“Excited delirium” removed from BART Police Department policy manual and will no longer be used in written reports

The term “excited delirium” was removed from the BART Police Department (BPD) policy manual and BPD has issued a departmental bulletin informing employees of the change. BPD employees will no longer use the term “excited delirium” in any written reports.

The change in policy was recommended by the BART Office of the Independent Police Auditor (OIPA) and revision was endorsed by the BART Police Citizen Review Board (BPCRB). The move is the latest step taken by BPD as part of its commitment to becoming the most progressive transit law enforcement agency in the country.

“This policy change affirms BPD’s commitment to continuous improvement through policy changes and ongoing training that exceeds industry standards,” said BART Police Chief Ed Alvarez.

The American Medical Association (AMA) opposes the use of “excited delirium” as an official medical diagnosis. The AMA has referred to studies demonstrating that the term has been misapplied and diagnosed disproportionately in connection with law enforcement-related deaths of Black and Brown individuals, who are also more likely to experience excessive sedative intervention instead of behavioral de-escalation.

The controversial term “excited delirium,” sometimes known as “agitated delirium,” has been in circulation since the mid-1980s. It has been used, largely by law enforcement, to describe someone acting in an extreme state of agitation or delirium.

Additionally, Physicians for Human Rights (PHR) (1997 Nobel Peace Prize Co-laureate) reconstructed the history of the term through a review of medical literature, news archives, and deposition transcripts of expert witnesses in wrongful death cases. PHR’s 2022 report concludes that the term “excited delirium” cannot be disentangled from its racist and unscientific origins and therefore should not be cited as a cause of death. PHR found that “excited delirium” is not a valid, independent medical or psychiatric diagnosis.

BART's Independent Police Auditor, Russell Bloom, commented, “Removing this terminology from the BPD policy manual is a meaningful step toward racial equity in policing at BART.  I and my team look forward to monitoring the implementation of this policy revision.”