Bureau of Prisons Psychology Services Suicide Risk Assessment "SENSITIVE BUT UNCLASSIFIED" Inmate Name: EPSTEIN, JEFFREY EDWARD Reg ft 76318-054 Date of Birth: 01/20/1953 Sex: M Facilit : NYM Unit Team: A&O Date: 07/09/2019 08:41 Provider: Chief Psychologist Type of Housing: Other Psychological Observation Cell Accommodation: Singe 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 sychological observation when he returned from court yesterday evening 7/8/19 for precautionary reasons. He is t a suicide watch at this time. Reason for Referral Inmate Epstein is being seen f e risk assessment today for precautionary reasons. Inmate Epstein has various risk factors for suicidality at this ing a high profile case with media attention, sex offense/trafficking charges, pre-trial status, and he had a court ing yesterday which could have given him bad news regarding his legal situation. As such, this writer instru &D staff s well as the Lieutenants Office, to immediately notify the psychology department when he returned fr . Inmate Epstein returned from court after duty hours and denied suicidality. The aforementioned staff notifi -call psychologist and inmate Epstein was placed on a precautionary psychological observation status until psychol ALlterview him this morning to conduct a suicide risk assessment. Developmental History Inmate Epstein denied any history of being the victimmha gipetrator of physical or sexual abuse. EditcaticinaingiatyirdnititiviaMpainnt Inmate Epstein reported he obtained his high school diplom d ed 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 nse 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 inpatiellr tient basis. Inmate Epstein denied any treatment in the past or present with psychotropic medication. He also d yracute mental health symptoms at this time. Self-Harm History Inmate Epstein denied any past or present suicidal ideation, intention or plan. He denied ever e fging 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. 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 (or a suicide risk assessment in an abundance of caution. Current Mental Status Level of Consciousness: Alert and Oriented Gemmed 07/09/2019 10:36 by /Chief Bureau of Prisons • NYM Pa0o 1 of 3 EFTA00024366

- Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318.054 Date of Birth: 01120/1953 Sex: M Facili : NYM Unit Team: A&O Date: 07/09/2019 08:41 Provider. Chief Psychologist 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. EP a neutral affect with approp 'a and volume. His thoughts irrelevant content. There not engage in any bizarre or ina explicitly denied recent and curre commitment to life and safety, agree N was alert and oriented. He was polite, calm, and cooperative in demeanor. He exhibited e. Eye contact and hygiene were appropriate. The inmate spoke with normal rate, tone, nized and coherent, with no loosening of associations or tangential, circumstantial, or ce of perceptual disturbance, delusional ideation, or a formal thought disorder. He did to behavior. He noted having normal sleeping and eating habits. Mr. EPSTEIN eation, planning, and intent. He was future-oriented and expressed a tact staff immediately should he experience suicidal ideation. RISK AND PROTECTIVE FACTORS SSED: This writer screened the inmate for a variety o suicide. The following STATIC risk factors were assessed behaviors: High Profile Crime, Lack of family connect vakdated factors commonly associated with risk for self-harm and and increase the inmate's risk for engaging in suicide related ender status Of the DYNAMIC risk factors assessed, none were foundo$r t. The following PROTECTIVE factors were assessed to be pres may decrease the inmate's risk of suicide:Able to identify reasons to live, Adequate problem solving skills, Denial of suici j 1jntention/plans, Future orientation, View of death as negative, Willingness to engage in treatment As noted above. Inmate Epstein is a 66-year-old Caucasian male. He including a high profile case with extensive media attention, sex offense/t proceeding yesterday which may have given him bad news regarding his leg writer that his only family at this time is his brother, with whom he does not haw k factors for suicidality at this time arges, pre-trial status, and he had a court Inmate Epstein also informed this ationship with. Despite these risk factors, inmate Epstein possesses a number of protective factors alt Inmate Epstein adamantly denied any suicidal ideation, intention or plan. He was very future oriented and requeste n call, to meet with his attorney, to take a shower, and to brush his teeth. He was eating his cereal when this writ d said "I have my paper spoon here." He reported he is going to have a bail hearing on Monday and believes he is go t sed from jail. Inmate Epstein reported he is a Banker and has a "big business" in the community and that "be n." He also revealed he enjoys learning and teaching. He has confidence in his attorney and described him as' petent." 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 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: Overall Chronic Suicide Risk for this Inmate is: Low Absent Generated 07/09/2019 10:36 by Chief Bureau of Prisons - NYM Page 2 of 3 EFTA00024367

Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Facilit : NYM Unit Team: A&O Date: 07/09/2019 08:41 Provider: /Chief Psychologist 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 Chief Psychologist on 07/09/2019 10:36 t e Generated 07109/2019 10.36 by 'Chief Bureau of Prisons - NYM Page 3 of 3 EFTA00024368

Bureau of Prisons Health Services See Amendment Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 763 8-054 Date of Birth 01/20/1953 Sex: M Race WHITE Encounter Date: 07/09/2019 08:41 Facility: NYM Amendment made to this note by Chief Psychologist on 07/10/2019 09:20. Bureau of Prisons - NYM EFTA00024369

Bureau of Prisons Psychology Services Suicide Risk Assessment "SENSITIVE BUT NCLASSIFIED" Inmate Name: EPSTEIN, JEFFREY EDWARD Reg If 76318-054 Date of Birth: 01/20/1953 Sex: M M Unit Team A&O Date: 07/09/2019 08:41 Provider ;Chief Psychologist 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: 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 psycholoc, ice' observation contact and suicide risk assessment this morning, 7/9/19, at 7:30 a.m. as it was determined he possessed same at-risk factors for suicidafity. Reason for Referral Inmate Epstein is being seen for suicide risk assessment today for precautionary reasons. Inmate Epstein has various risk factors for suicidally at this time including a high profile case with media attention, sex offense/trafficing 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 Lieutenants Office, to Immediately notify the psychology department when he returned from court Inmate Epstein returned from court after duty hours and denied suicidafity. 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. pevelnnmental HIctory Inmate Epstein denied any history of being the victim and/or perpetrator of physical or sexual abuse. Educational HIstoiy/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 rostitution) 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. I mate Epstein denied any treatment in the past or present with psychotropic medication. He also denied any acute men 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. Current Problem Inmate Epstein is currently on psychological observation due to his having multiple risk factors associate 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 Generated 07/10/2019 09:20 by Miller. Etista PhD/Chief Bureau of Prisons NYM Page I of 3 EFTA00024370

Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Facilit : NYM Unit Team. A&O Date: 07/09/2019 08:41 Provider. Chief Psychologist 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 rormal rate, tone, and volume. His thoughts were organized and coherent, with no loosening of associations or tangential, cir mstantial or irrelevant content. There was no evidence of perceptual disturbance, delusional ideation, or a formal though 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. 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 suici e:WIfingness 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 a this time including a high profile case with extensive media attention, sex offense/trafficking charges, pre-trial status, a d 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. I (i!, Despite these risk factors, inmate Epstein possesses a number of protective factors at this time. Inmate Epst in adamantly denied any suicidal ideation, intention or plan. He was very future oriented and requested a phone call, to m et 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 ball hearing on Monday and believes he Is going to be releas from Jail. Inmate Epstein reported he is a Banker and has a "big business" in the community and that "being alive is fu " He also revealed he enjoys learning and teaching. He has confidence in his attorney and described him as "compete t" Inmate Epstein denied any mental health history or history of suicidality. He also reported none of his family membe have mental health histories. Inmate Epstein stated he is a mathematician and took post graduate classes in this area of tudy. Inmate Epstein stated he has a support system in the community, including friends and other associates. Finally, initiate Epstein demonstrated a good sense of humor and did not appear dysphoric, agitated or anxious. No acute psychopathology was noted. Overall, inmate Epstein has numerous protective factors at this time that outweigh his risk factors for suicidaliJy. He has a positive outlook regarding his legal case, demonstrates no psychiatric symptoms, has no psychiatric or suici e history, and verbalized a desire to be alive at this time and future orientation. DIAGNOSIS- No Diagnosis, No Dx - Current Generated 07/10/2019 09:20 by Chef Bureau of Prisons NYt.1 Page 2 of 3 EFTA00024371

Inmate Name: Date of Birth: EPSTEIN, JEFFREY EDWARD Reg a: 76318-054 01/20/1953 Sex: M Unit Team: A&O Date: 07/09/2019 08:41 Provider: Chief Psychologist .11.17 /1 CONCLUSIONS The Overall Acute Suicide Risk for this Inmate is: Low Overall Chronic Suicide Risk for this Inmate is: Absent RECOMMENDATION Inmate Epstein is currently on psychological observation pending suitable housing placement. In light of his charges and extensive media coverage on the television, he will need to be confined in a suitable housing un will be seen daily while on psychological observation and will be seen for a psychological observation follow-u is released from observation. Inmate Epstein denied the need for psychological intervention, self-help materi He has been classified as a CC1-IMI-I inmate at this time. CARE1-MH is indicative of an inmate who shows of functional impairment associated with a mental illness and demonstrates no need for regular mental health Suicide Watch: A suicide watch Is not warranted at this time Completed by 'Chief Psychologist on 07/10/2019 09:20 rent sex offense Inmate Epstein session once he s, or follow-up. significant level teNention. Goneroled 07/10/2019 09:20 by Chief Bureau of Prisons NYM Pogo 3 of 3 EFTA00024372

Bureau of Prisons "SENSITIVE BUT UNCLASSIFIED" Psychology Services Diagnostic and Care Level Formulation Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M Facility: NYM Date: 07/09/2019 10:13 Provider: Chief Reg #: 76318.054 Unit Team: A&O 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 ast. Inmate Epstein denied any alcohol or substance abuse. He said it is well-known that he does not even drink Presenting Problem/Sym Inmate Epstein was seen sk assessment today for precautionary reasons. He did not mark any mental health items or symptoms on h ology Questionnaire (PSICI) when he entered the institution. Nonetheless, Inmate Epstein has various risk factors y including a high profile case with media attention, sex offense/trafficking charges. pre-trial status, and he had proceeding yesterday which could have given him bad news regarding his legal situation. Inmate Epstein return rom court • er duty hours yesterday evening and staff notified the on-call psychologist. Inmate Epstein was placed on . ,.; ionary psychological observation status until psychology could interview him this morning to conduct a fo risk assessment to determine whether he is currently at-risk for suicidality. Diagnostic Formulation Inmate Epstein has no history of mental health proble received inpatient or outpatient mental health treatment exhibit any acute psychopathology, is currently psychologi being classified as a CC1-MH inmate at this time. CARE1-M mental illness (Axis I "No Diagnosis") or is mildly ill and requires Care Level Formulation s not exhibit suicidality at this time. He has never any history of suicidality. Currently, he does not nd is in no psychological distress. As such, he is e of an inmate who either has no identifiable ention on an as-needed basis. CARE1-MH is indicative of an inmate who shows no significant level of illness and demonstrates no need for regular mental health intervention. Diagnosis: No Diagnosis, No Dx - Current Completed by iChief Psychologist on 07/09/2019 10:32 Oi airment air associated with a mental Ebeir Generaled 07/09/2019 10:32 by Chief Bureau of Prisons NYM Page 1 of 1 EFTA00024373

Bureau of Prisons Health Services See Amendment Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sox M Race: WHITE Encounter Date: 07/09/2019 10:13 Facility: NYA8 Amendment made to this note by Chief Psychologist on 07/09/201910:40. Bureau of Prison- NYM EFTA00024374

Bureau of Prisons "SENSITIVE BUT UNCLASSIFIED** Psychology Services Diagnostic and Care Level Formulation Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M Facility: NYM Date: 07/09/201910:13 Provider. Chief Reg #: 76318-054 Unit Team: A&O 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. presenting Problem/Symotom Inmate Epstein was seen by this writer for suicide risk assessment today, 7/9/19 at 7:30 a.m. for precautions reasons. He returned from court yesterday evening. He did not mark any mental health items or symptoms on his Psychology Questionnaire (PSI0) 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 curen0y at-risk for suicidality. Plannostic 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 sulcidality. 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 ntifiable mental illness (Axis I "No Diagnosis') or is mildly ill and requires clinical Intervention on an as-needed basis. Care Level Formulation CARE1-MH is indicative of an inmate who shows no significant level of functional impairment associated wi a mental illness and demonstrates no need for regular mental health intervention. Diagnosis: No Diagnosis, No Dx - Current Completed by Chief Psychologist on 07/09/2019 10:40 Generated 07709/2019 10'40 by ahief Bureau of Plears-MIA I Pagel oft EFTA00024375