BART police remove controversial term 'excited delirium' as part of reform efforts

BART police will no longer use the controversial term "excited delirium" in the department’s policy manual or in written reports as part of ongoing reform efforts, officials announced Thursday.

The agency made the change following recommendations by the BART Office of the Independent Police Auditor, a watchdog agency tasked with instituting reforms following controversial incidents like the police killing of Oscar Grant on New Year’s Day 2009.

Excited delirium has fallen under recent scrutiny after several studies have shown that the term is virtually always used to explain in-custody deaths that are disproportionately Black and Brown people. 

Medical literature loosely describes excited delirium as a state when a person is agitated, aggressive and distressed.

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

report released earlier this year by the Physician for Human Rights found that excited delirium has racist and unscientific origins

The diagnosis has also been rejected by major groups like the American Medical Association, the World Health Organization, the National Association of Medical Examiners, and the American Psychiatric Association. 

Excited delirium is often used to explain away deaths from asphyxia or cardiac arrest that may raise questions about police use-of-force, experts say.  

The debate over the term intensified in the Bay Area one year ago when a forensic pathologist ruled in Contra Costa County ruled the death of Angelo Quinto was the result of excited delirium.

Quinto, a 30-year-old former Navy sailor, was experiencing a mental health crisis when police held him face down in a prone position for several minutes. He stopped breathing and had blood on his face before he was later pronounced dead.

Quito’s family is suing the city of Antioch and its police department for wrongful death.

Evan Sernoffsky is an investigative reporter for KTVU. Email Evan at and follow him on Twitter @EvanSernoffsky