- Bureau of Prisons *"SENSITIVE BUT UNCLASSIFIED Psychology Services Suicide Risk Assessment Inmate Name: EPSTEIN, JEFFREY EDWARD Reg#: 76318-054 Date of Birth: 01/20/1953 Sex: M Facility: NYM Unit Team: A&O Date: 07/09/2019 08:41 Provider: PhD/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: Clinical Interview, Medical Record Inmate Epstein was placed on ological observation when he returned from court yesterday evening 7/8/19 for precautionary reasons. He i: a suicide watch at this time. Reason for Referral Inmate Epstein is being seen tg eae risk assessment today for precautionary reasons. Inmate Epstein has various tisk factors for suicidality at thi: i 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_as well as the Lieutenant's Office, to immediately notify the psychology department when he returned ! Inmate Epstein returned from court after duty hours and denied suicidality. The aforementioned staff noti call psychologist and inmate Epstein was placed on a precautionary psychological observation status until psychol terview him this morning to conduct a suicide risk assessment. Developmental History Inmate Epstein denied any history of being the victim’ ‘or of physical or sexual abuse, Inmate Epstein reported he obtained his high school diplom mathematics. some graduate classes in the area of Inmate Epstein reported he has served time in Palm Beach County ho“ 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 inpati tient basis. Inmate Epstein denied any treatment in the past or present with psychotropic medication. He also d cute mental health symptoms at this time. Self-Harm History Inmate Epstein denied any past or present suicidal ideation, intention or plan. He denied ever ging 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 for a suicide risk assessment in an abundance of caution. Current Mental Status Level of Consciousness: Alert and Oriented Generated 07/09/2019 10:36 by (I PhO/Chief = Bureau of Prisons - NYM Page 1 of 3 SDNY_00006406 EFTA_00000491 EFTA00134905

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_~ -_, a ~ Inmate Name: EPSTEIN, JEFFREY EDWARD Reg#: 76318-054 Date of Birth: 01/20/1953 Sex: M Facility: NYM Unit Team: A&O Date: 07/09/2019 08:41 Provider: PhD/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. EPSTEIN was alert and oriented. He was polite, calm, and cooperative in demeanor. He exhibited a neutral affect with approprial je. Eye contact and hygiene were appropriate. The inmate spoke with normal rate, tone, and volume. His thoughts nized and coherent, with no loosening of associations or tangential, circumstantial, or irrelevant content. There i of perceptual disturbance, delusional ideation, or a formal thought disorder. He did not engage in any bizarre or i e behavior. He noted having normal sleeping and eating habits. Mr. EPSTEIN explicitly denied recent and curre! idabideation, planning, and intent. He was future-oriented and expressed a commitment to life and safety, agreei tact staff immediately should he experience suicidal ideation. This writer screened the inmate for a variety ly validated factors commonly associated with risk for self-harm and suicide. ed ti The following STATIC risk factors were assess: and increase the inmate's risk for engaging in suicide related behaviors: High Profile Crime, Lack of family connecti6ris, lender status Of the DYNAMIC risk factors assessed, none were foun t. The following PROTECTIVE factors were assessed to be pre may decrease the inmate's risk of suicide:Able to identify reasons to live, Adequate problem solving skills, Denial of suici intention/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/tr: 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 hav factors for suicidality at this time rges, 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 denied any suicidal ideation, intention or plan. He was very future oriented and request attorney, to take a shower, and to brush his teeth. He was eating his cereal when this writ spoon here." He reported he is going to have a bail hearing on Monday and believes he is ed from jail Inmate Epstein reported he is a Banker and has a “big business" in the community and that "bein@al in.” 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. Inmate Epstein adamantly 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: Low Overall Chronic Suicide Risk for this Inmate is: Absent Generated 07/09/2019 10:36 by NN PhO/Chief Bureau of Prisons - NYM Page 2of 3 SONY_00006407 EFTA_00000492 EFTA00134906

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~ inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Facility: NYM Unit Team; A&O Date: 07/09/2019 08:41 Provider: PhD/Chief Psychologist 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 EEE PhO/Chief Psychologist on 07/09/2019 10:36 Generated 07/09/2019 10:36 by NN PhovChief = Bureau of Prisons - NYM Page 3 of 3 SONY_00006408 EFTA_00000493 EFTA00134907

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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: 07/09/2019 08:41 Facility: NYM Amendment made to this note by [EEE PhD/Chief Psychologist on 07/10/2019 09:20. Bureau of Prisons - NYM SONY_00006409 EFTA_00000494 EFTA00134908

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Lt ~ o~ Bureau of Prisons **SENSITIVE BUT lwc.asaen Psychology Services Suicide Risk Assessment Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M iit. NYM Unit Team: A&O Date: 07/09/2019 08:41 Provider: PhD/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 precautionary reasons. He is not on a suicide watch at this time. He was seen this morning for a contact and suicide risk assessment this morning, 7/9/19, at 7:30 a.m. as it was determined he possessed factors for suicidality. Inmate Epstein was placed on psychological observation when he returned from court yesterday evening cel ce Reason for Referral Inmate Epstein is being seen for suicide risk assessment today for precautionary reasons. Inmate Epstei risk factors for suicidality at this time including a high profile case with media attention, sex offen: | observation je at-risk has various pre-trial status, and he had a court proceeding yesterday which could have given him bad news regardin his legal the situation. As such, this writer instructed R&D staff, as well as the Lieutenant's Office, to immediately psychology department when he returned from court. Inmate Epstein returned from court after duty hours and denied suicidality. The aforementioned staff notified the on-call psychologist and inmate Epstein was placed on 4 precautionary psychological observation status until psychology could interview him this morning to conduct a suicide risk assessment. Developmental History Inmate Epstein denied any history of being the victim and/or perpetrator of physical or sexual abuse. Educational History/Cognitive Impairment Inmate Epstein reported he obtained his high school diploma and attended some graduate classes in the mathematics. Arrest History and Experience of Incarceration Inmate Epstein reported he has served time in Palm Beach County jail on sex offense charges (soliciting the past. He is now being charged with sex trafficking, on a federal level. Mental Health History denied any treatment in the past or present with psychotropic medication. He also denied any acute of tion) in Inmate Epstein denied any history of mental health treatment, either on an inpatient or outpatient basis. ee, 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 associat 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 Status Generated 07/10/2019 09:20 by Miler, Elissa PhD/Chief Bureau of Prisons - NYM Page 1 of 3 SDNY_00006410 EFTA_00000495 EFTA00134909

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-~ ~~, Inmate Name: EPSTEIN, JEFFREY EDWARD Reg#: 76318-054 Date of Birth: 01/20/1953 Sex: M - NYM Unit Team: A&O Date: 07/09/2019 08:41 Provider: PhD/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 dem @ neutral affect with appropriate range. Eye contact and hygiene were appropriate. The inmate spoke with and volume. His thoughts were organized and coherent, with no loosening of associations or tangential, irrelevant content. There was no evidence of perceptual disturbance, delusional ideation, or a formal thoug! not engage in any bizarre or inappropriate behavior. He noted having normal sleeping and eating habits. Mi explicitly denied recent and current suicidal ideation, planning, and intent. He was future-oriented and 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 suicide. disorder. "He did EPSTEIN self-harm and 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 sui engage in treatment, View of death as negative, Future orientation, Denial of suicidal ideation/intention/pians, 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 including a high profile case with extensive media attention, sex offense/trafficking charges, pre-trial status, proceeding yesterday which may have given him bad news regarding his legal situation. Inmate Epstein also writer that his only family at this time is his brother, with whom he does not have a close relationship with. Despite these risk factors, inmate Epstein possesses a number of protective factors at this time. Inmate denied any suicidal ideation, intention or plan. He was very future oriented and requested a phone call, to m Willingness to problem this time he had a court med this attorney, to take a shower, and to brush his teeth. He was eating his cereal when this writer arrived and said spoon here.” He reported he is going to have a bail hearing on Monday and believes he is going to be ri health histories. Inmate Epstein stated he is a mathematician and took post graduate classes in this area of Epstein stated he has a support system in the community, including friends and other associates. Finally, in demonstrated a good sense of humor and did not appear dysphoric, agitated or anxious. No acute Overall, inmate Epstein has numerous protective factors at this time that outweigh his risk factors for suicidality. positive outlook regarding his legal case, demonstrates no psychiatric symptoms, has no psychiatric or suici 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 EEN Pho/chief Bureau of Prisons - NYM Page 2 of 3 goNy_o00064 u EFTA_00000496 EFTA00134910

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-~ ~ . Inmate Name; EPSTEIN, JEFFREY EDWARD Reg# 76318-054 Date of Birth: 01/20/1953 Sex: M NYM Unit Team: A&O Date: 07/09/2019 08:41 Provider: PhD/Chief Psychologist CONCLUSIONS The Overall Acute Suicide Risk for this Inmate is: Low Overall Chronic Suicide Risk for this Inmate is: Absent RECOMMENDATIONS Inmate Epstein is currently on psychological observation pending suitable housing placement. In light of his sex offense charges and extensive media coverage on the television, he will need to be confined in a suitable housing uni{. Inmate Epstein will be seen daily while on psychological observation and will be seen for a psychological observation follow-up session once he He has been classified as a CC1-MH 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 IEEE Pho/Chief Psychologist on 07/10/2019 09:20 Generated 07/10/2019 09:20 by NNN PRO/Chiet Bureau of Prisons -NYM Page 3of 3 IN¥_00006412 EFTA_00000497 EFTA00134911

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Bureau of Prisons **SENSITIVE BUT UNCLASSIFIED” Psychology Services Diagnostic and Care Level Formulation Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Facility: NYM Unit Team: A&O Date: 07/09/2019 10:13 Provider: hD/Chief 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 Inmate Epstein was seen isk assessment today for precautionary reasons. He did not mark any mental health items or symptoms on hi logy Questionnaire (PSIQ) when he entered the institution. Nonetheless, Inmate Epstein has various risk factors ity including a high profile case with media attention, sex offense/trafficking proceeding yesterday which could have given him bad news regarding his court after duty hours yesterday evening and staff notified the on-call charges, pre-trial status, and he had legal situation. Inmate Epstein return 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! s not exhibit suicidality at this time. He has never received inpatient or outpatient mental health treatment any history of suicidality. Currently, he does not ind is in no psychological distress. As such, he is of an inmate who either has no identifiable ntion on an as-needed basis. exhibit any acute psychopathology, is currently psychologi being classified as a CC1-MH inmate at this time. CARE1-MH is mental illness (Axis | "No Diagnosis") or is mildly ill and requires Care Level Formulation CARE1-MH is indicative of an inmate who shows no significant level of illness and demonstrates no need for regular mental health intervention. irment associated with a mental Diagnosis: No Diagnosis, No Dx - Current Q Completed by (EEE PhD/Chief Psychologist on 07/09/2019 10:32 Generated 07/09/2019 10:32 by [EE PhO/Chief Bureau of Prisons - NYM Page 1 of 1 SONY_00006413 EFTA_00000498 EFTA00134912

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Bureau of Prisons Health Services See Amendment Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WH Encounter Date: 07/09/2019 10:13 Facility: © NYM Amendment made to this note by [EEE PhD/Chief Psychologist on 07/09/2019 10:40. Bureau of Prisons - NYM pn Y_00006414 EFTA_00000499 EFTA00134913

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~~ ~ Bureau of Prisons **SENSITIVE BUT UNCLASSIFIED Psychology Services Diagnostic and Care Level Formulation Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 176318-054 Date of Birth: 01/20/1953 Sex: M Facility: NYM Unit Team: |A&O Date: 07/09/2019 10:13 Provider: PhDiChief Relevant Historical Information Inmate Epstein is a 66-year-old Caucasian male, currently incarcerated on sex trafficking charges. He history of mental health treatment, either on an inpatient or outpatient basis. Inmate Epstein denied any past or present with psychotropic medication, He also denied any acute mental health symptoms at this . Inmate Epstein denied any past or present suicidal ideation, intention or plan. He denied ever engaging in any sui or self-injurious behavior in the past. Inmate Epstein denied any alcohol or substance abuse. He said it is that he does not even drink alcohol. Presenting Problem/Symptom Inmate Epstein was seen by this writer for suicide risk assessment today, 7/9/19 at 7:30 a.m. for precauti reasons. He returned from court yesterday evening. He did not mark any mental health items or symptoms on his Questionnaire (PSIQ) when he entered the institution. Nonetheless, Inmate Epstein has various risk factors suicidality including a high profile case with media attention, sex offense/trafficking charges, pre-trial status, a court proceeding yesterday which could have given him bad news regarding his legal situation. Inmate retumed from court after duty hours yesterday evening and staff notified the on-call psychologist. Inmate placed on a precautionary psychological observation status until psychology could interview him this a formal suicide risk assessment in order to determine whether he is currently at-risk for suicidality. Diagnostic Formulation Inmate Epstein has no history of mental health problems and does not exhibit suicidality at this time. He hasjnever received inpatient or outpatient mental health treatment and denied any history of suicidality. Currently, he dpes 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 able mental illness (Axis | "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 a mental illness and demonstrates no need for regular mental health intervention. Diagnosis: No Diagnosis, No Dx - Current Completed by IEEE PhO/Chief Psychologist on 07/09/2019 10:40 | | Generated 0709/2019 10:40 by EEE PhO/Chief Bureau of Prisons - NYM Page 1 of 1 SDNY_00006415 EFTA_00000500 EFTA00134914