EFTA00134915.pdf

Bureau of Prisons "SENSITIVE BUT UNCLASSIFIED" Psychology Services Clinical Intervention - Clinical Contact Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth 01/20/1953 Sex: M Facility: NYM Date: 07/10/2019 08:38 Provider PhD/Chief Reg # 76318-054 Unit Team: A&O Focus of Session Inmate Epstein was seen today for a psychological observation contact in the hospital area by this writer. Subjective/Objective Presentation Inmate Epstein appeared well and it was noted in his log book and eating/sleeping chart that he has been eating his meals, steeping, interacting with the inmate companions, and pacing in his cell. Today, he presented this writer with numerous concerns and requests. He stated he does not want to be housed in the SHU because he is not comfortable t there; he wants to be single-celled if he goes to the SHU; he wants Wane, not the Ducolex he received fron medical yesterday; he wants to be able to walk around and go to recreation; he does not want to wear an orange un form to his legal visits because he is treated like a punished inmate;" he wants a phone call before he leaves the psychological observation area; he wants a shower and towel; he would like to be housed in the cadre (5S) unit; and woufd like his property, paper, and a pen. Inmate Epstein's concerns were addressed by this writ& and it was explained to him he will not be single-celled or placed in a housing unit for safety and security concerns. His medical concerns (constipation) were discu with health services as well as his desire to be placed on Colace. Inmate Epstein was provided a shower this ming. interventionft Inmate Epstein was provided with supportive intervention and coping skills strategies today. He was rece e to interventions and was able to elucidate his various needs. He did not present with any acute psychopatho y and continues to deny any suicidal ideation, intention, or plan. He is looking forward to his bail hearing on Monday but stated he is aware that even if he gets bail, it will take at least two weeks to sort things out so he can leave the jail. Progress/Plan Inmate Epstein is not in any psychological distress, does not present with any mental health symptoms or Complaints, and is denying any suicidality. He appears psychologically stable at this time and can be released from the psychological observation area. Inmate Epstein will be housed in the 9S area with a cellmate. He will be seen again tomorrow by psychology to evaluate his mental status and psychological stability. Completed by PhD/Chief Psychologist on 07/10/2019 09:09 Generated 07/10/2019 09.09 by PhD/Chlef Bureau of Prisons - NYM Pepe 1 al 1 S NY_00006416 EFTA_00000501 EFTA00134915 Bureau of Prisons Psychology Services General Administrative Note "SENSITIVE BUT UNCLASSIFIED" Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sew M Facility: NYM Unit Team: MO Date: 07/11/2019 14:28 Provider: PsyD Comments This writer attempted to see Mr. Epstein in the morning and then again in the afternoon for a Psych Observation Follow Up, but he was in Attorney Conference. Completed by PsyD on 07/11/2019 15:51 Generated 07/11/2019 15.51 by PsyD Bureau of Pdsons - NYM Page 1 of 1 S NY_00006417 EETA_00000502 EFTA00134916 Bureau of Prisons "SENSITIVE BUT UNCLASSIFIED" Psychology Services Clinical Intervention - Clinical Contact Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: Date: 07/11/2019 15:21 Provider: M Facility: NYM PhD/Chief Reg ft. 76318-054 Urit Team: MO focus of Session Inmate Epstein was seen for his psychological observation follow-up in attorney conference this afternoon. Subjective/Objective Presentation Inmate Epstein reported he has been consulting with his attorney most of the day. He elucidated concerns t his incarceration including not receiving his property yet in SHU, feeling cold in his cell, not receiving his Cola , not having enough water in attorney conference, and a desire to recreate in SHU." Inmate Epstein was also upset a wearing an orange jumpsuit and being treated like "a bad guy" when he did not do anything wrong in the prison. Custody and security concerns were addressed with Inmate Epstein including why he has to wear his orange jumpsuit (due to his being housed in SHU). He requested that he be placed in a brown uniform during his legal visits. He was told his concerns would be addressed in the SHU meeting. Inmate Epstein stated he is not having any current problems with his cellmate and indicated he at bran cereal for breakfast and took a shower yesterday. He did not sleep well last night. Inmate Epstein continues to deny any suicidal ideation, intention or plan. He did not appear to be in any distress at this time. fntervention(a) Inmate EPSTEIN was provided with brief supportive interventions, CBT-based Interventions, and psychoeducation regarding additional coping strategies. Inmate EPSTEIN was receptive to these interventions. angrftinalln Inmate EPSTEIN was educated about both routine and emergency procedures for contacting Psychology staff. He was reminded of the self-help books and audiotapes available through the Psychology department. He will be seen next week after his bail hearing to assess his mental status and psychological stability. Completed by PhD/Chief Psychologist on 07/12/2019 07:51 Generated 07/12/2019 07.51 by PhDtGhlef Bureau of Prisons - NYM I Page 1 of 1 S NY_00006418 EFFA_00000503 EFTA00134917 Bureau of Prisons Psychology Services Clinical Intervention - Clinical Contact "SENSITIVE BUT UNCLASSIFIED" Inmate Name: EPSTEIN, JEFFREY EDWARD Reg t 78318-054 Date of Birth: 01120/1953 Sex: NI Facility; NYM Unit Tern: MO Date: 07/16/2019 12:48 Provider. MEM PhD/Chief Focus of Session Inmate Epstein called for this writer in attorney conference today. The officer in attorney conference notified this writer that he was asking to be seen. Thiklective/Objective Presentation Inmate Epstein reported he has not received a spoon or soap In SHU, nor did he receive the phone calls that were "promised to him." He told this writer we need to have mutual trust that his needs are met in the prison. This writer told inmate Epstein that she would address his concerns. On the way out, a staff member told this writer she wi nessed inmate Epstein receive two phone calls from the Li Nonetheless, this writer informed the SHU lieutenant o his concerns and he said he would ensure that he had soap, a spoon, and his Initial SHU phone call. Inmate stein did not have any psychological concerns today. He denied any mental health symptoms or suicidality. He has eating as best as he can and has requested a Kosher diet. InterventIon(s} Inmate EPSTEIN was provided with brief supportive and psychoeducation regarding additional coping EPSTEIN was receptive to these interventions. He continued with his legal visit. Progress/Plan Inmate EPSTEIN was educated about both routine and emergency procedures for contacting Psychology staff. He was reminded of the self-help books and audiotapes available through the Psychology department. There appears to be no need for follow up at this time. He will be seen in SHU for rounds and monthly SHU reviews. Completed by...5 PhD/Chief Psychologist on 07/18/2019 13:05 les. Inmate Generated 07/18/2019 13:05 by PhD/Ghlef Bureau of Prisons - NYM SDN Page 1 of I •_00006/19 EFTA 00000504 EFTA00134918 Bureau of Prisons Psychology Services SHU Review "SENSITIVE BUT UNCLASSIFIED'• Inmate Name: Date of Birth: Date: EPSTEIN, JEFFREY EDWARD 01/20/1953 Sex: 07/18/2019 07:21 Provider: M Facility NYM PhD/Chief Reg #: 76318.054 Unit Team: A8O Placed in SHU: Status: Basis of Review: 07/10/2019 ADMIN.DETENTION Inmate was interviewed Mental Status: No significant mental health issues. Comments Monthly SHU Review Note Type: Threat to Self: Adjustment: Threat to Others: SHU Low Satisfactory. segregation not detrimental Low Inmate Epstein was meeting with his legal team today and has a court hearing. He was not able to be seen for a SHU review. Another attempt to interview him for a SHU review will be done in the near future. Completed by PhD/Chief Psychologist on 07/18/2019 12:06 Generated 07118/2019 12:C6 by PhD/Chief Bereave/1 PriSOI* NYU - SD Peel of 1 Y_00006420 EFTA_00000505 EFTA00134919 Bureau of Prisons Psychology Services General Administrative Note '•SENSITIVE BUT UNCLASSIFIED'• Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #. 76318-054 Date of Birth: 01/20/1953 Sex. NYM Un t Team- Date: 07/23/2019 07:56 Provider: PhD/Chief Comments This On-Call Psychologist was contacted by the Operations Lt. at about 2 AM on 7/23/19 to inform Mr. Epstein was being placed on Suicide Watch because he was found with a string loosely hanging around his neck. Mr. Epstein will be seen today by the duty psychologist for a Suicide Risk Assessment. Completed by PhD/Chief Psychologist on 07/24/2019 07:59 Generated 0724/2019 07-59 by PhD/Chief Bureau of Prisons - NVM SDN1 Page 1 of 1 00006421 EFTA_00000506 EFTA00134920 Bureau of Prisons Psychology Services Suicide Risk Assessment "SENSITIVE BUT UNCLASSIFIED" Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M F li NYM Date: 07/23/2019 10:09 Provider. PsyD Reg ft: 76318-054 Unit Team: 5 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: Mica' Interview, Medical Record, Psychology Data System, Sentry Reason for Referral The On Call Psychologist, Dr. M, 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. ., "Inmate Epstein denied any history of mental health treatment, either on an inpatient or outpatient basis. Inmate Epstein denied any treatment in the pastor 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. M, "Inmate Epstein denied any past or present suicidal ideation, intention or plan. He denied ever engaging in any suicide attempts or self-injurious behaviix in the past." Substance Abuse History According to a Suicide Risk Assessment dated 7/09/19 by Dr. M, "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 moming 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. Wien Mr. Epstein was asked by this writer how he ended up on Suicide Watch, he denied remembering. I je 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 ring 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 tat his cellmate tried to kill him, which Mr. Epstein did not tell this writer when this writer had interviewed Mr. Epstei . This writer was not able to ask Mr. Epstein about this, since Mr. Epstein was now in Legal. The Captain was not ed 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 Generated 07/23/2019 15:38 by PayO Bureau of Prisons - NYM SDNY Page 1 of 3 00006422 EFTA_00000507 EFTA00134921 Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M NYM Date: 07/23/2019 10:09 Provider. 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 FACTORSASSESSED. 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/intentioNplans, 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 deniede 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 fofr 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. Reg #: 76318-054 Unit Team: 5 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 Pay0 Bureau of Prisons - NYM sots Page 2 of 3 Y_00006423 EFFA_00000508 EFTA00134922 Inmate Name: EPSTEIN. JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M : NYM Date: 0723201910:09 Provider. PsyD Reg #: 76318-054 Unit Team: 5 Completed by PsyD on 07/23/2019 15:38 Genersled 07/23/201915:38 by Pay() Bureau of Piteous • NYM SDN Page 3 of 3 00006424 EETA_00000509 EFTA00134923 Bureau of Prisons Psychology Services Post Suicide Watch Report "SENSITIVE BUT UNCLASSIFIED** Inmate Name: EPSTEIN, JEFFREY EDWARD Reg tt- 76318-054 Date of Birth: 01/20/1953 Sex: NYM Unit Team: 5 Date. 07/24/2019 09:23 Provider. 'h 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 Mood: Appropriate to Content Thought Process: 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, circum tantial, or irrelevant content. There was no evidence of perceptual disturbance, delusional ideation, or a formal thought di er. He did not engage in any bizarre or inappropriate behavior. He noted having normal sleeping and eating habits. Mr. E STEIN explicitly denied recent and current suicidal ideation, planning, and intent. He was future-oriented and expres commitment to life and safety, agreeing to contact staff immediately should he experience suicidal ideation or p$ychological distress. He also denied thoughts of harming others. a Risk Factors ABlirifell* 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 su cide 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 uicide 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. le to identify reasons to live, Adequate problem solving skills, Denial of suicidal ideation/intention/plans, Future orientation, Vidw 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 s fling in this area but denied experiencing any related pain. Mr. EPSTEIN continues to claim a lack of memory for the incident r King In this scar. The story he provided was vague, such that this writer challenged him a couple of times, but he insisted he was ing honest about his lapse in memory. The nature of the incident remain unclear. Mr. EPSTEIN Is incarcerated for a very high pro le crime with media attention. He was recently denied bail. He also reported difficulty managing his time in the SHU. He repo ed 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 appe r future-oriented as he endorsed an interest in being housed In general population. Weighing of Risk and Protective Factors: Mr. EPSTEIN adamantly denied sucidality. However, in light of his vag e self-report regarding the incident which precipitated his placement on Suicide Watch, combined with his fear for his own saf ty, reported Generated 07/24/2019 12:09 by Ph.D. Bureau of Pnsons NYM Page 1 of 3 SON _0000&425 EFTA 00000510 EFTA00134924 finiN "0"/N Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #. 76318-054 Date of Birth: 01/20/1953 Sex: NYM Unit Team: 5 Date: 07/24/2019 09:23 Provider: h.D. difficulty managing his time in the SHU, and the high profile nature of his alleged offense, Mr. EPSTEIN will be stepped down from Suicide Watch to Psychological Observation. Changes In Risk Factors Assessor( Upon a review of the log book. it was indicated Mr. EPSTEIN has been speaking to the inmate companions about having previously taught mathematics and physics. He has been observed pacing the cell as well as sleeping, eating, and drinking within normal limits. Upon interview today, Mr. EPSTEIN requested he be provided a toothbrush as well as a shower. His requeits were made known to the lieutenants and he was provided a shower prior to attending his legal visit. This writer alio provided him a toothbrush, toothpaste, and hygiene products. Asked about the alleged incident which transpired yesterday resulting in his placement on Suicide Watch, Mr. EPSTEIN said he is frustrated he has been placed in a "punishment cell for no reason." Specifically, Mr. EPSTEIN was referring to his placement in the SHU. Asked to recall the events surrounding the alleged incident, Mr. EPSTEIN sal his cell mate was "playing with a bed sheer and he claimed he does not recall the events thereafter. He said he r lied eating meat and drinking water and claimed the next event for which he has memory is his hearing himself snore aid waking up on a stretcher. Mr. EPSTEIN claimed he does not recall himself or his cell mate tying a string or rope around his neck. He said he has "been trying to remember and "wracking his mind." Asked if he experienced any interpersonal issues with t s cell mate, Mr. EPSTEIN described his cell mate as "agitated" and claimed his cell mate called him a "pedophile" for the first time yesterday. His cell mate was also reportedly reading a newspaper article about Mr. EPSTEIN, which bothered him and it was something he believed to be "strange" for their to be an article about him in his cell. Mr. EPSTEIN recalled throwing away the newspaper photograph of himself by crumpling it and flushing it down the toilet. Asked if his cell mate ever threatened to harm him, he denied this to be the case. Asked why he told the inmate companions yesterday his cell mate tried to kill him, while also claiming no memory of the incident, Mr. EPSTEIN again said he did not recall the incident and further stated, "I don't know if he put it there as a joke." Mr. EPSTEIN explained he had been experiencing difficulty sleeping in his SHU cell due to his inmate peers banging on the cell door and window, but has not been experiencing any other acute issues other than this. Reason for Removal from Watch Mr. EPSTEIN 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." Mr. EPSTEIN did express a feeling of safety being housed on Psychological Observation rather than in the SHU. He asked if he could remain on this status for a couple of days, he was advised his housing situation will be re-evaluated on a day-to-day basis. He expressed a desire to be housed in general population rather than in the SHU and asked if there were a "safer' unit for him to be housed In comparison to the one where he was initially placed. Mr. EPSTEIN claimed there were many MS-13 gang members on the initial unit. He was advised he will be maintained on Psychological Observation in the near future, but his long-term housing situation will be revisited, as it is not Ideal for one to remain in isolation on Psychological Observation for extended periods of time. Mr. EPSTEIN acknowledged this information and thanked this writer for her explanation and time. 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 Recommendations 1. Mr. EPSTEIN will be removed from Suicide Watch and stepped down to Psychological Observation. 2. While on Psychological Observation, he will be continuously observed by Inmate Companions. 3. While on Psychological Observation, he will be seen daily by Psychology. 4. Supportive and educative interventions were provided. 5. Mr. EPSTEIN was provided novels and a request was made for his legal paperwork to be provided to him on Psychological Generated 07/24/2019 12:09 by PeO. Bureau of Prisons - NYM Page 2 of 3 SD Y_00006426 EFFA_000005 1 1 EFTA00134925 Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: MA Facility: NYM Unit Team: 5 Date: 07/24/2019 09:23 Provider: h D. Observation. 6. This writer contacted the Pharmacy to indicate Mr. EPSTEIN has not been receiving his medication used to constipation. 7. Mr. EPSTEIN attended a legal visit today, after having been provided a shower. 8. Mr. EPSTEIN was educated about both routine and emergency procedures for contacting psychology. 9. The inmate was encouraged to reach out for PRN services should he experience any psychological distress. Completed by IIIMMINIPh.D. on 07/24/2019 12:09 slate his Generated 0724/2019 12.09 by Ph.0. Bureau of Pnsons - NYM Pan3•13 SDNY_ 006427 EFIA_000005 12 EFTA00134926 Bureau of Prisons "SENSITIVE BUT UNCLASSIFIED- Psychology Services Clinical Intervention - Clinical Contact Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: Vi Facility: NYM Date: 07/25/2019 10:14 Provider: PhD/Chief Reg #: 1 76318-054 Unit Team: 5 Focus of Session Inmate Epstein was seen by this writer this morning while on psychological observation in the hospital area of the prison. Subjective/Objective Presentation Inmate Epstein was in good spirits today and engaged in reciprocal conversation with this writer this morning. He smiled and remarked, 'welcome back' when this writer arrived. He continues to assert he does not remember how he received marks around his neck, remarking "I do not remember anything, maybe you can give me some cries ." He stated he just remembers going for a drink of water and the next thing he knew he woke up to the sound of his own snoring. When this writer attempted to get a more detailed account from him, indicating that it would be rare to have such impairments in memory as he does not suffer from an acute cognitive disorder, he smiled and said he understood my position. Inmate Epstein did reveal he is unhappy with his current confinement in Special Housing (SHU) as he considers it "a punishment cell." He said he finds the restrictions up there unfair as he has not done anything wrong. Inmate Epstein stated he feels it is dangerous in the SHU, he cannot sleep well up there due to noise from the other inmates, it smells, and it is difficult for him to work on his legal case up there. He stated he has not received the phone calls he was promised nor has he been able to receive recreation. It was explained to him that he spends the entire day in the attorney conference room and it is likely that he has missed the times when staff members have attempted to give him phone calls and recreation. Inmate Epstein also reported complaints about the attorney conference room, stating they do not take him to the bathroom frequently enough. Inmate Epstein adamantly denied any suicidality at this time, stating 'I am too vested in my case to fight it I have a life and I want to go back to living my life.' He denied any acute symptoms at this time. According to his log book, he has been eating, drinking, sleeping, and Interacting with the inmate compan ens. He has also been attending his daily legal visits. I I bltenientiolibil Inmate EPSTEIN was provided with brief supportive interventions and psychoeducation regarding additio /al coping strategies. Inmate EPSTEIN was mostly receptive to these interventions. He requested to be housed in general population rather than the SHU and stated he wanted to remain on psychological observation due to his concerns with being in the SHU. Progress/Plan In an abundance of caution, inmate Epstein will remain on psychological observation. He has yet to give an account of how he sustained the marks around his neck, is not revealing much about his mental status, and there are concerns about his adjustment at this time to being housed in the SHU. Inmate Epstein will be seen daily by psychology while on psychological observation. Completed by PhD/Chief Psychologist on 07/25/2019 10:43 Generaiet 07/25/2019 1043 by PhD/Calor Bureau of Prisons - NYM Page 1 of 1 DNY_00006428 EFTA_000005 1 3 EFTA00134927 Bureau of Prisons "SENSITIVE BUT UNCLASSIFIED" Psychology Services Clinical Intervention - Clinical Contact Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex. M Facility: NYM Date: 07/26/2019 09:09 Provider hD/Chief Reg #. 76318-054 Unit Team. 5 Focus of Session Inmate Epstein was seen while on psychological observation in our hospital area. Su jective/Objactive Presentation Prior to this writer's contact with him, Inmate Epstein showered and dressed himself for his legal visit today. He was smiling and did crack some jokes during the Interview. He did elucidate some complaints and suggested being disappointed with this writer as he wants "to trust me and for me to trust him." He stated he remains unhappy with legal visiting procedures as he cannot go to the bathroom as frequently as he would like to since he has a "weak bladder." Inmate Epstein also reported since coming to the psychological observation area, he has felt constipated and needs his Coleco. He had self-carry Colace in SHU, but since coming to the observation area, he has not had his medication. This writer immediately notified medical and his pills were being processed during the interview. Inmate Epstein also continues to complain about the conditions of SHU confinement (i.e., feeling punished, smells, noise, and restrictions). Wth regard to the events which lead to his initial placement on suicide watch, inmate Epstein stated he halno memory of the event. He asked to speak with his old cellmate "In to see if he can tell him what happened or see f his memory could be triggered. He remarked. "I am still trying to figure out how I got this (pointing to the scab around his neck)." Inmate Epstein denies remembering harming himself and/or being harmed by his cellmate. He does not exhibit symptoms of any cognitive disorder, seizure disorder, psychotic disorder, or dissociative disorder at this time or in the past. Inmate Epstein denied any current suicidal ideation, intention, or plan. He reported wanting to be alive to fight his legal case and go back and live life. He referred to himself as "a coward and "I'm Jewish." He said he is not the type who likes pain or would ever attempt to harm himself. While on psychological observation, inmate Epstein has been eating his meats, sleeping and interacting the inmate companions. He is in legal visiting the majority of the day and in the evenings. His log book and eating/ r chart reflect the same. He has been speaking to inmate companions about investment strategies and about pri adjustment Correctional Staff report during his legal visits, he is interacting with his attorney, animated, laughing, and joking. interventionist Inmate Epstein was provided with supportive and coping skills interventions today. He was receptive to therm but mostly wanted to express his complaints about his current prison confinement status and needs. He wanted this writer to address them. Progress/Plan Inmate Epstein will remain on psychological observation in an abundance of caution and pending housing arrangements to be made on Monday. He continues to be vague and reports memory deficits regarding the events which ead to a piece of sheet being placed loosely around his neck and marks with scabs around his neck. Completed by PhD/Chief Psychologist on 07/26/2019 10:05 Generated 07/28/2019 10:05 by Eliseo PhD/Chief Bureau of Prisons - NYM SDN Page 1 of I 00006429 EFTA 00000514 EFTA00134928 Bureau of Prisons "SENSITIVE BUT UNCLASSIFIED** Psychology Services Clinical Intervention - Clinical Contact Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M Facility: NYM Date: 07/27/2019 07:14 Provider: PsyD Reg #: 76318-054 Unit Team: 5 Focus of Session He was seen by writer while he was on Psych Observation. Subjective/Objective Presentation The "Eating/Shower Chart' indicated yesterday he ate dinner, drank liquids, and took a shower when offered. The Psych Observation Log noted he brushed his teeth, went to a Legal visit, talked about business and investing to an Inmate Companion, ate, an When interviewed, he st stated that for the 5 days b he is anxious about going back neck and he does not know why ill cannot remember what happened in SHU that caused the marks on his neck. He had only slept about 30 minutes each night because of noise in SHU. He stated because he stated he is going back to a place where he had gotten marks on his He said he has an appetite and is eatir He said is waking up every 1 1/2 hours. He stated he feels dehydrated because he is not drinking enough water be stated he feels he is not given enough bathroom breaks while with his Attorney. Medical was e-mailed with his t of feeling dehydrated. He said his Lawyers and friends are all emotionally supportive. Current Mental Status: He exhibited a neutral mood ly full range of affect. His speech was logical and coherent, with no loosening of associations or tangential ntial or irrelevant speech. Auditory and visual hallucinations were denied, and delusions were not elicited. t engage in any bizarre or inappropriate behavior. He denied current suicidal or self harm ideation. He stated' " He added he does not like pain and even does not like when he has to give blood. He agreed to immedia t aff and Inmate Companions if he starts to have suicidal or self harm thoughts. He was future oriented. He do o be an immediate danger to self. He denied thoughts of hurting others and he agreed to tell staff and Inmate ions if he has these thoughts. Interventionfsi Supportive and educative interventions were provided. He was given Tumin ndouts on stress management, sleep, and building a routine in SHU. He stated he wants it noted in his chart th given a pamphlet on sleep, but that is not going to help because of the noise in SHU that prevents him l)9 Progress/Plan He will remain on Psych Observation in an abundance of caution and pending housing a be made on Monday. While on Psych Observation, he will be seen daily by Psychology. Completed by PsyD on 07/27/2019 08:16 Generated 0727/2019 08:16 by PsyD Bureau of Prisons - NYM Page 1 of 1 SDNY_00006430 EFTA_000005 15 EFTA00134929 Bureau of Prisons Health Services See Amendment Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 07/27/2019 07:14 Facility: NYN Amendment made to this note by PsyD on 07/28/2019 09:19. Bureau of Prisons - NYM SONY. 00006431 EFTA_000005 1 6 EFTA00134930