Extreme Risk Protection Orders in Washington State: Understanding the Role of Health Professionals.

Objective: Extreme Risk Protection Orders (ERPO) allow a petitioner to file a civil order to temporarily restrict access to firearms among individuals ("respondents") deemed to be at extreme risk of harming themselves, others, or both. Although unable to file ERPOs for their clients in most states, health professionals may play a pivotal role in the ERPO process by recommending an eligible petitioner initiate the process. We describe the process of filing an ERPO when a healthcare, mental health, or social service professional contacted an ERPO petitioner. Method: Court documents of ERPOs involving health professionals in Washington State between December 8th, 2016 and May 10th, 2019 were qualitatively analyzed (n=24). We constructed pen portraits from the documents and analyzed them using an inductive qualitative thematic approach. Results: Themes included factors influencing the process by which each professional evaluated respondent behaviors, factors considered during assessment, factors influencing interpretation of respondent behaviors and subsequent provider response during a crisis. These influenced the outcome of the crisis event that led to ERPO filing. Conclusions: Each professional group differed in their approach to risk assessment of respondent behaviors. Strategies to better coordinate and align approaches may improve the ERPO process.

Suicide Prevention Experiences, Knowledge, and Training among School-based Counselors and Nurses in King County, Washington - 2016.

OBJECTIVE: Few studies have assessed the suicide-specific perceptions and awareness of school-based nurses and counselors. This project assessed the self-reported training, beliefs, and professional experiences of school counselors and nurses towards suicide prevention, and identified areas for enhancing efforts to respond to student suicidality. METHODS: A self-report needs assessment survey was conducted with school-based nurses and counselors in King County, Washington. Group comparisons and descriptive statistics were calculated to characterize providers' perceptions and experiences. RESULTS: Most training experiences reported by counselors and nurses corresponded with greater perceptions of comfort in applying suicide prevention knowledge and skills. Fewer respondents endorsed means safety and safety planning as regularly implemented interventions for at-risk students compared to other interventions. CONCLUSION: Means safety and safety planning appeared to be areas for enhancing existing suicide prevention efforts.