At least five people in the U.S. died while or shortly after their heads were covered with spit hoods while under medical supervision by state-run psychiatric facilities, The Seattle Times reported Jan. 25.
The Times surveryed all 50 states to assess their use of hoods.
The mesh fabric covers, used by law enforcement and medics to prevent spitting and biting, have been linked to serious risks, including asphyxiation. Spit hoods have been used in at least 29 states over the past decade, with 15 states stocking them in state-run psychiatric hospitals. Only four states — Arkansas, Michigan, Minnesota and Nevada — shared written spit hood policies when requested by the Times.
Four states — Hawaii, Oregon, Virginia and Washington — include spit hoods in standard restraint kits used in one or more psychiatric facilities, according to the report. Pennsylvania is the only state that bans all forms of restraint, including spit hoods, in its state-operated psychiatric hospitals.
None of the states surveyed track spit hood usage in a centralized or standardized way. The Times survey, conducted in fall 2025, reached out to state-run psychiatric oversight agencies in all 50 states. Twenty-nine states responded to at least one survey question. It also ran targeted searches of media reports, lawsuits and federal hospital inspection records.
