Special HousLg Unit Management (i 22 2.I Suicide Prevention EFTA00126016

00jecNwes ri!I n • 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 ',NV 70..555 EFTA00126017

ObjecHw a • Discuss management strategies for specific at risk inmates in this SHU • Review emergency response procedures 50,1,0.0855, EFTA00126018

01.0Z ZI.OZ 1.1.0Z £ OZ 600Z 800Z LOOZ 900? 900Z VOOZ £00Z tool 1.00Z 000Z _ 6661. 8661. L661. 9661. 9661. V661. £661. ?6-L8 98-Z8 1.8-0L EFTA00126019

Locked Un5te • 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 EFTA00126020

EFTA00126021

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 rescue opportunity EFTA00126022

Single Calls 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 5 01,_[0008561 EFTA00126023

Discuss local policies to ensure specific inmates are not single celled. These may include: - Special notation on Hot List - Special notation on cell door — Special notation on SHU board — Other EFTA00126024

Goad! SELJ Vlanagemen 's Good Suocods Pcrevention • 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 SONY 0,..U.63 EFTA00126025

Cood SHU Hanagemertft is good Suicide PrewenUon IL • Staff should wait for assistance prior to entering a SHU cell • 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 EFTA00126026

Behavior Disordered Enmess • 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! SONY 0000.65 EFTA00126027

Working with ahawkr Disordered inmess • Don't allow negative perceptions or frustrations to impact your professional judgment • Manage through collaboration between departments SONY :+ACrinb EFTA00126028

Working with Behavior Maundered [nmates • Manage with positive reinforcement — Catch them being good — Praise progress, not perfection — Address reasonable requests promptly • If a Suicide Risk Management Plan is in effect, follow it exactly 50..00.656, EFTA00126029

What is a Suicide Aris Managemernt 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 EFTA00126030

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 SDNY O0O0B569 EFTA00126031

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.) SOMY 00009570 EFTA00126032

Creating a Suicide Risk Management POan 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 EFTA00126033

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 EFTA00126034

Enacting a Suicide Risk Management Plan I' • 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 EFTA00126035

Be[laykr Disordered Mmees • Place PDS Photo Here • Inmate's Name & Location • List Risk Factors & Warning Signs Specific to the Inmate • Discuss Helpful Interventions: Especially Preventative Interventions SONY_C000857.1 EFTA00126036

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 iONV_000.575 EFTA00126037

• 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 SONV,0030.1.16 EFTA00126038

Nentall IF hmabs • Place PDS Photo Here • Inmate's Name & Location • List Risk Factors & Warning Signs Specific to the Inmate • Discuss Helpful Interventions: Especially Preventative Interventions SONV_3000.5, / 7 EFTA00126039

S TT d [as L ProscUws Cusiodv .. ,1 1411111 ,, f) • 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 these inmates whenever possible • Convey requests to speak to Psychology immediately • Place in higher visibility cells 5DW D0005578 EFTA00126040

Emergency Response J111 J, jr • Always initiate life saving measures • Ensure the response reflects the emergent nature of the situation • All staff should carry personal protective gear Dee EFTA00126041

Lesson Lear ad From Local Nock EFTA00126042

SHU @2 Lie • The Hot List — identifies inmates with mental health conditions who may become dangerous, self- destructive, or suicidal when placed into the SHU. SONV_50OO4S A I EFTA00126043

• PSY Alert is an enhanced tracking and monitoring system to ensure: - Special psychological needs are reviewed and considered by Psychology Services k,elbe oi, scrlapEr tinopl 4 EFTA00126044

• 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 EFTA00126045

Review/ of ObiscUwes • 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 um 00O66,84 EFTA00126046

t EFTA00126047