What is excited delirium and why is it important to law enforcement? Over the years the condition has been named and re-named as part of its very long and sorted history. A very small snap shot of what excited delirium entails is that it is a medical and physiological condition that sends the body into overdrive that elevates the heart and respiratory rates plus triggers other neurological changes. When the body can no longer operate at this very high capacity it begins to crash. This high level of agitation followed by the deceleration often has devastating effects on the individual that can result in an apparent unexplained death. Our bodies operate sort of like a machine if you continue to run them at elevated temperatures hotter then what they are designed for and ignore all of the built in safety features that indicate an impending issue eventually the engine is going to be pushed past its breaking point and seize thus rendering it inoperable. This same logic is what applies to how excited delirium can have disastrous results. Our bodies are only designed to handle so much our hearts can only beat so fast for so long until it says that’s it no more I can’t keep this rate up I quit. Usually the crash happens so quickly a normal arrhythmia cannot be established which will result in custody loss of life. In recent times this phenomenon has been more frequently tied to law enforcement and appears to happen after an individual has been in restraints for a period of time. The break down usually occurs when officers fail to realize they are struggling with an individual that is in the throes of a major medical crisis instead of simply resisting arrest. In order to fully appreciate and understand how we have gotten to where we are today with excited delirium we must first look back at its history and where it started.
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Originally, cases of excited delirium were for the most part seen in mental health facilities. These cases are documented in the United States as far back as 1849, when they were known as, “Bell Mania.” In these documented cases from the McLeon Asylum in Massachusetts under the care of Dr. Bell there were 40 cases which all required restraints and resulted in a 75% fatality rate. In the State of Carolina between the years of 1915-1937 there were 360 documented fatalities that listed the cause of death as, “exhaustion due to mental excitement.” Radical changes came in the form of pharmaceutical variety to the mental health facilities in the 1950’s. Heavy sedation drugs were readily available and administered quickly thus effectively sedating a patient completely preventing the individual from presenting all symptoms of the condition and preserving life. During this time of excited delirium’s history deaths were almost completely eradicated. Moving forward many changes were still to come. The deregulations and mental health care reform that took place during the 1970’s and 1980’s completely changed the way we deal with those members of our society that suffer with mental health issues. Many of those individuals that lived within the confines of a facility under the full time care of a doctor were simply released. Those individuals some who suffer from very extreme mental disorders were no longer in a safe environment and left to figure out how to effectively manage their life while being mentally ill. Many of these individuals as a result of their mental condition were unable or disinterested in securing employment, properly managing their medication, obtaining long term stable housing or any number of activities that the rest of society does every day without much thought or effort as part of our normal routine. Outpatient treatment is effective for some however other’s end up on the streets struggling to survive on a daily basis. Still other’s turn to street drugs and alcohol as a means to control and self-medicate. Many times stimulants such as cocaine and meth are used by these individuals. So now we have come to the point where a person who may suffer from a mental health disorder has reach a point where they are at the beginning of a psychotic episode. This person is acting in such a manner the situation has escalated
Originally, cases of excited delirium were for the most part seen in mental health facilities. These cases are documented in the United States as far back as 1849, when they were known as, “Bell Mania.” In these documented cases from the McLeon Asylum in Massachusetts under the care of Dr. Bell there were 40 cases which all required restraints and resulted in a 75% fatality rate. In the State of Carolina between the years of 1915-1937 there were 360 documented fatalities that listed the cause of death as, “exhaustion due to mental excitement.” Radical changes came in the form of pharmaceutical variety to the mental health facilities in the 1950’s. Heavy sedation drugs were readily available and administered quickly thus effectively sedating a patient completely preventing the individual from presenting all symptoms of the condition and preserving life. During this time of excited delirium’s history deaths were almost completely eradicated. Moving forward many changes were still to come. The deregulations and mental health care reform that took place during the 1970’s and 1980’s completely changed the way we deal with those members of our society that suffer with mental health issues. Many of those individuals that lived within the confines of a facility under the full time care of a doctor were simply released. Those individuals some who suffer from very extreme mental disorders were no longer in a safe environment and left to figure out how to effectively manage their life while being mentally ill. Many of these individuals as a result of their mental condition were unable or disinterested in securing employment, properly managing their medication, obtaining long term stable housing or any number of activities that the rest of society does every day without much thought or effort as part of our normal routine. Outpatient treatment is effective for some however other’s end up on the streets struggling to survive on a daily basis. Still other’s turn to street drugs and alcohol as a means to control and self-medicate. Many times stimulants such as cocaine and meth are used by these individuals. So now we have come to the point where a person who may suffer from a mental health disorder has reach a point where they are at the beginning of a psychotic episode. This person is acting in such a manner the situation has escalated