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Psychologist 1 noted that during Physician Assistant 1’s initial intake evaluation, on the intake questionnaire, Epstein denied having a history of mental health treatment and any history of mental health symptoms. Additionally, Forensic Psychologist 1 noted no suicidal ideations, attempts, or self-harm; no history of substance abuse or treatment; and no sexual offense convictions. During the evaluation, Epstein stated he had been previously incarcerated for 3 months for “prostitution,” and that he was currently charged with sex trafficking. Epstein denied recent or present morbid thoughts and denied passive or active suicidal ideation. It was noted in BOP records that Epstein’s verbalizations were future-oriented and did not have indications of helpless or hopeless thinking. According to Forensic Psychologist 1, Epstein did not meet the criteria for any psychological diagnosis and was designated as Mental Health Care Code 1. This is indicative of an inmate who does not show any significant level of functional impairment associated with a mental illness and does not demonstrate a need for regular mental health intervention. Epstein was educated on emergency procedures for contacting the Psychology Department staff, and Epstein agreed to contact staff if he needed Psychology Department services in the future. The MCC New York Chief Psychologist told the OIG that based on the Psychological Services Intake Questionnaire, inmates have four different Care Code ratings.*” Code 1 means there are no concerns about the inmate's mental health status; they have no needs and will not be followed up with unless requested by staff or the inmates. Code 2 means there is some history of mental health issues, but the inmate has them under control and the Psychology Department will follow up monthly. Code 3 is more severe, requiring weekly visits by the Psychology Department to ensure the inmate is stable and if unstable would be moved to observation. Code 4 inmates are seen daily by the Psychology Department and are under constant psychological observation. The Chief Psychologist stated that a Code 1 inmate can be on suicide watch. Suicide watch is for inmates who are showing immediate and exigent signs of being suicidal. Subsequent to the intake screening, on July 8, 2019, the Chief Psychologist consulted with the National Suicide Prevention Coordinator from the BOP’s Central Office, regarding the various risk factors associated with Epstein for suicidality. These risk factors were that Epstein was involved in a high-profile case with media attention, had been charged with sex offenses, was on pretrial status, and there was the potential for bad news from a court proceeding that day. A determination was made that upon Epstein’s return from court, staff were to notify the psychologist and place Epstein on a “watch status” until a thorough suicide risk assessment could be conducted. When Epstein returned from court on July 8, 2019, it was after duty hours and MCC New York staff contacted the Psychology Department and informed them that Epstein denied suicidality. However, for precautionary reasons, Epstein was placed on psychological observation status until Psychology Department staff could conduct a suicide risk assessment the following day. During Epstein’s period of psychological observation, inmate companions continuously observed him and kept a log that detailed Epstein’s activities in 15-minute increments. Under BOP policy, on a case-by-case basis, the Warden may authorize such an inmate 77 Upon reviewing a draft of this report, the Chief Psychologist noted that mental health care is classified into “levels,” not “codes.” 42 DOJ-OGR-00023409