New York Police Agencies Train Officers on a Discredited Medical Condition. Legislators Are Trying to Ban It.

After authorities cited it in notorious Black Lives Matter-era deaths in police custody, like those of George Floyd and Elijah McClain, top medical associations publicly disavowed it. The American Psychiatric Association declared that “there have been no rigorous studies validating excited delirium as a medical diagnosis,” while the American Medical Association decried it as “justification for excessive police force, disproportionately cited in cases where Black men die in law enforcement custody.” California, Colorado, and Minnesota have restricted citing excited delirium in official sources.

New York authorities, however, have continued to train officers on the discredited syndrome. In 2023, New York Focus revealed that the New York City Police Department was training its recruits to tase and pepper spray suspected excited delirium sufferers. Now, documents obtained by the police reform group Campaign Zero and shared with New York Focus show that half a dozen county sheriffs’ offices, as well as state-level agencies, have also recently included excited delirium in their training.

At least one sheriff’s office has within the last five years used training materials created by Axon, formerly known as Taser, which helped popularize the concept among law enforcement in the 2000s. As recently as 2023, the state Office of Mental Health and Division of Criminal Justice Services made training materials touting excited delirium syndrome available to local law enforcement agencies, the documents show.

OMH told New York Focus it no longer teaches the syndrome, though a sheriff’s department that uses its 2023 training said it has received no such updates from the office. DCJS, meanwhile, still embraces excited delirium, and sheriffs’ offices have taken various approaches to balancing the agency’s guidance and the controversy surrounding the syndrome.

The miscommunication and lack of coordination highlights a lag between medical consensus and police practice that advocates say has made it difficult to eradicate excited delirium from official sources.

“Agencies are recognizing that this is a pseudo-scientific term and has no place in our official documents or training materials,” said state Assemblymember Jessica González-Rojas.

González-Rojas sponsors a bill that would follow other states’ lead and effectively prohibit agencies from citing excited delirium in official sources. Citing New York Focus reporting, the bill would invalidate the syndrome as a defense in civil and criminal lawsuits and bar public offices and contractors from referencing it in policies, procedures, death certificates, and autopsy reports.

The bill has passed the state Senate and is slated for a vote in the Assembly. González-Rojas said she is optimistic about its chances of passing the Assembly before the end of that chamber’s legislative session next week.

However, the attorney general hasn’t updated her training recommendation — and agencies are following it.

Among them is the state Division of Criminal Justice Services, which provides training and other support to law enforcement across the state. DCJS’s crisis intervention training includes slides on excited delirium, the agency said, and records reviewed by New York Focus show that a recent version of the agency’s pepper spray training also includes slides on the syndrome. The documents indicate that the Oneida, Westchester, and Clinton county sheriffs’ offices have recently used excited delirium materials from DCJS.

“The material helps police recognize the presentation so they can differentiate it from criminal non-compliance,” a DCJS spokesperson said in a statement. “This is consistent with the February 2021 guidance from the Attorney General’s Office.”

DCJS training slides say that excited delirium patients don’t experience fatigue and can exhibit “superhuman strength” and “imperviousness to pain.” The materials instruct officers to “control and restrain” someone experiencing excited delirium as soon as possible, being careful not to place them in a position that could obstruct their breathing. They warn that pepper spray often doesn’t work to subdue the patients, advising law enforcement to “administer sedation ASAP” and take the person to the hospital.

In Colorado, first responders who diagnosed 23-year-old McClain with excited delirium forcibly injected him with what turned out to be a lethal dose of ketamine.

One of the DCJS training slides warns that excited delirium sufferers can die seemingly spontaneously after police restrain them. “[First] symptom of the impending death is the death,” the slide reads. Victims are “virtually never successfully resuscitated.”

The materials play into tropes that critics say make excited delirium not only a debunked theory, but a dangerous one. For one, they say that its reputation for endowing sufferers with extraordinary physical abilities can fuel more aggressive police responses. Critics also point out that police have used excited delirium as a way to avoid faulting cops for deaths in police custody.

“Excited delirium has no foundation in legitimate medical science and has been repeatedly rejected by leading authorities,” Campaign Zero, which uncovered the training documents, said in a statement. “The term continues to endanger lives, misrepresent the causes of death, and erode public trust.”