MCC New York Hours: 1 Date: September 6, 2019 Course SHU Suicide Prevention Course 7 Name Training And’ Nallle Vode Last Name First N BOP# qnature ) w EFTA00122285

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MCC NEW YORK TRAINING PARTICIPANT SIGN-IN LOG | COURSE TITLE: TRAINING DATE(S): From: Suicide Prevention/SHU Training COURSE CO _ December 7, 2018 To: December 7.2018 TRAINING TIMES: & To: 12:00$m | INSTRUCTOR(S): oy : Ma LAST NAME (PRINTED) | FIRST NAME (PRINTE | BOP ID __ TOTAL TRNG HRS DE: _ $1L | By signing above you attest but also to understanding the course material, the training. policies and to not only attending the above named training course, procedures pertaining to EFTA00122288

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10/10/2018 Specie Housing Unit Management Suicide Prevention Objectives + 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 Objectives + Discuss management strategies for specific at risk inmates in this SHU + Review emergency response procedures EFTA00122289

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BOP Inmate Suicides Rate per 100,000 40 - eI] 30 25 20 6 5 boctthhbssdall ~ ll veaeereererete Locked Units + 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 Single Cell Suicides in SHU 0 - * | 2013 20 201s 21% 10/10/2018 EFTA00122290

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Single Cells 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 distraction - Provides rescue opportunity Single Cells 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, Health Services, Unit Team, Recreation, Education, and Religious Services High Risk Inmates Discuss local policies to ensure specific inmates are not single celled. These may include: — Psychology Advisory List (TRU-SCOPE) — Special notation on cell door - Special notation on SHU board - SHU Program — Other 10/10/2018 EFTA00122291

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10/10/2018 Good SHU Management is Good Suicide Prevention + 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 feasonable requests promptly Good SHU Management is Good Suicide Prevention * Prior to entering a SHU cell to provide assistance staff should ensure their safety which may include waiting for assistance + 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 Behavior Disordered Inmates * 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! EFTA00122292

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a 4 Amgegsiaara Working with Behavior Disordered inna 2S + Negative perceptions or frustrations may impact your professional judgment and need to be monitored * Manage through collaboration between depanments + Agroup approach is indicated for the most demanding cases Working with Behavior Disordered inmates * Manage with positive reinforcement ~ Catch them being good — Praise progress, not perfection — “small steps” — Address reasonable requests promptly ~ Set one goal that is guaranteed to occur + Ifa Suicide Risk Management Plan is in effect, follow it exactly What is a Suicide Risk Management Pian? + 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 10/10/2018 EFTA00122293

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AL¥ou2¥a Suicide Risk Management Plan The goal of a Suicide Risk Management Pian is to increase inmate safety by decreasing behaviors that create risk for suicide or accidental death when the inmate cannot be engaged in positive change behaviors 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.) Creating a Suicide Risk Management Plan 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 10/10/2018 EFTA00122294

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AL¥o!2¥a 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 Enacting a Suicide Risk Management Plan + 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 Behavior Disordered Inmates * Place PDS Photo + Inmate's Name & Here Location + List Risk Factors & Warning Signs Specific to the Inmate * Discuss Helpful Interventions: Preventative Interventions 10/10/2018 EFTA00122295

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10/10/2018 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 Mentally Ill Inmates * 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 Mentally Ill Inmates + Place PDS Photo + Inmate's Name & Here Location + List Risk Factors & Warning Signs Specific to the Inmate Discuss Helpful Interventions: Especially Preventative Interventions EFTA00122296

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1vVaQatasca 10/10/2018 Sex Offenders and Protective Custody * 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 all inmates whenever possible + Convey requests to speak to Psychology immediately + Place in higher visibility cells Emergency Response + Always initiate life saving measures + Ensure the response reflects the emergent nature of the situation + All staff should carry personal protective gear Lesson Learned From Local Mock Drills EFTA00122297

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-_~ Cm) BVA@ANA TOA TH 1OGSAVANA4 Aa Get USAVAtAIAATHIOUSAGA<ALAAJHIGUSAHA>A0GAS§ 10/10/2018 Psychology Advisory List * The Advisory List SHU PSY Alert * PSY Alert is an enhanced tracking and monitoring system to ensure: — Special psychological needs are reviewed and considered by Psychology Services — Safety and security concems are highlighted for non-psychology staff Phone a Friend * 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 * Call to collaborate in managing high risk inmates * Call to discuss small problems before they get big — identifies inmates with mental health conditions who may become dangerous, self- destructive, or suicidal when placed into the 10 EFTA00122298

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Review of Objectives Understand suicde risk associated with locked units and single cells identity high risk groups — mentally ill inmates ~ behavior disordered inmates = sex offender and protective custody mmates Discuss management strategies for specific at risk inmates in this SHU Review emergency response procedures 2 VEQVAG/2013 45 11 EFTA00122299