.
37.

DR WEST: So you come to this realization… what
do you do next?

38.

DOROTHY PAUGH: I just sat down and wrote anemail to my state delegate in Maryland, Delegate
Geraldine Valentino Smith, and I just told her thestory. I said suicide has kicked my ass twice now
and now I want to kick its ass. And what works isgetting the firearm out of their hands. And so shesaid, I want to help you. And so we talked todifferent groups. And they said, well, it'll take us awhile to build a coalition and get some support andsee if we can get this through the legislature.
And so they said, well, wait a year. We'll do it next
year. And in the meantime, I had a health scare. I
had a blood clot that traveled to my lungs. I wasfine. But what it did was say, tell me that, hey, I
don't know exactly how long I have. And I felt
compelled. I said, I don't have to get this done, but I
have to try. So my legislator looked at me and said,
I made you a promise. She said, I'm filing that bill.
And in February of that year, 2018, Parkland
happened and that brought all kinds of people tothe table. And the law was passed its first year andtook effect in October of 2018.

39. Transition to new beat

9

40.

DR WEST: As of the end of 2022, nineteen states
and the District of Columbia have Extreme Risk
Protection Order laws.
Public health policy researcher Dr. Shannon
Frattaroli studies the effectiveness of these laws inpreventing gun violence.

41.

DR WEST: Dr. Frattaroli, I’m going to start with aquestion that I think many listeners are going tohave: are ERPO laws the same as “red flag” laws?

42.

SHANNON FRATTAROLI: Yes. So “red flag” lawis a term that has been popularized by the media,
and it's a term that I think more people are familiar
with than extreme risk protection order law. But
they are the same things.

43.

DR WEST: We’ve heard Dorothy Paugh explain
how ERPOs became law in Maryland. Can you talkabout how they became law in other parts of thecountry?

44.

DR SHANNON FRATTAROLI: So two of the 19
states and the district have laws that date back to
the turn of the century. So Connecticut was the firststate to pass a law like this in 1999. Indiana
followed soon after that. And then there was a long
period, more than a decade where there weren't
any states that enacted these kinds of laws. And atthat point in time, there was a group called the10Consortium for Risk-Based Firearm Policy thatcame together in the wake of the Sandy Hookmassacre and was looking at the evidence,
searching for answers, trying to inform policy
conversations because there was a window ofopportunity. The country was interested inpreventing the types of massacres that we saw in
Sandy Hook and that we've seen in far too many
places around the country. So what that group did
was to look at the evidence and to try to come up
with recommendations for how best to move thiscountry forward in a positive way.
And ERPO was one of the recommendations thatcame out of that effort. It was the result of looking
at the evidence and understanding that violence issomething that oftentimes happens on a trajectory,
that there are warning signs that there are
dangerous behaviors and that those escalate inmost cases, and that if we could just figure out away to intervene on that trajectory with a concrete
tool that would allow for the temporary removal ofthe most lethal forms of violence, then we could
really make a difference in what's happening again
on our streets and our homes and our schools andour communities.
So that recommendation came out from theconsortium in 2013 and in 2014, California passed
the first modern ERPO. Washington followed.
Oregon followed after that. And now we're at apoint less than ten years later where 19 states and11the District of Columbia have these laws on thebooks.
45.

DR WEST: How much do the states with ERPO
laws have in common?

46.

DR SHANNON FRATTAROLI: From a politicalperspective, I know this isn't your question, but thisis a viable policy. Right. We've seen people whoalign on the left, who align on the right agree that
this makes sense. We know from public opinion
polling that people, regardless of whether they
identify as liberal or conservative, if they'reregistered with the Republican Party or the
Democratic Party, if they're a gun owner, if they're
not, this is a law that consistently people say
makes good sense. And we see that in terms of thestates that have enacted these laws. So we havestates like California, like Washington,
Massachusetts, Maryland, that are traditionally sortof dismissed as, oh, those are those are liberalstates. Of course, they have these gun violence
prevention laws. But we also have ERPO laws instates like Nevada and New Mexico, Florida, youknow, states where typically you don't see
categorized as, you know, bastions of of gun
violence prevention. So this is a law that not only
makes sense for this country at this point in time,
as evidenced by the diversity of state legislaturesthat have been willing to both hear and pass ourlaws for their states.
12

47.

DR WEST: What kinds of behaviors might initiate
an extreme risk protection order?

48.

DR SHANNON FRATTAROLI: The laws aredeliberately constructed to specify behaviors andnot mental illness diagnoses. Because when we
look at the literature, what we find is that the best
predictors for violence aren't mental illness
diagnoses, but rather violent behaviors. So if
someone is threatening violence, if someone iswriting notes or recording messages that detailwhat they're planning to do in a violent way, if
someone is brandishing a firearm, pointing it
toward another person, all of those things are verystrong indicators that they're on a trajectory that willend in violent behavior. Not always, but oftentimes
those kinds of behaviors are the best indicatorsthat violence is imminent or will soon occur.

49.

DR WEST: What do we know about how often
ERPOs are being used?

50.

SHANNON FRATTAROLI: So the evidence that
we have about how ERPOs are being used in thestates that have them shows that there's
tremendous variation among those states andthere's tremendous variation within the states thathave the laws. So I'll give you an example. Florida,to the best of my knowledge, is a state that has
issued the most number of ERPOs there, upwards

13

of 6000 ERPOs that have been issued in that state.
If you look at how ERPO has been used in the
counties across the state of Florida, what you'll seeis that there are some counties where hundreds
have been issued and there are some counties
where exactly zero have been issued. So
tremendous variation.
We do see ERPOs being used in response tothreats or risk of suicide. We do see ERPOs being
used in response to threats of harm against others.
We do see ERPOs being used in situations where
an individual is threatening both. So they're boththreatening to, let's say, harm their family andthreatening to kill themselves. We are also seeing
documentation of ERPOs being used when there isa threat of a mass shooting event or a multiple
victim event. So ERPOs have been used acrossthis country, across the 19 states and the district
where they exist, really to respond to a variety ofviolent, threatening situations.
51.

DR WEST: Can we talk more about ERPOs andsuicide prevention. I think most people assume thatgun violence refers to mass shootings. But morethan half of the gun deaths in the United States arefrom suicide.
Do we know how effective ERPO laws are inpreventing suicide?

14

52.

DR SHANNON FRATTAROLI: Because our laws
are so new, we don't have definitive evidence withregard to impacts on suicide and prevention ofsuicide. The numbers are all pointing in the same
direction. But we just don't have enough data
points to be able to say that, yes, we see a
reduction in suicide as a result of ERPO. Rather,
we're at a place where everything seems to be
pointing in the direction that this is an important tool
for preventing gun suicide, and it's a promising tool.
And we're continuing to watch those numbers andto observe how it's being used and see how it's
being implemented. And studies are underway right
now that will get us closer to an answer to thatquestion.

53. Transition to new beat
54.

DR WEST: Sheriff Darren Popkin has been in law
enforcement for nearly forty years.
When ERPO became Maryland law in 2018, he
was responsible for training most of the state’s
police departments.

55.

DR WEST: Sheriff Popkin, can you walk me
through the process about how a concerned
person would go about implementing an extreme
risk protection order for somebody close to them?

56.

SHERIFF DARREN POPKIN: Maryland's law has
multiple steps to it. So it starts with a 911 call. It
15

could be related to a domestic violence case where
there is a threat and access to firearms. It could be
mental health where there is an immediate threat tothemselves or others, and there's an access tofirearms. We've had a number of cases here in
Maryland that involve the potential for school
shootings that we've been able to intercept before
anything else actually occurred. So there's different
multiple ways that someone may call 911 and bringthis forward.
Once an officer shows up at someone's house, it isa remarkably expedient process. So the officer
finds out the details the officer would either
recommend to the household member to they
could go to the court, they could go to the district
court commissioner.
If the family member doesn't feel comfortable goingto get the order in Maryland's law, the police officer
can be the petitioner can be the one who files forthe order.
These orders are issued 24 hours a day, sevendays a week. And it probably takes a couple ofhours to actually get in front of a judge or district
court commissioner, then to the home, and then to
be able to serve the order and actually get the
firearms. Approximately a few days later, there’s aninitial hearing, a temporary hearing. The judge
makes the determination of whether to keep theorder in force. And then after seven days, there isanother hearing that the judge will make the16determination of whether this is going to go to a
final order that will be good for up to one year. If
the order does go to final, the firearms are kept by
the law enforcement agency pending thecompletion of the order. And if someone doesn't if
someone doesn't adhere to the order, then there isa potential criminal penalty associated with it.
In most cases, there is the return of the firearms
once the orders are over.
57.

DR WEST: I can imagine that there are somefamily members who would be very anxious about
this process whether it's because they fear
consequences to their loved one as a result of theiractions, or they fear consequences or conflictwithin the relationship because they let it gooutside the home. What would you say to thosepeople?

58.

SHERIFF DARREN POPKIN: What I usually would
tell a family member is that doing nothing makes
you way less safe because that's often what wehear about when there are tragedies that and wego back and we look into what occurred during
particular cases, we find that this was somethingthat had been ongoing, that there was violence inthe family, that there were threats in the family, that
there were threats to use firearms.
But when you then get to a point it elevates tosomeone with the threats of using a firearm, then17everybody in that household is potentially put adanger to anybody out in the community ispotentially put at danger if they're if the threats arethat they're going to use that gun, say, in a schoolor if they're going to use it at a workplace violence
type of action. So doing nothing makes it way moredifficult, way more dangerous to anybody,especially in the home.
In Maryland, about 60% of the orders that are filed
are filed by the police officers. About 30 to 35% are
filed by family members. And then mental healthprofessionals do the remainder of the filings of. So
those 30%, 35% have of family members that do
this have felt so strong. They've listened to theofficers that show up. They're very, very
concerned. I mean, these are people that they love.
It's their it's their family. They don't want to seethem hurt and they certainly don't want to seeanyone else in their family hurt, and they certainly
don't want to see themselves hurt.
59.

DR WEST: Dr Fratteroli mentioned that there
hasn’t been enough research to say whether or notthese ERPOs are successful. You’ve been
implementing these for four years now. What has
your experience been?

60.

SHERIFF DARREN POPKIN: Maryland's law is
one of the tightest pieces of legislation having to dowith confidentiality on the extreme protective

18

orders. So I can't at all provide any names ofanybody who has either filed for the petition, beena subject of the petition. But I can talk anecdotallyof calls that I have received from family members
thanking the officers involved, thanking the process
because they believed that they were someone
was spiraling down so quickly and with the accessto firearms that someone was clearly going to gethurt. And because of the order, a tragic incident
doesn't occur.
Remember, at the end of the order, under
Maryland's law, I'm obligated to give the guns backas long as they're not prohibited. And so in many ofthese cases, we've given the guns back and nofurther orders have been issued. Someone's backto a level that they're, you know, that they've gotten
through whatever critical or crisis they felt and thecourt is determined that they're okay and they'reback to being regular residents and citizens of thestate with all the applicable laws that provide themthe opportunity to have guns and to live safely.
So it's working and and it's saving lives.
61.

DR WEST: You know, I think it speaks volumes
about the training and expertise of the officers who
serve these orders, because as you're telling me,
there are if there's 700 a year, we're talking on the
average of two of these served across the state
every day. And yet I don't turn on the news every
night and see a violent confrontation where police
19were trying to take somebody's guns. And so thatjust speaks to me about the level of training andexpertise of the officers who serve these orders or
who facilitate the process for the families.
62.

SHERIFF DARREN POPKIN: We had a very shortperiod of time when the when the bill passed in
April of that year to train 17,000 law enforcement
officers of this is a new option. This is a new tool.
This is a new potential that you could use. So in thelong run, you're not coming back to investigate
further crimes and God forbid, you know, ashooting or a homicide that occurred afterwards.
After four years of this in 99.9% of the cases, it's
remained civil. There's been cooperation. And thelaw enforcement officers who respond to the 911
calls are an incredibly large piece of this. And thetraining has been a very, very critical piece of this,because if the officer shows up at the 911 call anddoesn't explain this or doesn't let them know that
Maryland, you have this option to do this, theaverage person may or may not know. And then,
you know, you're walking away from a situation thatyou could have provided some proactive care for
and, you know, potentially saved a life.

63. Transition to new beat64.

DR WEST: In this final episode of Let’s Talk AboutYour Guns, we learned what you can do when the20

conversation breaks down. You’re worried thatsomeone you care about is in crisis and hasaccess to a gun. Extreme Risk Protection Orders
give us that ability to protect them by temporarily
separating them from their guns.
65.

DR WEST: Thank you to Dorothy Paugh, Dr
Shannon Frattaroli, and Sherriff Darren Popkin forjoining me.

66.

DR WEST: You’ve been listening to Let’s Talk
about Your Guns. This podcast is made possibleby The Henry M. Jackson Foundation for the
Advancement of Military Medicine. It’s produced
by Podville Media for the Center for the Study ofTraumatic Stress at the Uniformed Services
University.

67.

DR WEST: To learn more about our mission andfor additional resources, please visit cstsonline.org.

68.

DR WEST: Be sure to subscribe to the show on
your favorite podcast app and leave a five-starreview.
Thanks for listening.

69.

PRESENTER: The views expressed are those of
the speakers and do not necessarily reflect theviews, opinions, or policies of the Uniformed
Services University, the Department of Defense,
the US Government, or The Henry M. Jackson
21

Foundation for the Advancement of Military
Medicine, Inc.
70.

PRESENTER: Mention of trade names,
commercial products, or organizations does notnecessarily constitute or imply endorsement by the
Uniformed Services University, the Department of
Defense, or the US Government or The Henry M.
Jackson Foundation for the Advancement ofMilitary Medicine, Inc.

22