Family members and friends are in a unique position to help if they’re worried about someone killing themself or others with a gun. Experts say in these situations, loved ones can step in to prevent a tragedy.

That’s because few gun owners who experience mental health crises are being treated by a therapist, according to Cathy Barber, a senior researcher who specializes in suicide with the Injury Control Research Center at Harvard’s School of Public Health. And she said those who are receiving mental health treatment may have only a tenuous connection with their provider.

“So it’s those who love them who will notice that they’re withdrawing, that they’re feeling trapped, that maybe they’ve gone through a horrible divorce or an arrest that’s making a depression worse,” Barber explained.

Experts say family and friends can know when to act if they listen carefully.

“If an individual is saying, you know, ‘I’m so mad, I’m going to kill somebody’ or a specific person or something like that, it’s important to take that seriously,” said psychologist Alice LoCicero, who works with gun owners. “If there’s a person making threats, that’s important to take seriously. That doesn’t mean we know for sure 100% that something terrible is going to happen. But we do have to listen to the person and take seriously what they say.”

Ask about storing their gun

What do you say to a loved one who may pose a threat to themselves and others, and is reluctant to part with their guns?

Barber suggests something along these lines: “I know these guns are important to you. I’m worried for your safety, for your life. I wonder if we could put them in storage for now, or if we can change the combination on the safe until you’re back to normal?”

This is not an argument over the politics or morality of guns, she said, but about diminishing the immediate threat.

“Gun owners can often be really attuned to assessing threat, and sometimes the threat is really one’s own mental health. And the threat to the family is that a family member might take their life,” she said.

LoCicero emphasized that these conversations may be difficult, and they may not result in the desired outcome.

“No one should ever feel that they have to succeed — or that they have to succeed in 10 minutes — in convincing the person that they probably should at least temporarily give up their firearms,” she said. “But for the sake of safety, it’s important to try.”

A man holds up a gun lock box.
A Seattle-area official demonstrates a gun-lock box. Tony Gomez, Violence and Injury Prevention Manager for Public Health - Seattle & King County, did the demonstration during a news conference by the Alliance for Gun Responsibility and other activists, Thursday, Jan. 21, 2016, in Olympia, Wash.
Elaine Thompson/AP AP

Red flag and yellow flag laws

Sometimes those conversations about gun storage aren’t feasible, especially if a person’s mental health is deteriorating quickly or if there is an immediate threat. In those cases, many states have extreme risk protection order statutes, commonly referred to as red flag or yellow flag laws.

Red flag laws, which are on the books in more than 20 states and the District of Columbia, allow law enforcement officers and family members to request a judge order that a person’s weapons be temporarily removed from their possession if there is reason to believe that the gun owner is a danger to themselves or others.

Maine is the only state with a yellow flag law. Through that process, law enforcement must obtain a medical evaluation for a person before they can petition a judge to have their firearms removed.

Research has shown that these laws are effective at preventing a significant number of suicides among those deemed to be high risk. Experts believe that these laws are also helpful in preventing violence against others, because nearly 80% of those who commit mass shootings make explicit threats prior to carrying out an attack.

The mass shooting in Lewiston, Maine, took place a week after the Massachusetts House unveiled a new push to crack down on unregistered ghost guns, strengthen the ban on assault weapons and expand the state’s red flag law. The state Senate has not yet put forward its own version of a gun bill, but the Senate president vowed to pass a bill and get it to the governor by the end of the legislative session next summer.

Rep. Marjorie Decker of Cambridge sponsored the original 2018 legislation, which was signed into law by then-Gov. Charlie Baker that summer.

“What that bill did was it allows people to file for an extreme risk protection order and then quickly, within hours, somebody is assessed to see if they’re a danger to themselves or others,” Decker explained.

Right now, immediate family members and law enforcement officials can seek such orders in Massachusetts. If the House’s changes are enacted into law, that would expand to other groups — including employers, some school administrators and health care providers.

Since its passage, the number of individuals subject to the state’s red flag law has been lower than Decker expected. In total, people have surrendered firearms under 41 orders that have been issued since the law went into effect up through the end of last year. Decker said expanding the law is necessary to reduce gun violence.

Barber said red flag laws, if implemented properly, should be “very rarely used.”

“They should only be used in the most extreme cases, when a person has lost their ability to make decisions,” Barber said, like if the person is having hallucinations that tell them what to do.

Retired Maine state police officer Jonathan Shapiro, a former director of the Maine Safety Center in Augusta, said taking the guns out of the hands of mentally unstable individuals can be more challenging than many assume.

“You see the various laws — yellow flag or whatever each state calls them — in place, which is trying to maintain that balancing act between what in this country is arguably someone’s Second Amendment right, and also the safety needs that are surrounding any diagnosis of who might pose a risk to public safety, to self or others, and who does not. And that’s a very difficult call to make,” Shapiro said.

Barber believes that using a red flag law on someone considering suicide may, in fact, be counterproductive.

“If somebody is feeling suicidal and struggling, that’s not the time to involuntarily hospitalize them. ... In mental health treatment, the goal is to preserve that person’s decisional autonomy as much as possible,” she said.

Barber is working with the Gun Owners’ Action League, based in Northborough, on an educational video with the goal of educating firearm users and their families about the warning signs that could lead to suicide or outward aggression.