BOP suicide risk assessment of Jeffrey Epstein, July 23, 2019

EFTA00056021¶

SENSITIVE BUT UNCLASSIFIED¶

Bureau of Prisons Psychology Services Suicide Risk Assessment¶

Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M Facility: NYM Unit Team: 5 Date: 07/23/2019 10:09 Provider: Imeri, Darlene PsyD¶

Type of Housing: SHU Administrative Segregation Cell Accommodation: Double-Cell¶

FINDINGS This assessment and the resulting recommendations are based on the following sources of information: Clinical Interview, Medical Record, Psychology Data System, Sentry¶

Reason for Referral The On Call Psychologist, Dr. Miller, had been contacted by the Operations Lt. at about 2 AM on 7/23/19 to inform her that Mr. Epstein was being placed on Suicide Watch because he was found with a string around his neck. Mr. Epstein was seen by this writer for a Suicide Risk Assessment at about 9:10 AM on 7/23/19.¶

This note is being entered at about 3:35 PM on 7/23/19.¶

Mental Health History According to a Suicide Risk Assessment dated 7/09/19 by Dr. Miller, “Inmate Epstein denied any history of mental health treatment, either on an inpatient or outpatient basis. Inmate Epstein denied any treatment in the past or present with psychotropic medication. He also denied any acute mental health symptoms at this time.”¶

Self-Harm History According to a Suicide Risk Assessment dated 7/09/19 by Dr. Miller, “Inmate Epstein denied any past or present suicidal ideation, intention or plan. He denied ever engaging in any suicide attempts or self-injurious behavior in the past.”¶

Substance Abuse History According to a Suicide Risk Assessment dated 7/09/19 by Dr. Miller, “Inmate Epstein denied any alcohol or substance abuse. He said it is well-known that he does not even drink alcohol.”¶

Current Problem Earlier this morning Mr. Epstein was found by SHU staff in his cell with a string loosely tied around his neck. It is unclear at this time if Mr. Epstein had placed the string around his own neck.¶

When Mr. Epstein was asked by this writer how he ended up on Suicide Watch, he denied remembering. He stated he got a drink of water last night in his cell and went back to bed. He said the next thing he remembered is hearing himself snore. He said he wants to know why he is on Suicide Watch. He was informed that staff stated he was found in his cell with a string on his neck. According to Medical records, he had been seen by Medical for this and had a rule out of self inflicted injuries.¶

When this writer reviewed the Staff Suicide Watch Log, it noted that Mr. Epstein told the staff watching him that his calorie tried to kill him, which Mr. Epstein did not tell this writer when this writer had interviewed Mr. Epstein. This writer was not able to ask Mr. Epstein about this, since Mr. Epstein was now in Legal. The Captain was notified about this notation and the Captain stated they were already aware of this statement.¶

Current Mental Status Level of Consciousness: Alert and Oriented Psychomotor Activity: Normal General Appearance: Normal Behavior: Cooperative Mood: Appropriate to Content¶

EFTA00056022¶

Inmate Name:	EPSTEIN, JEFFREY EDWARD				Reg #:	76318-054
Date of Birth:	01/20/1953	Sex: M	Facility: NYM		Unit Team:	5
Date:	07/23/2019 10:09	Provider:	Imeri, Darlene PsyD

Thought Process: Goal Directed¶

Thought Content: Normal¶

Current Mental Status: He exhibited a neutral mood with a full range of affect. His speech was logical and coherent, with no loosening of associations or tangential, circumstantial or irrelevant speech. Auditory and visual hallucinations were denied, and delusions were not elicited. He did not engage in any bizarre or inappropriate behavior. He denied current suicidal or self harm ideation and he agreed to immediately tell staff if he starts to have suicidal or self harm thoughts. He was future oriented. He does not appear to be an immediate danger to self. He denied thoughts of hurting others and he agreed to tell staff if he has these thoughts.¶

RISK AND PROTECTIVE FACTORS ASSESSED:¶

This writer screened the inmate for a variety of empirically validated factors commonly associated with risk for self-harm and suicide.¶

The following STATIC risk factors were assessed to be present and increase the inmate’s risk for engaging in suicide related behaviors: High Profile Crime, Lack of family connections, Sex offender status¶

The following DYNAMIC risk factors were assessed to be present and increase the inmate’s risk for engaging in suicide related behaviors: Current physical pain¶

The following PROTECTIVE factors were assessed to be present and may decrease the inmate’s risk of suicide: Able to identify reasons to live, Adequate problem solving skills, Denial of suicidal ideation/intention/plans, Future orientation, View of death as negative, Willingness to engage in treatment¶

Risk Factors: He was found by staff in his cell in SHU with a string loosely tied around his neck, which Mr. Epstein stated he did not remember anything about. It is unclear at this time if Mr. Epstein had placed the string around his own neck or if someone else did. According to Medical, he had a circular line around the base of his neck, which he denied knowing how he obtained. He stated his throat hurts which was reported to Medical. He has a high profile sex offense case and recently was denied bail. When asked if he has any friends or family that are emotionally supportive, he stated he does not know what that means. When emotional supports were explained to him and then again asked if he as any family or friends that are emotionally supportive, he was vague and said he has a lot of people.¶

Protective Factors: He denied current suicidal or self harm thoughts or ever having these thoughts. He denied a history of self harm and suicide attempts. He denied a family history of suicidal and self harm attempts. He denied having any chronic medical conditions. He denied feeling hopeless. He denied a history of childhood abuse. He denied fearing for his safety. He denied feeling like a burden to anyone. He reported he is sleeping adequately. He stated he lives to have fun, to enjoy life, and to learn. He said his future plans include fighting his case and going back to his normal life.¶

Whereas, he is denying suicidal and self harm thoughts and has a lot of protective factors, he is denying that he remembers how he ended up on Suicide Watch and has marks encircling his neck. It is unclear at this time if he had placed the string around his neck or if someone else did. He will remain on Suicide Watch for further observation and safekeeping.¶

DIAGNOSIS:¶

No Diagnosis, No Dx - Current¶

CONCLUSIONS¶

The Overall Acute Suicide Risk for this Inmate is: Moderate¶

Overall Chronic Suicide Risk for this Inmate is: Absent¶

RECOMMENDATIONS¶

1. Mr. Epstein will remain on Suicide Watch for further observation and safekeeping.

2. While on Suicide Watch, he will be continuously observed by Inmate Companions.

3. While on Suicide Watch, he will be seen daily by Psychology.

4. Supportive and educative interventions were provided.

5. Medical was informed that he reported his throat hurts.

Suicide Watch: A suicide watch was initiated by non-clinical staff and continues to be warranted Suicide Watch was initiated on: 07/23/2019 01:40¶

Generated 07/23/2019 15:38 by Imeri, Darfene PsyD¶

Page 2 of 3¶

Bureau of Prisons - NYM¶

EFTA00056023¶

Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M Facility: NYM Unit Team: 5 Date: 07/23/2019 10:09 Provider: Imeri, Dariene PayD¶

Completed by Imeri, Dariene PayD on 07/23/2019 15:38¶

Generated 07/23/2019 15:38 by Imeri, Dariene PayD Bureau of Prisons - NYM Page 3 of 3¶

SENSITIVE BUT UNCLASSIFIED¶

Bureau of Prisons¶

Psychology Services Post Suicide Watch Report¶

Inmate Name:	EPSTEIN, JEFFREY EDWARD				Reg #:	76318-054
Date of Birth:	01/20/1953	Sex:	M	Facility: NYM	Unit Team:	5
Date:	07/24/2019 09:23	Provider:	DiMisa, Samantha Ph.D.
Watch Start Date:	07/23/2019 01:40		Watch Stop Date:		07/24/2019 08:45
Total Time on Watch:	31 hrs 5 minutes
Watch Conducted By:	Both inmates and staff		Transfered to Medical Center:		No
Current Mental Status
Level of Consciousness:	Alert and Oriented
Psychomotor Activity:	Normal
General Appearance:	Normal
Behavior:	Cooperative
	Respite to Content
	Goal Directed

Thought Content: Normal¶

Current Mental Status: Mr. EPSTEIN was alert and oriented. He was polite, calm, and cooperative in demeanor. He exhibited a neutral affect with appropriate range. Eye contact and hygiene were appropriate. The inmate spoke with normal rate, tone, and volume. His thoughts were organized and coherent, with no loosening of associations or tangential, circumstantial, or irrelevant content. There was no evidence of perceptual disturbance, delusional ideation, or a formal thought disorder. He did not engage in any bizarre or inappropriate behavior. He noted having normal sleeping and eating habits. Mr. EPSTEIN explicitly denied recent and current suicidal ideation, planning, and intent. He was future-oriented and expressed a commitment to life and safety, agreeing to contact staff immediately should he experience suicidal ideation or psychological distress. He also denied thoughts of harming others.¶

Risk Factors Assessed:¶

This writer screened the inmate for a variety of empirically validated factors commonly associated with risk for self harm.¶

The following STATIC risk factors were assessed to be present and increase the inmate’s risk for engaging in suicide related behaviors: High Profile Crime, Lack of family connections, Sex offender status¶

The following DYNAMIC risk factors were assessed to be present and increase the inmate’s risk for engaging in suicide related behaviors: Current physical pain, Fear for own safety¶

The following PROTECTIVE factors were assessed to be present and may decrease the inmate’s risk of suicide: Able to identify reasons to live, Adequate problem solving skills, Denial of suicidal ideation/intention/plans, Future orientation, View of death as negative, Willingness to engage in treatment¶

Risk Factors: Mr. EPSTEIN has a significant scar around his neck, which is now scabbing over. He reported swelling in this area but denied experiencing any related pain. Mr. EPSTEIN continues to claim a lack of memory for the incident resulting in this scar. The story he provided was vague, such that this writer challenged him a couple of times, but he insisted he was being honest about his lapse in memory. The nature of the incident remain unclear. Mr. EPSTEIN is incarcerated for a very high profile crime with media attention. He was recently denied bail. He also reported difficulty managing his time in the SHU. He reported being fearful for his safety if he is to return to the cell with his previous cell mate.¶

Protective Factors: Mr. EPSTEIN adamantly denied current suicidal ideation or intent or a history of suicide attempts. He stated, “I have no interest in killing myself.” He explained, although his situation is “not perfect” due to his being incarcerated, he noted he has “lots to do for [his] legal case.” He described having a “wonderful life,” to include interactions with “interesting people and projects.” He said “it would be crazy” to take his life. He furthered, “I would not do that to myself.” He denied feelings of hopelessness, although did report being “depressed” and “unhappy” about his current legal situation. He previously denied a history of childhood abuse. He reported he is sleeping adequately now that he is no longer in the SHU. He appear future-oriented as he endorsed an interest in being housed in general population.¶

Weighing of Risk and Protective Factors: Mr. EPSTEIN adamantly denied suicidality. However, in light of his vague self-report regarding the incident which precipitated his placement on Suicide Watch, combined with his fear for his own safety, reported¶

Generated 07/24/2019 12:09 by DiMisa, Samantha Ph.D. Bureau of Prisons - NYM¶

Page 1 of 3¶