Welcome to TechMed Conversations. I’m Kelly Thomas. I’m joined today by April Zioli.

April is an associate professor of health management and policy at the School of Public Health at the University of Michigan and director of policy core at the Institute for Firearm Injury Prevention, also at the University of Michigan. Her research focuses on the prevention of firearm violence, intimate partner violence, and homicide through the use of policy and law. April, thank you so much for joining us today to have this conversation.

Yeah. Thank you for having me. So what does the process look like to actually put, red flag law into place to help protect other people?

It depends on the state.

In some states like Florida, only law enforcement officers can petition the court for an extremist protection order.

And they find about these cases through calls to the police or crisis calls, and a crisis response team then calls the police or involves the police.

Other states like Maryland, family members and intimate partners can petition as well. And so they might go to the court themselves and ask for this extremist protection order.

Intimate partners are also the ones who petition for domestic violence protective orders. And so one of the things that we’re interested in learning is how these two types of protective orders co occur and interplay. You know? Do people get both? Do they decide for one over the other, and why are those decisions made?

Mhmm.

And what happens if someone who has, an extremist protection order on them, if they already have a firearm in their house, is that searched for, or is it just the purchase of new firearms?

So extremist protection orders are against purchase and possession of a firearm. So they will be flagged in the background check system, so they can’t purchase.

But it also involves relinquishment of any firearms that you already have. And, again, the process depends on the state, but, generally, you can always relinquish to law enforcement. So law enforcement might knock on your door to serve the order, explain the order, and ask for the firearms then and there. You might also have been in court for the hearing and, you know, been told you have to relinquish your firearms to law enforcement.

In some states, you’re also allowed to transfer the firearm to a licensed firearm dealer and then bring proof of that transfer to law enforcement or the court. So they really do try to make sure that you have relinquished all of your firearms, and they try to get information on how many firearms you have during the court hearing, you know, from law enforcement, from an intimate partner.

In some cases, there may be search warrants if there is probable cause to believe that you haven’t relinquished all of your firearms.

Mhmm.

If there’s, family members, children involved, is there a help for the children or the person who has filed the order to, you know, live somewhere else if that if they have to, or is it just about removing the the firearm?

For extremist protection orders, it is only about removing the firearm. That is the only thing that that’s going to do. For domestic violence protective orders, they may include a provision that says during the time of this domestic violence protective order, the person who petitioned gets to stay in the family home or, there’s going to be child support, that kind of thing. Now if someone needs to go into hiding, if they are in a really dire situation, and there is a great amount of risk, and they do not feel like they are safe if their abuser knows where they are.

There are generally in communities, local organizations, domestic violence service agencies that you can provide temporary shelter.

These organizations are amazing and hardworking and provide a lot of services such as mental health services.

They are also cash strapped and, you know, may not have as many resources as we would like them to have. There’s always room to fund them better.

With the study that you were talking about, these were extremist protection orders put in place with a threat of violence. And do you think that this will impact future laws and policy to include more when there is a threat and not after something has already happened?

Yeah. So extremist protection orders are for threat or use of of violence. So it’s, reactive and proactive.

But we absolutely need more policies that prevent acts of violence.

And, you know, that’s really the point of extremist protection orders to prevent gun violence before it starts.

What we know is that a large percentage of people who die by suicide or commit interpersonal gun violence can legally own the firearm.

What extremist protection orders do is, you know, have people look at the risk behaviors that someone is engaging in. Because generally, when someone is threatening when someone is suicidal or homicidal or, you know, going to engage in gun violence, there are signs. Yeah. They’ve done something.

They’ve threatened suicide. They’ve already been physically violent to their spouse. They’ve said, I’m gonna shoot you. You know?

So their intentions, you know, can be known, and these risk behaviors can be taken to the court both under the domestic violence protective order and extremist protective orders.

And they can, again, temporarily prohibit that person from having this incredibly deadly weapon, even if that person is otherwise legally able to own the gun. Mhmm. And, again, after that order expires, if they haven’t done anything in the meantime that qualifies them from having a gun, they get that right back.

So these orders are about a moment in time, a period of dangerousness.

Is there anything else that could be put in place that you would consider to be effective?

Misdemeanor convictions, convictions for felony crimes, those will remove the guns often for someone’s lifetime, you know, if if that’s necessary.

The, you know, kind of the the rub with all of these orders or convictions, all of these legal firearm restrictions, they require someone to engage the legal system first.

And not everybody is going to want to do that. You know, some people have had a really bad experience in the past with the legal system, and they don’t wanna approach that again.

They may fear discrimination and, you know, the outcomes of discrimination.

So they’re really only gonna work for people who use the system.

So the big answer, you know, to your question about how do we get these to work better for people, is that the legal system itself needs to work better for people so that people will use it.

April, what led you to focus your work on studying firearm and intimate partner violence?

I’ve been studying intimate partner violence and guns since I was a doctoral student.

And the reason I focus on intimate partner violence is through looking at my friends, my female friends, and seeing situations that they’ve gone through and realizing that someone has to do something. And I’ve never been a person to say someone has to do something. Oh, well. I hope someone does something.

I needed to do something.

And, you know, so I started studying intimate partner violence, went to get my PhD, and moved into intimate partner homicide as the most extreme form of intimate partner violence. And you can’t study homicide without also studying guns.

And so that experience has made me the researcher I am now.

Certainly, the increased levels of funding and being able to obtain some of that funding has helped me expand my research into this area.

You have this unique perspective from doing studies like these in your research where you’re looking more at community level actions and red flag laws and how they affect people, and now you are working closely with people who are seeking domestic violence orders. What’s been surprising to you transitioning or working in this new kind of capacity?

Yeah. So I’m doing a study that is surveying, following people who have petitioned for these domestic violence protective orders who’ve had gun involved intimate partner violence.

And we’re recruiting in three states with three very different types of domestic violence protective odor or firearm restriction laws.

And we’re still in the process of recruiting. I have no results to share yet.

But what I can say is that by limiting the people we speak to to those who have firearm involved, intimate partner violence, at the end of almost every single one of these interviews, we think that is the worst case of intimate partner violence I have ever heard.

Intimate partner violence is always bad, but there are definitely levels to the tactics that people use and to how often people may use physical violence or threats of violence.

There are cases where, you know, it’s bad, but you’re not worried that a person is going to be killed in any kind of near time at least unless something changes.

But with these cases, the violence is so severe and so virtually deadly.

Obviously, my participants are alive. You know? But the things that they have been through are potentially deadly events, and so it just brings home that these intimate partner violence perpetrators who are using guns are the worst of the batch. They are the ones who are just constantly terrorizing their intimate partners.

Oh, it’s really devastating.

What’s the best way for people that are in these relationships to seek help?

There isn’t one best way.

We often say the survivor knows best what is safe for them because sometimes staying for another week or another month or another two months might be the safest thing to prevent the homicide that might occur when they try to leave because leaving is when homicide is most likely to happen.

But that being said, I’m not advocating for everybody to just stay. Domestic violence protective orders can be a great tool to use. Extremeist protection orders can also be a tool if there isn’t a different way to remove the gun. For example, if you’re in a state that doesn’t allow dating partners to have these firearm restrictions, but it does have an extreme risk protection order, You might want the extremist protection order. Additionally, domestic violence service agencies can help you with what’s available in your area, and community groups may be good as well.

The survivor will know whether or not they can approach their community groups, whether it’s safe to do so, whether it’s safe to go to law enforcement.

Mhmm. But, hopefully, there are enough options that people can gain safety. And in the meantime, we’re trying to make more options and improve the ones we have. Mhmm.

April, why do you have hope that we can solve the problem and the incidence rate of firearm violence and and homicide?

I have hope because firearm violence is preventable because we know of some evidence based ways to prevent intimate partner homicide. For example, those domestic violence protective order firearm restrictions are shown in multiple studies to reduce homicide intimate partner homicide.

Gun violence is often their signs, you know, before someone attempts gun violence, maybe suicide, maybe homicide, it’s often not a surprise that those people acted in that way.

And there are things that we can do to prevent it beforehand, those violent gun acts.

It also isn’t the case that somebody’s just going to use a different weapon, you know, to commit a homicide. It isn’t that if we take away a gun, somebody’s gonna, you know, commit homicide with a knife.

Guns are uniquely lethal.

And we know this. We all know this. That’s why people want a gun for home protection instead of, you know, settling on their butcher’s knife because they are uniquely lethal.

They are a range weapon. You don’t have to be right up next to the person, and they’re going to do an incredible amount of damage to the human body.

We also know that sometimes people aren’t intending to commit a homicide. You know, they didn’t go into the day thinking this is the day I’m going to kill my partner.

But something happened during the day. They became angry.

They had a gun on their hip or on the table next to them, and they picked it up and they used it.

And if the gun wasn’t there, there might have still been some level of violence, but it wouldn’t have been a homicide.

We can prevent these acts, and we have some tools to do so. And we’ll develop more tools to cover as many people as possible, as many people as need these tools.

Mhmm.

Do you know of any education programs in local communities where people can learn more about what signs they might need to look for if they’re in a situation where they’re feeling unsafe?

The National Domestic Violence Hotline has some amazing resources and information on their website, which will be linked.

And they also in addition to having a website with resources, they are a hotline.

And, you know, so you can call them. You can call them twenty four seven. They do English and Spanish.

You talk to somebody, and they can help you figure things out in the short term.

So I would urge people to use these resources.

We’re grateful that you are focused on this type of research and intimate partner violence, firearm violence. Thank you so much for chatting with Teddna today. We really appreciate it. Thank you.