Updated medical guidance on excited delirium, the controversial term accused of covering up deaths in police custody, including that of George Floyd, is being brought forward before its scheduled date of October 2025, reports The BMJ today. The move comes as attitudes towards the use of the term appear to be changing, explains journalist Chris Stokel-Walker. For instance, last month Colorado joined California in banning police, medical staff and coroners from using the term, and the UK Independent Office of Police Conduct (IOPC) removed the phrase from its incident forms.
The phrase "excited delirium" was first coined by two doctors working in Miami in the 1980s, but subsequent analyses have never found a reliable medical basis for its use in the medical lexicon. Yet it and a related term more common in the UK, "acute behavioral disturbance" (ABD), have been mentioned as a cause of death or contributing factor in 44 cases of UK police restraint since 2005, according to an investigation published in March 2024 by the charity Inquest, the Royal College of Psychiatrists and the Observer. An earlier study published in July 2023 found that mentions of ABD in mental health records in one London NHS trust increased year-on-year between 2006 and 2021.
James MacCabe, professor of epidemiology and therapeutics at King's College London, believes that the use of both terms is misguided, while Catherine Polling, NIHR clinical lecturer in general psychiatry , also at King's College London,.
