Colorado’s Peace Officers Standards and Training (POST) board, the organization that provides training and certification for law enforcement in the state, has voted unanimously to eliminate the controversial term “excited delirium” from all training documents, effective January 2024.
The move follows intense scrutiny of the diagnosis, criticized for its racial implications and potential misuse to absolve law enforcement in cases of in-custody deaths.
According to law enforcement experts, the term “excited delirium” has been associated with suspects exhibiting hyperactive or agitated behavior during police encounters.
Following the POST mandate, officers will no longer be trained on the diagnosis. Critics argued that it has been disproportionately applied to create a racial stereotype that serves as a legal justification for law enforcement actions.
A 9News Denver investigation found that the deaths of over 225 individuals across the country have been connected with the term. According to a Virginia Law Review analysis of in-custody deaths from 2010 to 2020, 56% of cases attributing deaths to “excited delirium” involved Black and Latino victims.
The controversy gained prominence following the case of Elijah McClain, an unarmed Black man who died in 2019 after being forcibly restrained by Aurora, Colorado, police officers and administered an overdose of ketamine by paramedics.
McClain’s case prompted a re-evaluation of the diagnosis, with advocates and several prominent physician groups, including the American Medical Association and the National Association of Medical Examiners, challenging its validity. This year, both the National Association of Medical Examiners and the American College of Emergency Physicians have dropped the use of the term. There are now no major medical organizations that recognize it as a potentially fatal medical condition.
The decision to strike “excited delirium” from law enforcement training materials aligns with the broader national movement to address systemic issues in policing and mental health crises. Other terms, such as “cocaine psychosis” and “sudden in-custody death,” were also removed from training manuals during the same vote.
Fort Collins Police Chief Jeff Swoboda, a member of the POST board, explained the importance of adopting more neutral terms to describe individuals in distress and promoting appropriate responses by law enforcement.
“Looking at distress and the care people should receive after any sort of arrest and when they’re in custody and getting the help that they need is where my understanding was,” he told Colorado Public Radio. “And now recognizing, if someone is in distress whatsoever, how should we treat people in custody?”
The move also aims to shift the culture and improve the treatment of individuals in custody, especially during mental health emergencies.
State Representative Judy Amabile, an advocate for police reform, applauded the decision.
“I’m really glad to see this. Now we need to make sure we don’t substitute one term for another term and we do in fact change the culture a little bit and say we are going to describe symptoms and we’re going to train on appropriate responses to the behaviors we are seeing,” Amabile stated.
While the elimination of “excited delirium” from law enforcement training is a significant step, activists and lawmakers continue to push for further reforms, with Amabile planning to introduce legislation prohibiting the term’s use in documents like autopsy and police reports.
