EFTA00129947.pdf

• • FD.246.1 (Rov.1-44)9) U.S. Department of Justice Federal Bureau of Investigation FileNumberC 19 Bureau Field Office Criminal Investigative and Administrative Files Armed and Dangerous FOIPA DO NOT DESTROY NCIC ELSUR OCIS Escape Risk Suicidal Financial Privacy Act Other See also Nos. hLIgk il .1 .‘\ \IL‘11\ EFTA00129947 Type # Acquired By Date Serial Attachment Type OST Notes Vol 1A 46 i 2019-08-12 100 Physical 2 lA 45 2019-08-28 80 Digital 2 1A 44 2019-08-23 80 Digital and Physical 2 lA 43 2019-08-20 79 Digital and Physical 2 1A 42 2019-08-15 78 Digital and Physical 2 lA 41 2019-08-28 77 Digital 2 1A 40 2019-08-16 77 Digital and Physical 2 1A 39 2019-08-16 77 Digital and Physical 2 1A 38 2019-08-30 76 Digital and Physical 2 1A 37 2019-08-30 76 Digital and Physical 2 1A 36 2019-09-03 74 Digital and Physical 2 1A 35 2019-08-29 73 Digital and Physical 2 1A 34 2019-08-29 73 Digital and Physical 2 1A 33 2019-08-29 73 Digital and Physical 2 1A 32 I 2019-08-29 73 Digital and Physical 2 1A 31 2019-08-29 72 Digital and Physical 2 EFTA00129948  FD-340c (4-II -03) File Number ore P - Nit - 3151 22:1 Field Office Acquiring Evidence Y0 Serial # of Originating Document Date Received CR (toll zac\ From (Name of Crantributorthiterriewee) I (Address) 4 (aty and State) By To Be Returned O Yes (a No Receipt Given O Yes No Grand Jury Material - Disseminate Only Pursuant to Rule 6 (e) Federal Rules of Criminal Procedure O Yes Er No Federal Taxpayer Information (VII) O Yes O r No Title: Reference: Mere Nalocc4Cca( r\i‘oort\cict_ (Conzannication Enclosing Material) Description: O Original notes re interview of rekorenLQ -)),(Qp, ,9 Wer0n CtA“ItU\ 0Q -a p ovimaiti cn slzg 1 ton 5\ EFTA00129949  PDS-BEMR SUICIDE RISK ASSESSMENT GUIDE — Version 3 Key Principles to Consider When Conducting Suicide Risk Assessment (adapted from Granello, 2011): - Risk or Protective Factor Absent 0 Risk or Protective Factor Not Assessed Mental Status Exam: In PDS you will be required to select a value for each of the areas below. You can make additional comments. Level of Consciousness c Psychomotor Activity C General Appearance O Behavior O Mood O Thought Process C Thought Content In PDS you will be required to select a value for each of the risk/dynamic/protective factors below: + - 0 STATIC FACTORS + - 0 DYNAMIC FACTORS + - 0 PROTECTIVE FACTORS 000 Chronic Medical Condition 000 Agitation OOO Able to Identify Reasons to Live OOO Family Hx of Suicide OOOCurrent Intoxication 000 Adequate Problem Solving Skills OOO High Profile Crime OOOCurrent Physical Pain 000 Denial of Suicidal Ideation OOO Hx of Childhood Abuse OOOCurrent Suicidal Ideation OOO Future Orientation 000 Hx of Psychiatric Hospitalization OOOCurrent Suicidal Intent OOO Religious Beliefs Against Suicide 000 History of Mental Illness OOOCurrent Suicidal Plan 000 Social Support in the Institution 000 Past Suicide Attempt 000 Fear for Own Safety OOO Supportive Family Relationships 000 History of Violent Behavior OOO Feeling Hopeless/Helpless OOO View of Death as Negative 000 Lack of Family Connections 000 Feels Like a Burden 000 Willingness to Engage in Tx OOO Sex Offender Status 000 Non-Adherence to Medical Tx 000 Problem Solving Deficits 000 Recent Significant Loss 000 Sleeps Problems 000 Social Isolation GOO Uncontrolled Mental Health Issues Additional validated risk factors that may be relevant: Sentence >2O years; Self-harm in past month; Dual Diagnosis; Male Gender; History of Self-Injurious Behavior; Chronic/Uncontrolled Pain; No Spouse (Single, Divorced, Widowed) EFTA00129950  Suicide Risk Assessment in PDS-BEMR Classification of Suicide Related Behaviors Suicide Related Communication. Any verbal or non-verbal interpersonal communication of thoughts, wishes, or intent for suicide that does NOT produce self-injury. Actions do not produce self-injury, although they have that intent. Examples may include - placing a noose around one's neck in the presence of staff; - writing a letter that states. -the world would be better without me*: - stating, -I'm going to kill myself.' Suicide Related Behavior: A self-inflicted, potentially injurious behavior for which there is evidence that the person either (a) wished to use the appearance of a suicide attempt to attain some other end, or (b) intended, to some degree. to kill him/herself. Yes No Undetermined Suicide Attempt: A non-fatal self-directed potentially injurious behavior with any intent to die as a result of the behavior. A suicide attempt may or may not result in injury. Non-Suicidal Self Directed Violence: If there is no evidence, whether implicit or explicit, of suicidal intent it is not an attempt, it is This is your judgment and includes inmate self-report. Look at the big picture and account for other data that corroborates or contradicts self-report. This is a distinction that the executive staff and/or the IDO need to have made for them. Yes or No Medical interventions are not an injury, but are undertaken to avoid or address an injury. Lethality Assessment Asphyxiation - Hanging Asphyxiation - Other Cutting Fire Ingestion - Prescription Medication Ingestion - Non-Prescription Medication Ingestion - Other Jumping Other Most of these are self-explanatory. Ingestion — Other is appropriate for swallowing razors and other foreign objects. EFTA00129951  Low Lethality: - Death is impossible or highly improbable - The individual may receive medical attention. but it is not required for survival - Frequently, the act is done in a public setting. or is reported by the individual to ensure detection and assistance. - Examples placed noose loosely around neck and did not attach the other end to another object. swallowed 10 Tylenol pills in front of staff, scratches or superficial cuts on neck or wrist. Moderate Lethality: - Death is a possible, but not highly probably, outcome of the act, in the opinion of the average person. - Opportunity for detection and intervention was not certain - Medical or crisis intervention may be required to reduce the risk of death (e.g., pumping stomach. suturing cuts). - Examples swallowed 30 Tylenol cut neck and lost significant blood. placed ligature around neck and applied pressure. High Lethality - Death is the probable outcome, although immediate and vigorous medical attention may reduce the risk. - The individual took measures to avoid detection and intervention. or the method was so lethal that intervention was not likely to prevent death - Examples placed ligature around neck and lost consciousness, attempted to hang self. but stopped when cellmate awoke took a potentially lethal overdose and did not alert staff. Examples of Protective Factors (Sanchez, 2001; United States Public Health Service, 1999) • Strong connections to family and community support • Skills in problem solving, coping and conflict resolution • Sense of belonging, sense of identity, and good self-esteem • Cultural, spiritual, and religious connections and beliefs • Identification of future goals • Constructive use of leisure time (enjoyable activities) • Support through ongoing medical and mental health care relationships • Effective clinical care for mental, physical and substance use disorders • Easy access to a variety of clinical interventions and support for help seeking • Restricted access to highly lethal means of suicide Low Acute Risk Suicidal ideation is absent or is of limited frequency, intensity, duration and specificity. There are NO identifiable plans and NO assooated intent There is good self-control based on both self-report and objective assessment. There may be mild symptomatology and morbid rumination may be present. Few risk factors are present and protective factors are identified, including available and accessible social support. Moderate Acute Risk Suicidal ideation is frequent with limited intensity and duration. Suicidal plans have some specificity, but NO associated intent. There is good self- control. limited to moderate symptomatology. some risk factors are present. and protective factors are identified. including available and accessible social support. Denial of ideation and intent may be present. if objective markers, such as suicide threats to others and agitation. contradict the self-report High Acute Risk Frequent. intense, and enduring suicidal ideation, specific plans. Many risk factors are identified. Objective markers of risk are present (e.g.. lethal method, rehearsal behaviors. saying -goodbye'): self-report of subjective intent may or may not be present There is evidence of impaired self-control, severe symptomatology. multiple nsk factors are present, and few. if any protective factors. Present - Chronic Rick is present when there is a history of two or more suicide attempts Absent - Chronic Risk is absent when there is a history of one or zero suicide attempts. Note: Self-harm behaviors are not counted as suicide attempts. EFTA00129952 Recommendations: If suicide risk is present, consider recommending the following interventions: - Suicide Watch - Brief Cognitive Behavioral Therapy for Suicide - Positive Reinforcement - Safety Plan - Psychiatric Referral - Reasons for Living Card - CBT/DBT Skills Training Groups - Coping Cards - Recommendation for Double Cell - Psychology Alert Code - Change Care Level (UPDATE Diagnostic and Care Level Formulation) - Property Restriction (If Returning to Restricted Housing) - Suicide Risk Management Plan - Consult with Unit Team - Assign a Mental Health Cadre - A suicide watch is not warranted at this time - A suicide watch is to be initiated immediately - A suicide watch was initiated by non-clinical staff and continues to be warranted - A suicide watch was initiated by non-clinical staff and is no longer warranted EFTA00129953 Date Notes EFTA00129954  The Suicidal Mode ( Predispositions to Suicide ( Trigger (Perceived Loss) Genetic & biological factors Relationship problems Family history of suicide Abuse or other trauma history Impulsivity Aggression =4* Financial stress Onset of illness Legal problems Traumatic events Previous suicidal behaviors Recent loss of a significant other C sychiatric history \ Other major life changes f Thoughts Hopelessness Perceived burdensomeness Isolation / loneliness Reasons for living Reasons for dying impaired problem solving Behaviors Substance abuse Self-harm Preparing for death Practicing / rehearsing suicide Suicide threats Poor expression of emotion ocial withdrawal K Physiology Agitation Sleep disturbance Concentration problems Physical pain EFTA00129955  The Suicidal Mode C Predispositions to Suicide .....\ ( Trigger (Perceived Loss) [4, Thoughts J Behaviors In> Suicidality 2 Physiology 2 EFTA00129956  PDS-BEMR POST SUICIDE WATCH REPORT GUIDE Watch End Date: Watch End Time: AM/PM Watch Conducted By: Transferred to a Medical Center: No/Yes Both Inmates & Staff Inmate Staff Mental Status Exam: In PDS you will be required to select a value for each of the areas below. Elaborate below. 0 Level of Consciousness Q Psychomotor Activity n ' General Appearance 0 Behavior 0 Mood Thought Process n Thought Content Narrative for Risk Factors Assessed: EFTA00129957  - Risk or Protective Factor Absent 0 Risk or Protective Factor Not Assessed Mental Status Exam: In PDS you will be required to select a value for each of the areas below. You can make additional comments. C Level of Consciousness 0 Psychomotor Activity cm General Appearance 0 Behavior Mood CD Thought Process Thought Content In PDS you will be required to select a value for each of the risk/dynamic/protective factors below: + - 0 STATIC FACTORS + - 0 DYNAMIC FACTORS - 0 PROTECTIVE FACTORS 000Chronic Medical Condition 000Agitation 000 Able to Identify Reasons to Live 000 Family Hx of Suicide 000 Current Intoxication 000 Adequate Problem Solving Skills 000 High Profile Crime 000 Current Physical Pain 000 Denial of Suicidal Ideation 000 Hx of Childhood Abuse 000Current Suicidal Ideation 000 Future Orientation 000 Mx of Psychiatric Hospitalization 000Current Suicidal Intent 000 Religious Beliefs Against Suicide 000 History of Mental Illness 000Current Suicidal Plan 000Social Support in the Institution 000 Past Suicide Attempt 000 Fear for Own Safety 000Supportive Family Relationships 000 History of Violent Behavior 000 Feeling Hopeless/Helpless 000 View of Death as Negative 000 Lack of Family Connections 000 Feels Like a Burden 000 Willingness to Engage in Tx 000 Sex Offender Status 000 Non-Adherence to Medical Tx 000 Problem Solving Deficits 000 Recent Significant Loss 000Sleeps Problems 000Sooial Isolation 000 Uncontrolled Mental Health Issues Additional validated risk factors that may be relevant: Sentence >20 years; Self-harm in past month; Dual Diagnosis; Male Gender; History of Self-Injurious Behavior; Chronic/Uncontrolled Pain; No Spouse (Single, Divorced, Widowed) EFTA00129958  Low Acute Risk Suicidal ideation is absent or is of limited frequency, intensity, duration and specificity. There are NO identifiable plans and NO associated intent There is good self-control based on both self-report and objective assessment. There may be mild symptomatology and morbid rumination may be present. Few risk factors are present and protective factors are identified. including available and accessible social support. Moderate Acute Risk Suicidal ideation is frequent with limited intensity and duration. Suicidal plans have some specificity, but NO associated intent. There is good self-control, limited to moderate symptomatology, some risk factors are present. and protective factors are identified, including available and accessible social support. Denial of ideation and intent may be present. if objective markers. such as suicide threats to others and agitation. contradict the self-report. High Acute Risk Frequent. intense, and enduring suicidal ideation. specific plans. Many risk factors are identified. Objective markers of risk are present (e.g.. lethal method. rehearsal behaviors. saying "goodbye): self-report of subjective intent may or may not be present There is evidence of impaired self-control severe symptomatology. multiple risk factors are present. and few. rf any protective factors. Present Chronic Risk is present when there is a history of two or more suicide attempts Absent Chronic Risk is absent when there is a history of one or zero suicide attempts. Reason for referral Change in nsk factors: Reason for removal from watch Diagnosis. Recommendations EFTA00129959 Date Progress Notes Thanks to Christopher Bush & Scott Forbes in the development of this guide Version 3 EFTA00129960  Page I of I - Epstein From: To: Date: 7/25/2019 1:35 PM Subject: Epstein The from Central Office, Dr. contacted me today about Epstein. He thought that housing him with another sex offender in SHU would be a good idea. I told him I would speak with the executive staff about his suggestion. Also, Dr. thought it wise that we keep him down here for a bit (as is the plan already). I am heading to the hospital in about a half an hour or so. If you need me for anything, feel free to call my cell phone . Thank you. , Psy.D. U.S. Department of Justice/ Federal Bureau of Prisons Metropolitan Correctional Center 150 Park Row New York, New York 10007 Office: Fax: E-mail: file:///C:/Users/bop19019/AppData/Local/Temp/X Pgrpwise/5D39B00FN YMDOM1N Y M... 8/26/2019 EFTA00129961  Page 1 of 1 - Suicide Watch/Psych Observation Update From: To: Suicide Watch/Psych Observation Update Date: 7/30/2019 12:30 PM Subject: Suicide Watch/Psych Observation Update Inmate Epstein #76318-054 is being taken off of Psych Observation and needs to be housed with an appropriate cellmate. Suicide Watch None Psych Observation None Thank you, file:///C/Users/bop18967/AppData/LocaUTemp/1/XPgrpwise/5D403854N YMDOM1N Y... 8/13/2019 EFTA00129962  Page 1 of 3 Recipients: 71 Acknowledged: 27, Response Pending: 44 Read Read Response Pending Response Pending Response Pending Response Pending Response Pending Response Pending Response Pending Response Pending Response Pending Read Response Pending Read Response Pending Read Response Pending Response Pending Read Read Response Pending Response Pending Response Pending Response Pending Read Response Pending Response Pending Read Response Pending Response Pending Response Pending Read Response Pending Read Read Response Pending file:///ClUsers/bop18967/AppData/Localfremp/2/XPgrpwise/5D403854NYMDOM1NY... 8/14/2019 EFTA00129963  Page 2 of 3 Read Response Pending Response Pending Response Pending Read Read Response Pending Read Read Response Pending Response Pending NYM/Duty Officer— Response Pending NYM/Food Svcs— Response Pending Response Pending Response Pending Response Pending Response Pending Response Pending Response Pending Response Pending Read Read Response Pending Read Transferred Read Response Pending Read Read Response Pending Read Response Pending Read Read Read Attachments: User: 0, System: 2 Send Options: file:///ClUsers/bop18967/AppData/Localifemp/2D(Pgrpwise/5D403854NYMDOM1NY... 8/14/2019 EFTA00129964  Page 3 of 3 fileJ//ClUsers/bop18967/AppData/LocaVTemp/2/XPgrpwise/5D403854NYMDOMINY... 8/14/2019 EFTA00129965 Suicide Prevention EFTA00129966  At-Risk Settings • Restrictive Housing • Single Cells • Private Spaces EFTA00129967 EFTA00129968 It is recommended that all SHU inmates be double-celled unless there is a compelling reason not to do so. — Reduces isolation — Reduces privacy — Provides distraction — Provides rescue opportunity EFTA00129969 ED-340c(4- )1.03) File Number 90A —k\•-t- 2 c 1 21 -3- Field Office Acquiring Evidence ki 14/-4O Serial # of Originating Document 1-3 Date Received 3' IL ( i From 5IA (_) Co. 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I notified staff that a body alarm and medical emergency was called in SHU. Staff responded, than I received a call from staff in SHU telling me to call 911 for an ambulance. I notified the New York Police Department via the institutional NYPD telephone. I then informed NYPD that we need and ambulance and medical assistance for one of our inmates. Staff then continued to respond getting a stretcher and a defibrillator, escorting the inmate down to medical. The New York City Fire Department and Emergency Medical Services (EMS) arrived at 6:43am to the institution and were escorted to the 2nd floor medical area. EMS departed the institution with inmate Epstein and BOP escort via ambulance and chase car to local hospital at 7:10am. CSO / EFTA00129977 FT)-340c(4- 11-03) Number - - 31 5- 12- -2- 7""' Meid Office Acquiring Evidence 10,4O Serial I of °reinnring Documnd 9 29 or Date Received 7 From (Name of Cemtributornntervk-wee) l a rem ll"31-------- alli !JH ( l) (»(' By No To Be Returned Ei Yes ❑ Yes No Receipt GIN en to Ruk 6 (e) Grand Jury Material - Dissemtnate Only Federal Rules of Clinilnal Procechur ❑ Yes Federal Tiorpayer Information (FEI) D Yes Reference: (0 So eantileeEzelostnestaterkil Description: ❑ Original notes re Interview ei t I EFTA00129978  NYMFC 530.03 • BUREAU OF PRISONS COUNT SHEET 08-10-2019 PAGE 001 • NEW YORK MCC 00:35:17 QTRG RO •••• OCTG EU e... OUTCOUNT SECTION A F F F E H M R S TR V OC T E N N S O S G A N I U0 T J Y Y S D E N S TU COUNT Y K S P I D I N VERIFY COUNT AREA CENSUS V T T COUNT COUNT AREA B-A 26 /k 26 B-A C-A 10 _ark' 10 C-A S-N 83 2 2 Kf 01 E-N B-S 79 1 1 78 E-S /)( 0-N 78 78 G-N ;1 / 4 7# 0-5 88 -dT 88 0-S H-A 4 .P. V .- 4 H-A I-N 86 4) ( 86 I-N K-N 89 ...k 89 K-N K-S 137 1 1 ...)/( 136 K-S R-A 1 1 R-A Z-A 72 72 2-A Z-B 5 5 2-B TOTAL 758 4 754 COUNT VERIFY OFFICIAL PREPARING OFFICIAL TAKING CO COUNT CLEARED TIER: avoci Jac-) EFTA00129979  Center —Meiropolitan Correetbaa — — — — . OfficialCMint Slip :Metropolitan Correctional Center IM - • • New York, New York Unit: Time: Official Coun Count: Volt: Daie. Print Name: _1 -- Count: t Time: 12 --„ Signature: \ 1. Print Name: Print Name: Signature: — Signature: —....—-- Print Name: 2. Signature: Metropolitan Connectional Center Official Count Slip Metropolitan Correctional Center Unit: ft-. Del New York, New York Count: me: Official Coun lip Print Name: Unil• Date: Signature: Count: Print Name: f. Print Name 1. Signature: Signature: 2. Print Naine 2. Signature: Metropolitan Correctional Centel Official Count Slip Unit: Date: