EFTA00121843 # MCC NEW YORK ## TRAINING PARTICIPANT SIGN-IN LOG COURSE TITLE: ___ Suicide Prevention/SHU Training ___ COURSE CODE: ___ TRAINING DATE(S): From: ___ December 7, 2018 To: ___ December 7, 2018 TOTAL TRNG HRS: ___ TRAINING TIMES: From: ___ 8:00 am To: ___ 12:00 pm INSTRUCTOR(S): **NOTE:** INSTRUCTOR(S) MUST ATTACH AGENDA OR SUMMARY OF TRAINING | LAST NAME (PRINTED) | FIRST NAME (PRINTED) | BOP ID | SIGNATURE | OFFICE USE | | :--- | :--- | :--- | :--- | :--- | | 1. | | | | | | 2. | | | | | | 3. | | | | | | 4. | | | | | | 5. | | | | | | 6. | | | | | | 7. | | | | | | 8. | | | | | | 9. | | | | | | 10. | | | | | | 11. | | | | | | 12. | | | | | | 13. | | | | | | 14. | | | | | | 15. | | | | | | 16. | | | | | | 17. | | | | | | 18. | | | | | | 19. | | | | | | 20. | | | | | By signing above you attest to not only attending the above named training course, but also to understanding the course material, policies and procedures pertaining to the training. ## SENSITIVE - LIMITED OFFICIAL USE EFTA00121844 10/10/2018 ## Objectives - Understand suicide risk associated with locked units and single cells - Identify high risk groups – mentally ill inmates - behavior disordered inmates - sex offender and protective custody inmates ## Objectives - Discuss management strategies for specific at risk inmates in this SHU - Review emergency response procedures 1 EFTA00121845 10/10/2018 BOP Inmate Suicides ## Locked Units - Locked units include SHUs, SMUs, ADX, Seclusion, Extended lock down units, etc. - Every year between 30 and 80% of inmate suicides occur on a locked unit - Single Cells in locked units are especially risky for high-risk inmates Single Cell Suicides in SHU 2 EFTA00121846 10/10/2018 Single Cells 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 Single Cells When an inmate cannot be double celled: – Place at-risk inmates in higher visibility cells - Reduce or eliminate tie-off points - Increased monitoring of property - Additional out of cell contacts with Psychology, Health Services, Unit Team, Recreation, Education, and Religious Services ## High Risk Inmates Discuss local policies to ensure specific inmates are not single celled. These may include: - Psychology Advisory List (TRU-SCOPE) - Special notation on cell door - Special notation on SHU board - SHU Program - Other Do Not Cell Alene 3 EFTA00121847 10/10/2018 ## Good SHU Management is Good Suicide Prevention - Complete SHU rounds as directed by policy and document them accurately - Observe inmates & report concerns to the SHU Lieutenant, Psychology Services, and/or the next shift, as appropriate - Respond to inmate concerns and accommodate reasonable requests promptly ## Good SHU Management is Good Suicide Prevention - Prior to entering a SHU cell to provide assistance staff should ensure their safety which may include waiting for assistance - Cut down tools should never be used for any purpose other than responding to a suicide emergency - Know the location of the AED and how to use it ## Behavior Disordered Inmates - 30% suicides are committed by behaviorally disordered inmates in SHU - At risk for suicide AND accidental death - Must be assessed by psychology EVERY time they make a new threat of self-harm - Must be taken seriously! 4 EFTA00121848 â â â ⊥ ⊥ ⊥ ⊥ !â 10/10/2018 ## Working with Behavior Disordered Inmates - Negative perceptions or frustrations may impact your professional judgment and need to be monitored - Manage through collaboration between departments - A group approach is indicated for the most demanding cases ## Working with Behavior Disordered Inmates - Manage with positive reinforcement – Catch them being good – Praise progress, not perfection – “small steps” - Address reasonable requests promptly - Set one goal that is guaranteed to occur - If a Suicide Risk Management Plan is in effect, follow it exactly ## What is a Suicide Risk Management Plan? - The Plan we will discuss today is not the same as the plan used by the institution when an inmate is in restraints - A Suicide Risk Management Plan is also NOT: - Punishment - Stricter rules - Extreme deprivation - Social isolation - Less work for staff 5 EFTA00121849 âLY♠!!♡♥â 10/10/2018 ## Suicide Risk Management Plan The goal of a Suicide Risk Management Plan is to increase inmate safety by decreasing behaviors that create risk for suicide or accidental death when the inmate cannot be engaged in positive change behaviors ## Suicide Risk Management Plan - A Suicide Risk Management Plan IS: – Feedback: immediate and frequent Reinforcement: of positive behaviors or neutral behaviors that replace harmful behaviors Collaboration: between psychology, custody, other departments, and executive staff **Targeted:** self-harm behaviors and other behaviors that place the inmate in danger (cutting, cell fires, etc.) ## Creating a ## Suicide Risk Management Plan Psychology Services identifies key issues through observation of the inmate and input from staff: High risk behaviors -Elements of the environment that perpetuate dangerous behavior Reinforcers that may be used to reward positive behavior 6 EFTA00121850 âL¥♦!!‡♥â 10/10/2018 ## Creating a ## Suicide Risk Management Plan - These are combined into a brief, individualized plan that indicates: – Management strategies - When reinforcers will be provided - What harmful behaviors will trigger more intensive risk management strategies ## Enacting a ## Suicide Risk Management Plan - Present the plan to the inmate; this is usually done collaboratively by the Captain and Chief Psychologist - Be prepared: Behaviors usually get worse before they get better - All staff need to adhere to the plan - Discuss concerns and issues along the way to ensure staff members are being consistent ## Behavior Disordered Inmates - Place PDS Photo Here - Inmate's Name & Location - List Risk Factors & Warning Signs Specific to the Inmate - Discuss Helpful Interventions: Especially Preventative Interventions 7 EFTA00121851 10/10/2018 ## Mentally Ill Inmates - Approximately 30 to 60% of BOP suicides are completed by mentally ill inmates - Disorders most frequently include Depression, Bipolar Disorder, and Schizophrenia - Symptoms may include psychosis, poor hygiene, lack of energy, poor appetite, insomnia, agitation, and lack of interest in things that were once of interest ## Mentally Ill Inmates - Monitor these inmates closely; look for changes in mood and behavior and report them to Psychology - Build positive rapport with these inmates to assist them with problem solving and meeting their needs - During shake downs, ensure medications are not being hoarded and property has not been modified to allow self-harm ## Mentally Ill Inmates • Place PDS Photo Here - Inmate's Name & Location - List Risk Factors & Warning Signs Specific to the Inmate - Discuss Helpful Interventions: Especially Preventative Interventions 8 EFTA00121852 ♡❤â®ä‹ä8ç✆ 10/10/2018 ## Sex Offenders and Protective Custody - Both of these groups are at heightened risk for suicide – Both groups may be fearful of other inmates– Both groups may be experiencing shame - Double-cell all inmates whenever possible - Convey requests to speak to Psychology immediately - Place in higher visibility cells ## Emergency Response - Always initiate life saving measures - Ensure the response reflects the emergent nature of the situation - All staff should carry personal protective gear ___ ## Lesson Learned From Local Mock Drills 9 EFTA00121853 ♭♭♭♭♭!!♭7ü♠♩♣♠♭©ú§♭♭!!♭4â♠♩♣♠♭√ú§♭♭ä♠3ä♠♩♣♠♭©ú§♭♭ä↙â1å♠♩♣♠♭©ú§♭♭ä►â0ç♠♩ 10/10/2018 ## Psychology Advisory List - The Advisory List - identifies inmates with mental health conditions who may become dangerous, self-destructive, or suicidal when placed into the SHU. ## PSY Alert - PSY Alert is an enhanced tracking and monitoring system to ensure: - Special psychological needs are reviewed and considered by Psychology Services Safety and security concerns are highlighted for non-psychology staff ## Phone a Friend - You are required to refer an inmate to Psychology Services if you observe behaviors that indicate she or he may be at risk for suicide - Call to collaborate in managing high risk inmates - Call to discuss small problems before they get big 10 EFTA00121854 1 v10/10/2018 S ## Review of Objectives - Understand suicide risk associated with locked units and single cells - Identify high risk groups - mentally ill inmates - behavior disordered inmates - sex offender and protective custody inmates - Discuss management strategies for specific at risk inmates in this SHU • Review emergency response procedures ## QUESTIONS? 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