EFTA00134933.pdf

V.S. Department of Justice Federal Bureau of Prisons Program OPi: CPD/PSB NUMBER: P5324.08 DATE: 4/5/2007 SUBJECT: Suicide Prevention Statement Program RULES EFFECTIVE: 3/15/2007 1. PURPOSE AND SCOPE. The Bureau of Prisons (Bureau) operates a suicide prevention program to assist staff in identifying and managing potentially suicidal inmates. Each Warden will ensure that a suicide prevention program is implemented consistent with this policy. In addition, Wardens will facilitate a discussion regarding the issue of suicide at department head meetings, staff recalls, lieutenants' meetings, etc., to heighten staff awareness about the need to detect and report any changes in inmate behavior that might suggest suicidal intent. 2. SUMMARY OF CHANGES. This re-issuance adds the following new procedures for preventing inmate suicides: a. Suicide prevention training will include three mock suicide emergencies per year, one on each shift. One of these exercises must be conducted in the Special Housing Unit (SHU) during the morning or evening watch. b. Specific minimum criteria that must be included in a Suicide Risk Assessment and a Post-Watch Report are delineated. c. Designation of a room for suicide watch outside of the Health Services area requires written approval of the Regional Director. d. Specific criteria that exclude an inmate from consideration for an inmate companion position are delineated. e. Correctional Services will notify Psychology Services when an inmate requests protective custody (PC). Psychology Services will no longer be required to monitor SENTRY for entry of a PC code. 3. PROGRAM OBJECTIVES. The expected results of this program are: a. All institution staff will be trained to recognize signs and information that may indicate a potential suicide. S ON Y_00006434 EFTA_00000519 EFTA00134933  P5324.08 4/5/2007 Page 2 t suicides with appropriate b. Staff will act to preven and referrals. sensitivity, supervision, receive found to be suicidal will c. Any inmate clinically oth er ervision, counseling, and appropriate preventive sup treatment. 4. DIRECTIVES AFFECTED a. Directive Rescinded (3/1/04) P5324.05 Suicide Prevention Program b. Directives Referenced l Housing Units Inmate Discipline and Specia P5270.07 (12/29/87) entation Program (4/3/03) P5290.14 Admission and Ori es Manual (8/13/93) P5310.12 Psychology Servic Application of Restraints P5566.06 Use of Force and (11/30/05) 05) P6031.01 Patient Care (1/15/ P6340.04 Psychi atric Ser vic es (1/15/05) in m Statement are contained c. Rules cited in this Progra . 26 CFR 552.40 through 552.41 5. STANDARDS REFERENCED lt ociation Standards for Adu a. American Correctional Ass 4-4 084 ,4- 408 4-1 ,4- 4th Edition: Correctional Institutions, 4370M,4-4371M,and 4-4 373 M. Association Performance Based b. American Correctional tion: 4- nda rds for Adu lt Loc al Detention Facilities, 4th Edi Sta -ALDF-4C- F-7 8-0 8,4 -AL DF- 78- 10, 4-A LDF-7B-10-1,4-ALDF-4C-29M,4 ALD 30M,and 4-ALDF-4C-32M. See Section 7a. 6. INSTITUTION SUPPLEMENT. Referral POL ICY . Eac h Bur eau ins titution, other than Medical 7. that s (MR Cs), wil l imp lem ent a suicide prevention program Center h Bureau outlined in this policy. Eac conforms to the procedures tte n pro ced ure s p specific wri medical center is to develo and the ten t wit h the spe cia liz ed nature of the institution consis intent of this policy. s. MRCs serve a unique a. Medical Referral Center e addressing the needs of a wid evaluation/treatment function nda rds of car e. ting community sta range of inmates, while mee ution pon sible for developing an Instit Psychology Services is res man agi ng the local procedures for Supplement that describes SDNY_00006435 EFTA_0O0O0520 EFTA00134934  P5324.08 4/5/2007 Page .3 components. Suicide Prevention Program's ent document significant treatm that the MRC psychologists are to ical Data System (PDS) so information in the Psycholog atment. ble for post-discharge tre information is readily availa n ter Contract Facilities. Whe b. Residential Reentry Cen al Ree ntry ties (including Residenti contracts for outside facili Statement of Work will include a the Centers (RRCs)) are used, ed Bureau n pla n or program that meets accept Suicide preventio standards. tract rs (CCMs) will monitor con Community Corrections Manage ine their capability to manage at- erm facilities regularly to det The CCM will consult the Regional eff ect ive ly. risk populations ator if questions arise abo ut the Psychology Services Administr n Pro gram or ility's Suicide Preventio adequacy of a contract fac fer ent a suicidal inmate to a dif about the need to transfer log y tact Central Office Psycho facility. The CCM will con -wide or interagency issues. tem Services when there is sys all possible evidence and In the event of a suicide, ved to provide data and support for ser documentation will be pre onstruction. subsequent invest iga tor s doing a psychological rec er-action ector will authorize an aft Ordinarily, the Regional Dir to be conducted by the Regional , review of a suicide at a RRC findings will be documente d as a str ato r. The Psychology Admini ach ment A. Report as outlined in Att Psychological Reconstruction ty ct Prisons. Private securi c. Privately-Managed Contra a suicide prevention and contract facilities maintain ance with American Correctional pli intervention program in com ant Director, nda rds . Ordinarily, the Assist Association (ACA) sta action on, will authorize an after-conducted Correctional Programs Divisi be tract private prison, to review of a suicide at a con tral Office Psychology Services Cen under the direction of the will be documented as a Administrator. The fin din gs achment A. cho log ica l Rec ons tru cti on Report as outlined in Att Psy 8. PROGRAM ADMINISTRATION. gram h institution must have a Pro a. Program Coordinator. Eac gra m. on's suicide prevention pro Coordinator for the instituti be responsible for managing the ll The Program Coordinator sha s and for ensuring that the inm ate treatment of suicidal the vention program conforms to institution's suicide pre ntification, ref err al, ass essment, ine s for tra ini ng, ide guidel in this policy. and intervention outlined logist will be the Program Ordinarily, the Chief Psycho nator's responsibilities wil . l not nat or. The Pro gra m Coo rdi Coordi chologist er than a doctoral-level psy be delegated to staff oth SDNY 00006436 EFTA_0000052I EFTA00134935  P5324.08 4/5/2007 Page 4 institution di na to r, in conjunction with ailable The Prog ra m Co or en su re th at ad eq uate coverage is av st n for training, executive staff, mu nt from the institutio or sh e is ab se when he annual leave, etc. ion is e th e in it ia l period of incarcerat b. Training. Wh il serious r de te ct in g po tential suicides, me fo n the often a critical ti e at an y ti me . Line staff are ofte ar is on suicidal crises may al behavior based id en ti fy si gn s of potential suicid first to s. ractions with inmate their frequent inte ring that m Co or di na to r is responsible for ensu Program The Prog ra aff. The is available to st appropriate training that all st af f will be trained en su re e signs Coordina to r wi ll gy se rv ic es pe rs onnel) to recogniz holo (ordinarily by psyc l suicide, the appropri ate referral ve of a po te nt ia indicati ques. e prevention techni process, and suicid evention at ud e di sc us sions of suicide pr aff of Wardens wi ll in cl gs , st af f re ca ll s, etc., to remind st in department head meet te s constantly for si gns of suicidal to ob se rv e in ma the need behavior. ention training r Al l Staff. Suicide prev 1) Tr ai ni ng fo tional Techniques cl ud ed in th e In tr oduction to Correc procedures will will be in in lo ca l suicide prevention Tr ai ni ng Training and curriculum. it ut io n Familiarization du ri ng In st be provided . at all institutions Annual Training (AT) will focus on: Training for staff risk factors; identifying suicide icides; iles of completed su typical inmate prof vior; ntially suicidal beha recognition of pote ation associated with s; appropriate inform te rring suicidal inma identifying and refe ., a suicide ide emergency (e.g responding to a suic pr oper use of ing location and in progress), includ ; and suicide cut-down tool of suicide ordinator, location name of Program Co watch room, etc. m nt al Sp ec ia li ty Training. The Progra 2) Supp le me f having r su pp le me nt al training.to staf Coordinator wi ll of fe specialty . Or di na rily, supplemental frequent inmate co nt ac ts s Assistants, se rv ic es st af f (i.e., Physician' training for he al th Registered on er s, Em er ge nc y Me dical Technicians, Nurse Practiti SONY 00006437 EFTA_00000522 EFTA00134936  P5324.08 4/5/2007 Page 5 ered ), lie ute nan ts, and cor rectional counselors is off on AT. Nurses instituti after the conclusion of approximately six months pro vid ed dur ing regularly enc our age d tha t thi s training be It is possible. scheduled meetings when (SHU) Sup ple men tal Tra ini ng for Special Rousing Unit 3) cidal recognizing potentially sui Staff. Information about low will be inc lud ed in the SHU post and pro ced ure s to fol suicide inmates exa mple of post orders for orders. Att ach men t B is an prevention in a SHU. Captain Eme rge ncy Res pon se Tra ining. At a minimum, the 4) cide cho log ist wil l joi ntl y conduct three mock sui and Chief Psy months yea rly , one on eac h shift, approximately four h emergenci es xes wil l com ple te the exercises separately at eac apart. Com ple plex. institution within the com at least one of these Within the calendar year, in the SHU during the exercises will be conducted (Institutions that do evening or morning watch. ps) are exempted from not have a SHU [e.g., Cam still required to this requirement, but are e emergencies yearly). conduct three mock suicid e emergency training Confirmation of mock suicid Associate Warden over the will occur in writing to Psychology Ser vic es wit h a copy to the Suicide nator for placement in a Prevention Program Coordi e. See sample training documentation fil ment C. memorandum format in Attach on to the supplemental This training is in additi utenants, health speciality training for lie nal counselors. services staff, and correctio ATES. 9. IDENTIFICATION OF AT-RISK INM een a . Medical staff are to scr a. Medical Staff Screening is at ris k for signs that the inmate newly admitted inmate for ce wit hin screening is to take pla suicide. Ordinarily, this ins tit ution. inmate's admission to the twenty-four hours of the /NP) ant/Nurse Practitioner (PA + The Physician's Assist tionally distur bed inm ates on will refer suicidal or emo nat or or Program Coordi an emergency basis to the designee. b. Psychological Intake. Pre-Sentence Detainees, and 1) Pre-Trial Detainees, ause of the FDCs, FTCs, or Jails. Bec Holdovers in MCCs, MDCs, short length of stay in MCCs, MDCs, high rate of admissions and SDNY_00006438 EFTA_00000523 EFTA00134937  P5324.08 4/5/2007 Page 6 chological units, the comprehensive psy FDCs, FTCs and Detention wil l be logy Services ordinarily intake conducted by Psycho ng sui cidal or who are suspected of bei performed only on inmates s or table (e.g., mental illnes appear psychologically uns withdrawal), or who request services se significant substance abu via the Psycholog y Ser vic es Inmate Questionnaire. -Return Inmates. For newly 2) Newly Assigned or Writ a s or writ-return inmates, assigned designated inmate comprehensive psychological intake psychologist will conduct a 's admission to the institution. ate within 14 days of the inm For transferred inmates, a 3) Transferred Inmates. intake comprehensive psychological psychologist will conduct a tit uti on if ate's admission to the ins within 30 days of the inm s it is clinically warranted based upon the psychologist determine ble inmate records. the PSIQ and other availa ion or s in Administrative Detent c. Inmates in SRUs. Inmate ris k for tus often may be at higher Disciplinary Segregation sta SHU will cid al beh avi or. Inm ate s being transferred into the crying, sui g., potential suicide risk (e. be monitored for signs of f-h arm , or eng aging in nal ly dis tra ugh t, thr eats of sel emo tio eral con duc t to pur pos efu lly effect removal from the gen referred mis l be ibiting such behavior wil population). Inmates exh to the Shift Lieutenant. g Inmates. Inmates requestin 1) Protective Custody (PC) act ual ly tec tiv e cus tod y or dem anding to be housed alone maytective pro When an inmate requests pro be contemplating suicide. Services tod y or dem and s to be celled alone, Correctional cus staff will immediately: rdinator or designee in + notify the Program Coo normal business hours, or Psychology Services during l g hours notify the on-cal + during non-routine workin psychologist. on within 72 PC inm ate sho uld be scr eened for suicidal ideati The ted by rs of bei ng pla ced int o SHU. When clinically indica hou l be Suicide Risk Assessment wil this screening, a formal conducted. y staff to Pro gra m Coo rdi nat or wil l work closely with custod g., The tal status for behavior (e. monitor each PC inmate's men n, sing agitation, depressio hopelessness, anxiety, increa d for an increased level of nee psychoses) that suggests a services. m l Precautions. The Progra 2) Inmates Requiring Specia of or wil l pro vid e SHU sta ff with a list ("hot list") Coordinat SONY 00006439 EFTA_00000524 EFTA00134938  P5324.08 4/5/2007 Page 7 dangerous, conditions who may become inmates with mental health the SHU . al when placed into self-destructive, or suicid needed and This list will be updated as Services, Health distributed to Correctional ff. This list will be Services, and Unit Team sta ff. made available to all sta list" is placed into When an inmate on this "hot vices Supervisor will the SHU, a Correctional Ser immediately. notify Psychology Services 3) SHU Custodial Issues. olvement. At a minimum, the A) Program Coordinator Inv of SHUs ee will make weekly rounds Program Coordinator or design inm ates se areas concerning any and consult with staff in tho needing special attention. or Log. The Program Coordinat B) Review of Lieutenant's det erm ine if log each working day to will review the Lieutenant's in the SHU . lth problems has been placed to assess an inmate with mental hea inmate as soon as possib le A psychologist will see the and alert SHU staff. the inmate's mental status Services policy contains C) Health Services. Health received s placed in SHU continue to procedures to ensure inmate needed medications. notified whenever an Psychology Services will be /her medication. If inmate refuses or misses his to become violent, the inmate has the potential without the al self-destructive, or suicid ist s wil l notify SHU staff of medication, psycholog this. h ry SHU will be equipped wit D) Suicide Rescue Tool. Eve ure t is sharp, stored in a sec a suicide rescue tool(s) tha trained ble. All SHU staff will be location, and readily availa cedures for responding to a suicide pro to use the tool and in the emergency. or SKS. The Program Coordinat E) Inmate Removal from the pot ent ial ate exhibiting significant will arrange to have an inm pla ced on sui cid e watch. SHU and for suicide removed from the returned ril y, onc e the cri sis is over, the inmate will be Ord ina ction that was imposed. to the SHU to satisfy any san ff may identify an inmate as d. Staff Referral. Any sta observed ent ial ly sui cid al at any time based upon the inmate's pot behavior. SDNY_00006440 EFTA_00000525 EFTA00134939 P5324.08 4/5/2007 Page 8 SDNY 00006441 EFTA_00000526 EFTA00134940  P5324.08 4/5/2007 Page 9 HTLY ANY INMATE SUICIDE STAFF MUST NEVER TARE LIG INFORMATION OR HINTS FROM THREATS OR ATTEMPTS OR ANY ATE BEING POTENTIALLY OTHER INMATES ABOUT AN INM SUICIDAL. may be staff mem ber who has reason to believe an inmate Any suicidal should: s ate under direct, continuou • ordinarily maintain the inm observation, t for assistance, and • contact the Shift Lieutenan contact the Program • during regular working hours, any other available e., Coordinator or designee (i. psychologist ). hours, the Shift Lieutenant • During non-routine working• chologist and continue psy will contact the on-call ce direct, contin uou s obs erv ation, or immediately pla the inmate on suicide watch. ately rge ncy sit uat ion s, the Shi ft Lieutenant will immedi In eme that in watch. It should be noted place the inmate on suicide ff member may place an inmate on emergency situations any sta re the cedures may apply to MRCs whe suicide watch. Special pro may be limited to specific clinical initiation of suicide watch staff. play a Inm ate Ref err al. In add ition to staff, inmates can e. tate rol e in hel pin g to pre ven t inmate suicides. To facili by: vital referrals on will encourage inmate this process each instituti institution inmate including a statement in the • als encouraging inmates to handbook/orientation materi or situation that may or notify staff of any behavi is ups et and potentially suicidal, suggest an inmate inmate referrals into the incorporating the topic of • lesson plan for Psychology Admissions and Orientation Services, sing unit addressing the • placing posters in each hou topic, and on is made available to • ensuring that the informati as appropriate, inmates in multiple languages particularly Spanish. SONY_00006442 EFTA_00000527 EFTA00134941  P5324.08 4/5/2007 Page 10 During T OF IDENTIFIED INMATES. 10. SUICIDE RISK ASSESSMEN t of suicide ates referred for assessmen regular working hours inm priority basis. During non -regular potential will be seen on a con sul t with or or designee should hours, the Program Coordinat imm edi ately or ose to see the inmate institution staff and may cho cas e, the suicide watch. In either have the inmate placed on 24 hou rs of ividual assessment within inmate will receive an ind referral. will be completed when: A Suicide Risk Assessment Psychology Services because staff refer an inmate to suicide (e.g., the inmate the inmate may be at risk for talks about ending his or refuses his or her property, her life), behavior is suggestive of an inmate's written or verbal suicide, or suggestive of self-harm, an inmate exhibits behavior sent that would lead the any other condition is pre essment is warranted. clinician to believe an ass ted in PDS k Assessment will be comple Ordinarily, the Suicide Ris nts outlined above. At a minimum, within 24 hours of the incide l include: wil the Suicide Risk Assessment erral, reason for / source of ref risk factors assessed, risk assessment findings, diagnosis, and follow-up recommendations. ed e a referral based on observ When a staff member has mad l also who interviews the inmate wil ed the behavior, the psychologist erv iew the staff member who obs make every effort to interv in the 's comments will be included behavior. The staff member report/clinical notes. tion of the suicide risk 11. INTERVENTION. Upon comple or or designee will determine rdinat assessment, the Program Coo the ent ion that best meets the needs of the appropriate interv us beh avi or doe s not self-injurio inmate. Because deliberate entions essari ly ref lec t sui cid al intent, a variety of interv nec med on suicide watch may be dee other than placing an inmate rdinator, such as heightened staff Coo appropriate by the Program ation, inm ate int era cti on, a roo m/cell change, greater observ or SDNY 00006443 EFT4_00000528 EFTA00134942  P5324.08 4/5/2007 Page 11 ication. ent in res tra int s, or ref erral for psychotropic med placem l assume Coordinator or designee wil In any case, the Program ent ion and cle arly ommended interv responsibility for the rec document the rationale. the Program Coordinator a. Non-suicidal Inmates. If suicidal, does not appear imminently determines that the inmate for thi s conclusion ll doc ume nt in wri ting the basis he/she sha n will tre atm ent rec omm end ati ons made. This documentatio and any tral file. medical, psychology, and cen be placed in the inmate's ermines Sui cid al Inm ate s. If the Program Coordinator det b. cide, the imminent potential for sui the individual to have an ins tit ution's cide watch in the inmate will be placed on sui ion s and findings of n room. The act designated suicide preventio wit h cop ies going to l be documented, the Program Coordinator wil fil e, and the record, psychology the central file, medical Warden. 12. SUICIDE WATCH. ms on must have one or more roo a. Housing. Each instituti on sui cid e wat ch. housing an inmate designated specifically for in ade qua te con trol allow staff to mainta The designated room must obs erv e and mising the ability to of the inmate without compro protect the inmate. cide watch designating a room for sui + The primary concern in and mai nta in erve, protect, must be the ability to obs . adequate control of the inmate ructed access, privacy, and unobst The room must permit easy times. vision of the inmate at all m may not have fixtures or The suicide prevention roo ury. t would easily allow self-inj architectural features tha ignated ced in the institution's des Inmates on watch will be pla non-administrative suicide prevention room, a lth ordinarily located in the hea detention/segregation cell ate will not cell's location, the inm services area. Despite the l ind ications t unless there are medica be admitted as an in-patien ate hospitalization. that would necessitate immedi be room in a different area may Placement of a suicide watch uti ons . tures of some instit warranted given the unique fea e of the m for suicide watch outsid + However, designating a roo written approval of the Health Services area requires ms must meet all of the Regional Director. Such roo ve. requirements identified abo SDNY_00006444 EFTA_00000529 EFTA00134943  25324.08 4/5/2007 Page 12 ls disciplinary segregation cel + Administrative detention and cel ls. approved as suicide watch will not be designated or be placed Und er eme rge ncy con dit ions a suicidal inmate may the • in a cell other than temporarily on suicide watch be ch room. The inmate must institution's designated wat watch room as soon as one cide moved to a designated sui becomes availa ble . the nt. While on suicide watch, ctive b. Conditions of Confineme re