Spokane police, firefighters, dispatchers and ambulance drivers will undergo training to better identify and respond to people experiencing “excited delirium,” the condition that investigators theorize Otto Zehm was suffering from during his fatal encounter with police last year.
Police Chief Anne Kirkpatrick also announced Monday new limits on Taser use when subduing suspects as well as the use of hoods to prevent suspects from spitting on officers and emergency personnel.
Kirkpatrick defended the Taser as a valuable tool but said officers will be allowed to apply a Taser only “two or three times” if the suspect does not react to it.
Kirkpatrick, Mayor Dennis Hession and Fire Chief Bobby Williams announced the protocols and joint training at a Monday news conference at Spokane City Hall.
“Not every incident we go on is going to be one of excited delirium,” said Williams, who added that firefighters and police must nonetheless be prepared to respond. “It is a medical emergency where we need to get the patient to the hospital as quickly as possible.”
Excited delirium, however, remains controversial.
The mainstream medical community has yet to recognize it as a scientifically accepted diagnosis. In fact, it can be found nowhere in the Diagnostic and Statistical Manual of Mental Disorders, which is known as the bible of mental illnesses, said attorney Breean Beggs, of the Center for Justice.
“In that they list every traditionally recognized mental illness, and they have no definition for ‘excited delirium,’ ” said Beggs, who is helping represent Zehm’s family.
Zehm, a mentally ill janitor, was mistaken last March for a robber. He was beaten and received several Taser jolts in a confrontation with Spokane police at a convenience store. He stopped breathing after being hogtied and placed on his stomach for more than 15 minutes.
A plastic “non-rebreather” mask, not attached to oxygen, may have limited Zehm’s ability to breathe but was ruled by the Spokane County medical examiner not to have caused his death.
Videos of the confrontation clearly show that Zehm became agitated after he was confronted by Officer Karl Thompson for a crime Zehm didn’t commit, Beggs said.
“It did not appear that (Zehm) was in an agitated state prior to the police officer hitting him with the baton,” Beggs said. “But if he was in an agitated state, the worst thing you could do is hogtie him and leave him in the prone position.” Williams estimated that emergency officials respond to just three to four excited delirium cases each year.
Excited delirium is characterized by paranoia, confusion and agitation. Authorities who support such diagnoses say sufferers can exhibit sweating, great strength, shouting, resistance to pain and violent resistance. It can result in death.
Kirkpatrick said it can be difficult to distinguish between someone suffering from excited delirium and someone who is on drugs, has a mental health condition or is simply violent. She said officers are trained to respond to behavior. As an example of how behavior can be misleading, Kirkpatrick described a situation in which she once arrested a man for drunken driving. It was later discovered he was having a stroke.
The excited delirium training and protocol changes are a result of the Zehm case.
Beggs applauded the city for increasing officers’ training in dealing with mentally ill residents.
“Hopefully, better training will prevent future Otto Zehm cases,” Beggs said. “I applaud them asking, ‘What can we do better in the future?’ That is good news for everyone.”
Kirkpatrick said hoods, rather than masks, will be used to prevent spitting.
Training to recognize and respond to excited delirium will start Friday. It is expected to take two months for all police and fire personnel to complete the training.
Kirkpatrick said she’s unaware of any other city teaching its officers about the condition.
Some Spokane County Sheriff’s Office personnel also will observe the training.
“We want one protocol for us to all respond in one way to our community that suffers from mental illness,” Kirkpatrick said.