Colorado expanded its red flag law. Few additional cases resulted.

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In early June 2023, a La Plata County man showed up to his therapist’s office with a drastic style change — instead of the flannel and cowboy boots he typically wore, he was outfitted in black combat boots, a T-shirt with a skull on it and a necklace that appeared to be made out of fake human teeth.

If you or someone you know is in a crisis, call, text or chat the Suicide and Crisis Lifeline at 988. In Colorado, you can contact Colorado Crisis Services at 1-844-493-TALK (8255) or text TALK to 38255.

It was a sign of trouble. Two weeks later, he told his mental health provider, who had been seeing him for about a year for vague homicidal ideation, that he was on administrative leave from work and likely to be fired after talking to coworkers about corpses and death. One week after that, he said he wanted to cause severe injury or kill a former co-worker after their shift in the parking lot.

His therapist said they planned to contact law enforcement over the threat.

“You gotta do what you gotta do,” he responded, according to court records in the county. “I know myself and I’m not going to lie.”

The therapist ended up filing a petition for an extreme risk protection order against their client, asking a judge to remove any of his guns and block his ability to purchase firearms for one year.

A county judge granted a temporary ERPO right away. A few weeks later, the judge issued the yearlong order.

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In the 15 months since Colorado expanded the types of people who can use the state’s “red flag” law, few educators and mental health professionals have asked a court to remove guns from a potentially dangerous person.

Since the law went into effect on April 28, 2023, just 10 of over 200 petitions across the state came from the additional categories of eligible petitioners, according to a Colorado Newsline analysis.

“It’s still a win — 5% is better than 0%. We’ve got to start somewhere, and maybe that’s where it is,” said state Sen. Tom Sullivan, a Centennial Democrat who sponsored Colorado’s original red flag law and its 2023 expansion. “We continue to find out that people who need the information about how to file petitions still don’t know how to do that. We’ve got to continue to stay on top of it.”

Questions raised after Club Q

Colorado implemented its extreme risk protection order law, colloquially known as the red flag law, in 2020. It allows certain people to ask their county or district court to temporarily ban someone from possessing or buying guns to prevent self-harm or harm to others. The original law allowed law enforcement, family members, roommates and other people with personal relationships to the respondent to file a petition. A judge ultimately decides whether to grant the order based on evidence and a hearing.

During the law’s first few years, private individuals filed most petitions, but law enforcement requests were much more likely to result in an order, according to an analysis from Colorado Public Radio.

The law’s scope and effectiveness came into question following the 2022 Club Q shooting in Colorado Springs, in which the shooter had a history of violent threats that law enforcement knew about. They did not petition for an ERPO against the shooter — claiming an existing mandatory protection order made an order redundant — but El Paso County is one of many Colorado jurisdictions that declared themselves Second Amendment sanctuaries and would limit or reject use of ERPOs.

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In 2023, lawmakers expanded the law to also allow educators, doctors, mental health professionals and district attorneys to file petitions. At the time, bill sponsors said it was a way to extend use of the red flag law, especially in areas where local law enforcement is reluctant to seize someone’s guns. Professionals who interact with a potentially dangerous person at school, in a therapy session or at the doctor’s office now have a method to alert a judge about their concerns.

“For patients at imminent risk of harm to themselves or others, extreme risk protection orders are potentially life saving interventions that help to prevent an at risk person for accessing highly lethal means such as firearms, which are extremely lethal when used in suicide attempts,” Dr. Katherine Hoops of the Johns Hopkins Center for Gun Violence Solutions wrote in an email. “Especially now, when we see growing numbers of young people dying by suicide, health professionals need effective and evidence-based strategies … to prevent these deaths, including allowing clinicians to directly petition for extreme risk protective orders.”

Firearm deaths, especially suicide, have increased steadily in Colorado, according to state data. In 2006, 358 people died by suicide with a gun. In 2021, the most recent year for which finalized mortality data is available, it was 701 people. Colorado has a higher rate of both firearm deaths and firearm suicides than the national average.

With the 2023 law, Colorado now has one of the most expansive policies around red-flag petitioners, according to research from the Bloomberg American Health Initiative at Johns Hopkins University. Many states with ERPO laws limit petitioners to law enforcement and household or family members.

Leanne Rupp, the executive director of Colorado’s chapter of the National Association of Social Workers, said the group welcomed the law as an extension of their toolkit to keep clients safe.

“We’ve heard far too many stories of clinicians who’ve lost clients to suicide by firearm due to the client not meeting an imminent risk threshold outlined by other laws that have existed for some time,” she said.

Involuntary psychiatric holds, for example, aren’t possible or appropriate in some cases, and an ERPO could be a better solution for the client’s health and safety.

At the same time, the new ability for licensed clinicians might not yet be widely known.

“Part of me speculates that it will take time for folks to learn about the expansion of the petitioner list and the process,” she said. “Some of this is that we just need more time.”

Colorado tracks with national trends

Between April 28, 2023, and June 28, 2024, two educators, six mental health professionals and two district attorneys petitioned for an ERPO. Those cases were in Adams, Arapahoe, Boulder, Gunnison, Jefferson, La Plata, Larimer and Morgan counties. Eight of those requests were granted by local courts.

In one instance, the board of trustees at the Colorado School of Mines in Golden successfully petitioned to take away the gun of a suicidal student. The student attempted to die by suicide and checked himself into a hospital for mental health care, according to court documents. He continued to make statements about self-harm into the new year, which were reported to the university, and in February he told friends he bought a gun.

The school filed an ERPO petition and the court granted a yearlong order less than a week later.

In another case, a mental health professional in Boulder County successfully pursued an ERPO when their client said they planned on buying a gun to kill their father after their discharge from a mental health facility.

The 8th Judicial District Attorney’s office in Larimer County petitioned in January to prevent a person from accessing guns once they left a detention center. The person allegedly used an AK-style rifle to rob a convenience store. A judge approved the request.

Newsline is withholding the names of red flag petitioners and respondents to protect the privacy of individuals in potentially dangerous situations.

If a psychologist or social worker or whoever it may be were to file an ERPO, it could have a chilling effect on that client’s willingness to seek or remain in treatment.

– Edie Sonn, of the Colorado Behavioral Healthcare Council

Experts say that Colorado’s low uptake rate among expanded petitioner categories is in line with other states, such as Maryland, which allows medical professionals to petition, and California, where employers, co-workers and educators are eligible alongside more common petitioner classes.

“Since those laws have been implemented, those groups have been quite low. So I’m not surprised that they’re also low in Colorado,” said Leslie Barnard, an assistant research professor at the University of Colorado School of Medicine who is active in the school’s Firearm Injury Prevention Initiative.

She has been working on a multi-state study of ERPO petitioners and, across the board, the number of health professionals is very small.

“We know from surveys in Maryland that medical professionals oftentimes are unaware that ERPOs are tools that they can use and that are available to them,” she said. “It’s the same thing we see with social workers in these surveys.”

She said that after an explanation of the law, those same professionals say ERPOs are a tool they would use in some circumstances.

Additionally, the numbers could reflect the distinct nature of a client-therapist relationship compared with that of a respondent and law enforcement. Mental health clinicians have more intervention options, and there might be confidentiality concerns for doctors and health professionals, who do not want to contribute to a deterioration of trust among their patients.

“Some of it is that balancing act … with concerns that clinicians in the mental health space have about damaging rapport with their clients, and walking the fine line between ensuring we’re keeping clients safe and that we’re providing support, but we’re also respecting confidentiality and limiting that involuntary decision making for them whenever possible,” Rupp said.

Edie Sonn, the senior director of external affairs of the Colorado Behavioral Healthcare Council, echoed that concern and the importance of a strong therapeutic relationship built on trust. She said that the low uptake might indicate that clinicians are doing every intervention short of filing an ERPO against a client.

“If a psychologist or social worker or whoever it may be were to file an ERPO, it could have a chilling effect on that client’s willingness to seek or remain in treatment,” she said.

That’s particularly a concern in rural and agricultural parts of the state, which often see higher rates of suicide and have fewer mental health clinicians in general.

Law enforcement agencies, which have the most success when filing ERPO petitions, also have the infrastructure in place to fill out paperwork correctly and attend necessary hearings. Completing legal documents such as an ERPO petition isn’t part of a therapist’s regular job description.

The Behavioral Health Council hosted an educational webinar last fall with the nonprofit Everytown for Gun Safety. Sonn said a few dozen health care leaders attended to learn about the new law. Similarly, the NASW Colorado chapter hosted a continuing education event with Colorado Ceasefire in February to provide information about the new law and petition process. About 50 people attended, and the organization posted the recording online. Rupp said the event was a mix of clinicians who were aware of the expanded law and professionals who learned about it for the first time.

“It’s a learning curve for clinicians who haven’t dealt with this type of paperwork and this legal documentation and accessing the court system in this way,” she said.

The 2023 law also provided the Colorado Department of Public Safety with funding to maintain an ERPO hotline with information on the process. Since it opened the hotline, the department said it has received nine calls.

Additionally, the law directed the Office of Gun Violence Prevention to incorporate ERPO information into existing educational campaigns. During the first phase of the office’s campaign, known as “ Let’s Talk Guns Colorado ,” the website’s ERPO information page had the second-highest view rate, after the homepage, according to Kacie Henderson, the office’s communications specialist.

The office also plans to use a bit over $450,000 from a federal grant to develop a new ERPO training curriculum and an online toolkit for mental health and health care professionals.

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