2

# Bureau of Prisons
Psychology Services
Suicide Risk Assessment

**SENSITIVE BUT UNCLASSIFIED**

Inmate Name: EPSTEIN, JEFFREY EDWARD
Date of Birth: 01/20/1953 Sex: M
Date: 07/09/2019 08:41 Provider:

Facility: NYM

Reg#: 76318-054
Unit Team: A&O

Type of Housing: Other Psychological Observation
Cell Accommodation: Single Cell

## FINDINGS

This assessment and the resulting recommendations are based on the following sources of information: Clinical Interview, Medical Record Inmate Epstein was placed on psychological observation when he returned from court yesterday evening 7/8/19 for precautionary reasons. He is not on a suicide watch at this time.

situation. As such, this writer instructed R&D staff, as well as the Lieutenant's Office, to immediately notify the Inmate Epstein denied any history of being the victim and/or perpetrator of physical or sexual abuse. See Amendment

# Bureau of Prisons
Psychology Services
Suicide Risk Assessment (cont.)

## Reason for Referral

Inmate Epstein is being seen for suicide risk assessment today for precautionary reasons. Inmate Epstein has various

risk factors for suicidality at this time including a high profile case with media attention, sex offense/trafficking charges,

pre-trial status, and he had a court proceeding yesterday which could have given him bad news regarding his legal

psychology department when he returned from court. Inmate Epstein returned from court after duty hours and denied

suicidality. The aforementioned staff notified the on-call psychologist and inmate Epstein was placed on a precautionary

psychological observation status until psychology could interview him this morning to conduct a suicide risk assessment.

Developmental History

# Bureau of Prisons
Psychology Services
Suicide Risk Assessment (cont.)

## Reason for Referral (cont.)

- Educational History/Cognitive Impairment

Inmate Epstein reported he obtained his high school diploma and attended some graduate classes in the area of

mathematics.

- Arrest History and Experience of Incarceration

Inmate Epstein reported he has served time in Palm Beach County jail on sex offense charges (soliciting prostitution) in

the past. He is now being charged with sex trafficking, on a federal level.

- Mental Health History

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

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

Inmate Epstein denied any alcohol or substance abuse. He said it is well-known that he does not even drink alcohol.

# Bureau of Prisons
Psychology Services
Suicide Risk Assessment (cont.)

## Medical Concerns

Inmate Epstein denied any significant medical problems, other than a history of high triglycerides. He reported feeling constipated at this time.

Current Problem

Inmate Epstein is currently on psychological observation due to his having multiple risk factors associated with suicidality. He denies any suicidality at this time and has no mental health or suicide history. He is being seen for a suicide risk assessment in an abundance of caution.

## Current Mental Status

Level of Consciousness: Alert and Oriented

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# Bureau of Prisons
Psychology Services
Suicide Risk Assessment (cont.)

## Current Mental Status (cont.)



Inmate Name: EPSTEIN, JEFFREY EDWARD
Date of Birth: 01/20/1953 Sex: M
Date: 07/09/2019 08:41 Provider:

Facility: NYM

Reg #: 76318-054
Unit Team: A&O

Psychomotor Activity: Normal
General Appearance: Normal
Behavior: Cooperative
Mood: Appropriate to Content
Thought Process: Goal Directed
Thought Content: Normal

Inmate Epstein did not exhibit any acute psychopathology and exhibited a clear mental status.

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 suicidabideation, 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.

# Bureau of Prisons
Psychology Services
Suicide Risk Assessment (cont.)

## 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 be behaviors: High Profile Crime, Lack of family connections, Sex-offender status status

Of the DYNAMIC risk factors assessed, none were found to be present. found to be present.

# Bureau of Prisons
Psychology Services
Suicide Risk Assessment (cont.)

## RISK AND PROTECTIVE FACTORS ASSESSED: (cont.)

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

present and increase
Sex-offender

men
be present and may
of suicidal

As noted above, Inmate Epstein is a 66-year-old Caucasian male. He has various fisk factors for suicidality at this time male. He has including a high profile case with extensive media attention, sex offense/trafficking charges, pre-trial status, and he had a court proceeding yesterday which may have given him bad news regarding his legal situation, Inmate Epstein also informed this writer that his only family at this time is his brother, with whom he does not have a close relationship with.

# Bureau of Prisons
Psychology Services
Suicide Risk Assessment (cont.)

## RISK AND PROTECTIVE FACTORS ASSESSED: (cont.)

Despite these risk factors, inmate Epstein possesses a number of protective factors at this time Inmate Epstein adamantly denied any suicidal ideation, intention or plan. He was very future oriented and requested a phone call, to meet with his attorney, to take a shower, and to brush his teeth. He was eating his cereal when this writer arrived and said "I have my paper spoon here." He reported he is going to have a bail hearing on Monday and believes he is going to be released from jail. Inmate Epstein reported he is a Banker and has a "big business" in the community and that "being alive is fun" He also revealed he enjoys learning and teaching. He has confidence in his attorney and described him as "competent." Inmate Epstein denied any mental health history or history of suicidality. He also reported none of his family members have mental health histories. Inmate Epstein stated he is a mathematician and took post graduate classes in this area of study. Inmate Epstein stated he has a support system in the community, including friends and other associates. Finally, inmate Epstein demonstrated a good sense of humor and did not appear dysphoric, agitated or anxious. No acute psychopathology was noted.

# Bureau of Prisons
Psychology Services
Suicide Risk Assessment (cont.)

## RISK AND PROTECTIVE FACTORS ASSESSED: (cont.)

Overall, inmate Epstein has numerous protective factors at this time that outweigh his risk factors for suicidality. He has a positive outlook regarding his legal case, demonstrates no psychiatric symptoms, has no psychiatric or suicide history, and verbalized a desire to be alive at this time and future orientation.

## DIAGNOSIS:

No Diagnosis, No Dx - Current

## CONCLUSIONS

The Overall Acute Suicide Risk for this Inmate is: Low
Overall Chronic Suicide Risk for this Inmate is: Absent

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inmate Name: EPSTEIN, JEFFREY EDWARD
Date of Birth: 01/20/1953 Sex: M
Date: 07/09/2019 08:41 Provider:

Facility: NYM

Reg#: 76318-054
Unit Team: A&O

# Bureau of Prisons
Psychology Services
Suicide Risk Assessment (cont.)

## RECOMMENDATIONS

Inmate Epstein is currently on psychological observation pending suitable housing placement. In light of his current sex offense charges and extensive media coverage on the television, he will need to be confined in a suitable housing unit Inmate Epstein will be seen daily while on psychological observation and will be seen for a psychological observation follow-up session once he is released from observation. Inmate Epstein denied the need for psychological intervention, self-help materials, or follow-up. He has been classified as a CC1-MH inmate at this time. CARE1-MH is indicative of an inmate who shows no significant level of functional impairment associated with a mental illness and demonstrates no need for regular mental health intervention.

Suicide Watch: A suicide watch is not warranted at this time

Completed by on 07/09/2019 10:36

See Amendment

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# Bureau of Prisons
Health Services
See Amendment

Inmate Name: EPSTEIN, JEFFREY EDWARD
Date of Birth: 01/20/1953 Sex: M
Encounter Date: 07/09/2019 08:41

Reg #: 76318-054
Race: WHITE
Facility: NYM

<table><tr><th>Encounter</th><th>Date: 07/09/2019 08:41</th><th></th><th>Facility:</th><th>NYM</th><th></th></tr><tr><td>Amendment</td><td>made to this note by</td><td>Bureau of Prisons - NYM</td><td>st on 07/10/2019 09:20.</td><td></td><td></td></tr></table>

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**SENSITIVE BUT UNCLASSIFIED**

# Bureau of Prisons
Psychology Services
Suicide Risk Assessment

Inmate Name: EPSTEIN, JEFFREY EDWARD
Date of Birth: 01/20/1953 Sex: M
Date: 07/09/2019 08:41 Provider:

Facility: NYM

Reg#: 76318-054
Unit Team: A&O

Type of Housing: Other Psychological Observation
Cell Accommodation: Single Cell

# Bureau of Prisons
Psychology Services
Suicide Risk Assessment (cont.)

## FINDINGS

This assessment and the resulting recommendations are based on the following sources of information: Medical Record, Clinical Interview

Inmate Epstein was placed on psychological observation when he returned from court yesterday evening 7/8/19 for precautionary reasons. He is not on a suicide watch at this time. He was seen this morning for a psychological observation contact and suicide risk assessment this morning, 7/9/19, at 7:30 a.m. as it was determined he possessed some at-risk factors for suicidality.

# Bureau of Prisons
Psychology Services
Suicide Risk Assessment (cont.)

## Reason for Referral

Inmate Epstein is being seen for suicide risk assessment today for precautionary reasons. Inmate Epstein has various risk factors for suicidality at this time including a high profile case with media attention, sex offense/trafficking charges, pre-trial status, and he had a court proceeding yesterday which could have given him bad news regarding his legal situation. As such, this writer instructed R&D staff, as well as the Lieutenant's Office, to immediately notify the psychology department when he returned from court. Inmate Epstein returned from court after duty hours and denied suicidality. The aforementioned staff notified the on-call psychologist and inmate Epstein was placed on a precautionary psychological observation status until psychology could interview him this morning to conduct a suicide risk assessment.

## Developmental History

Inmate Epstein denied any history of being the victim and/or perpetrator of physical or sexual abuse.

## Educational History/Cognitive Impairment

Inmate Epstein reported he obtained his high school diploma and attended some graduate classes in the area of mathematics.

# Bureau of Prisons
Psychology Services
Suicide Risk Assessment (cont.)

## Arrest History and Experience of Incarceration

Inmate Epstein reported he has served time in Palm Beach County jail on sex offense charges (soliciting prostitution) in the past. He is now being charged with sex trafficking, on a federal level.

## Mental Health History

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

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

Inmate Epstein denied any alcohol or substance abuse. He said it is well-known that he does not even drink alcohol.

## Medical Concerns

Inmate Epstein denied any significant medical problems, other than a history of high triglycerides. He reported feeling constipated at this time.

# Bureau of Prisons
Psychology Services
Suicide Risk Assessment (cont.)

## Current Problem

Inmate Epstein is currently on psychological observation due to his having multiple risk factors associated with suicidality. He denies any suicidality at this time and has no mental health or suicide history. He is being seen for a suicide risk assessment in an abundance of caution.

## Current Mental Status

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Inmate Name: EPSTEIN, JEFFREY EDWARD
Date of Birth: 01/20/1953 Sex: M
Date: 07/09/2019 08:41 Provider:

Facility: NYM

Reg #: 76318-054
Unit Team: A&O

st

# Bureau of Prisons
Psychology Services
Suicide Risk Assessment (cont.)

## Current Mental Status (cont.)

Level of Consciousness: Alert and Oriented

Psychomotor Activity: Normal

General Appearance: Normal

Behavior: Cooperative

Mood: Appropriate to Content

Thought Process: Goal Directed

Thought Content: Normal

Inmate Epstein did not exhibit any acute psychopathology and exhibited a clear mental status.

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.

# Bureau of Prisons
Psychology Services
Suicide Risk Assessment (cont.)

## 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: Sex offender status, Lack of family connections, High Profile Crime

Of the DYNAMIC risk factors assessed, none were found to be present.

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

As noted above, Inmate Epstein is a 66-year-old Caucasian male. He has various risk factors for suicidality at this time including a high profile case with extensive media attention, sex offense/trafficking charges, pre-trial status, and he had a court proceeding yesterday which may have given him bad news regarding his legal situation. Inmate Epstein also informed this writer that his only family at this time is his brother, with whom he does not have a close relationship with.

# Bureau of Prisons
Psychology Services
Suicide Risk Assessment (cont.)

## RISK AND PROTECTIVE FACTORS ASSESSED: (cont.)

Despite these risk factors, inmate Epstein possesses a number of protective factors at this time. Inmate Epstein adamantly denied any suicidal ideation, intention or plan. He was very future oriented and requested a phone call, to meet with his attorney, to take a shower, and to brush his teeth. He was eating his cereal when this writer arrived and said "I have my paper spoon here." He reported he is going to have a bail hearing on Monday and believes he is going to be released from jail. Inmate Epstein reported he is a Banker and has a "big business" in the community and that "being alive is fun." He also revealed he enjoys learning and teaching. He has confidence in his attorney and described him as "competent." Inmate Epstein denied any mental health history or history of suicidality. He also reported none of his family members have mental health histories. Inmate Epstein stated he is a mathematician and took post graduate classes in this area of study. Inmate Epstein stated he has a support system in the community, including friends and other associates. Finally, inmate Epstein demonstrated a good sense of humor and did not appear dysphoric, agitated or anxious. No acute psychopathology was noted.

# Bureau of Prisons
Psychology Services
Suicide Risk Assessment (cont.)

## RISK AND PROTECTIVE FACTORS ASSESSED: (cont.)

Overall, inmate Epstein has numerous protective factors at this time that outweigh his risk factors for suicidality. He has a positive outlook regarding his legal case, demonstrates no psychiatric symptoms, has no psychiatric or suicide history, and verbalized a desire to be alive at this time and future orientation.

## DIAGNOSIS:

No Diagnosis, No Dx - Current

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(

Inmate Name: EPSTEIN, JEFFREY EDWARD
Date of Birth: 01/20/1953 Sex: M
Date: 07/09/2019 08:41 Provider:

Facility: NYM

Reg #: 76318-054
Unit Team: A&O

## CONCLUSIONS

The Overall Acute Suicide Risk for this Inmate is: Low
Overall Chronic Suicide Risk for this Inmate is: Absent

# Bureau of Prisons
Psychology Services
Suicide Risk Assessment (cont.)

## RECOMMENDATIONS

Inmate Epstein is currently on psychological observation pending suitable housing placement. In light of his current sex offense charges and extensive media coverage on the television, he will need to be confined in a suitable housing unit. Inmate Epstein will be seen daily while on psychological observation and will be seen for a psychological observation follow-up session once he is released from observation. Inmate Epstein denied the need for psychological intervention, self-help materials, or follow-up. He has been classified as a CC1-MH inmate at this time. CARE1-MH is indicative of an inmate who shows no significant level of functional impairment associated with a mental illness and demonstrates no need for regular mental health intervention.

Suicide Watch: A suicide watch is not warranted at this time

Completed by|

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# Bureau of Prisons
Psychology Services

**SENSITIVE BUT UNCLASSIFIED**

# Diagnostic and Care Level Formulation

Inmate Name: EPSTEIN, JEFFREY EDWARD
Date of Birth: 01/20/1953 Sex:
Date: 07/09/2019 10:13 Provider:

M Facility: NYM

Reg #: 76318-054
Unit Team: A&O

# Diagnostic and Care Level Formulation (cont.)

## Relevant Historical Information

Inmate Epstein is a 66-year-old Caucasian male, currently incarcerated on sex trafficking charges. He 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. 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. Inmate Epstein denied any alcohol or substance abuse. He said it is well-known that he does not even drink alcohol.

# Diagnostic and Care Level Formulation (cont.)

## Presenting Problem/Symptom

Inmate Epstein was seen for suicide risk assessment today for precautionary reasons. He did not mark any mental
health items or symptoms on his Psychology Questionnaire (PSIQ) when he entered the institution. Nonetheless, Inmate
Epstein has various risk factors for suicidality including a high profile case with media attention, sex offense/trafficking
charges, pre-trial status, and he had a court proceeding yesterday which could have given him bad news regarding his
legal situation. Inmate Epstein returned from court after duty hours yesterday evening and staff notified the on-call court after duty hours yesterday evening and staff notified the
psychologist. Inmate Epstein was placed on a precautionary psychological observation status until psychology could a precautionary psychological observation status until
interview him this morning to conduct a formal suicide risk assessment to determine whether he is currently at-risk for suicide risk assessment to determine whether he is currently
suicidality.

Amendment

on 07/09/2019 10:32 on 07/09/2019 10:32

# Diagnostic and Care Level Formulation (cont.)

## Diagnostic Formulation



Inmate Epstein has no history of mental health problems and does not exhibit suicidality at this time. He has never

problems

and

does

not

exhibit

suicidality

at

this

time.

He

received inpatient or outpatient mental health treatment and denied any history of suicidality. Currently, he does not

treatment

and

denied

any

history

of

suicidality.

Currently,

he

exhibit any acute psychopathology, is currently psychologically stable and is in no psychological distress. As such, he is

psychologically

stable

and

is

in

no

psychological

distress.

being classified as a CC1-MH inmate at this time. CARE1-MH is indicative of an inmate who either has no identifiable

time.

CARE1-MH

is

indicative

of

an

inmate

who

either

has

no

mental illness (Axis I "No Diagnosis") or is mildly ill and requires clinical intervention on an as-needed basis.

mildly

ill

and

requires

clinical

intervention

on

an

as-needed

basis.

# Diagnostic and Care Level Formulation (cont.)

## Care Level Formulation

CARE1-MH is indicative of an inmate who shows no significant level of functional impairment associated with a mental

shows

no

significant

level

of

functional

impairment

mental

health

intervention.

associated

illness and demonstrates no need for regular mental health intervention.

Diagnosis:

No Diagnosis, No Dx - Current

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# Bureau of Prisons
Health Services
See Amendment

Inmate Name: EPSTEIN, JEFFREY EDWARD
Date of Birth: 01/20/1953 Sex: M
Encounter Date: 07/09/2019 10:13

Reg#: 76318-054
Race: WHITE
Facility: NYM

<table><tr><th>Amendment made to this note by</th><th>Bureau of Prisons - NYM</th><th>st on 07/09/2019 10:40.</th></tr></table>

EFTA00033305





**SENSITIVE BUT UNCLASSIFIED**

# Bureau of Prisons
Psychology Services
Diagnostic and Care Level Formulation

Inmate Name: EPSTEIN, JEFFREY EDWARD
Date of Birth: 01/20/1953
Date: 07/09/2019 10:13

Sex:
Provider:

M

Facility: NYM

Reg #: 76318-054

Unit Team: A&O

# Bureau of Prisons
Psychology Services
Diagnostic and Care Level Formulation (cont.)

## Relevant Historical Information

Inmate Epstein is a 66-year-old Caucasian male, currently incarcerated on sex trafficking charges. He 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. 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. Inmate Epstein denied any alcohol or substance abuse. He said it is well-known that he does not even drink alcohol.

# Bureau of Prisons
Psychology Services
Diagnostic and Care Level Formulation (cont.)

## Presenting Problem/Symptom

Inmate Epstein was seen by this writer for suicide risk assessment today, 7/9/19 at 7:30 a.m. for precautionary reasons. He returned from court yesterday evening. He did not mark any mental health items or symptoms on his Psychology Questionnaire (PSIQ) when he entered the institution. Nonetheless, Inmate Epstein has various risk factors for suicidality including a high profile case with media attention, sex offense/trafficking charges, pre-trial status, and he had a court proceeding yesterday which could have given him bad news regarding his legal situation. Inmate Epstein returned from court after duty hours yesterday evening and staff notified the on-call psychologist. Inmate Epstein was placed on a precautionary psychological observation status until psychology could interview him this morning to conduct a formal suicide risk assessment in order to determine whether he is currently at-risk for suicidality.

# Bureau of Prisons
Psychology Services
Diagnostic and Care Level Formulation (cont.)

## Diagnostic Formulation

Inmate Epstein has no history of mental health problems and does not exhibit suicidality at this time. He has never received inpatient or outpatient mental health treatment and denied any history of suicidality. Currently, he does not exhibit any acute psychopathology, is currently psychologically stable and is in no psychological distress. As such, he is being classified as a CC1-MH inmate at this time. CARE1-MH is indicative of an inmate who either has no identifiable mental illness (Axis I "No Diagnosis") or is mildly ill and requires clinical intervention on an as-needed basis.

## Care Level Formulation

CARE 1-MH is indicative of an inmate who shows no significant level of functional impairment associated with a mental illness and demonstrates no need for regular mental health intervention.

## Diagnosis:

No Diagnosis, No Dx - Current

Completed by on 07/09/2019 10:40

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