Bureau of Prisons “SENSITIVE BUT UNCLASSIFIED™ Psychology Services Clinical Intervention - Clinical Contact Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Facility: NYM Unit Team: |5 Date: 07/27/2019 07:14 Provider: (PsyD 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 The Psych Observation Log noted he brushed his teeth, went to a Legal visit, talked about business and i to an Inmate Companion, ate, and slept. When interviewed, he stated he still cannot remember what happened in SHU that caused the marks on his neck. He stated that for the 5 days before that he had only slept about 30 minutes each night because of noise in SHU. He stated he is anxious about going back to SHU because he stated he is going back to a place where he had gotten marks on his neck and he does not know why it happened. | He said he has an appetite and is eating. He said he is waking up every 1 1/2 hours. He stated he feels because he is not drinking enough water because he stated he feels he is not given enough bathroom breaks while with his Attorney. Medical was e-mailed with his complaint of feeling dehydrated. He said his Lawyers and fri emotionally supportive. Current Mental Status: He exhibited a neutral mood with a full range of affect. His speech was logical and no loosening of associations or tangential, circumstantial or irrelevant speech. Auditory and visual hall denied, and delusions were not elicited. He did not engage in any bizarre or inappropriate behavior. He den ied current suicidal or self harm ideation. He stated "I'm a coward." He added he does not like pain and even does not like when he has to give blood. He agreed to immediately tell staff and Inmate Companions if he starts to have suici harm thoughts. He was future oriented. He does not appear to be an immediate danger to self. He denied hurting others and he agreed to tell staff and Inmate Companions if he has these thoughts. Intervention(s) Supportive and educative interventions were provided. Turning Points handouts on stress management, , and building a routine in SHU were placed on his cell door to be given to him when his food slot is opened. He stated he wants it noted in his chart that he is being given a pamphlet on sleep, but that is not going to help because of the noise in SHU that prevents him from sleeping. Progress/Plan He will remain on Psych Observation in an abundance of caution and pending housing arrangements to be made on Monday. While on Psych Observation, he will be seen daily by Psychology. Completed by [EMH PsyD on 07/28/2019 09:19 Generated 07/28/2019 09:19 by EEE PsyD Bureau of Prisons - NYM Page 1 of 1 IN¥_00007833 EFTA_00000957 EFTA00135340

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Bureau of Prisons “SENSITIVE BUT Psychology Services Clinical Intervention - Clinical Contact Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Facility: NYM Unit Team: | 5 Date: | 07/28/2019 08:33 Provider: [EN PsyD Focus of Session He was seen by writer while he was on Psych Observation. Sublective/Objective Presentation | The "Eating/Shower Chart” noted that yesterday he ate breakfast. He is not in the Psych Observation cell hours per day because of being in Attorney Conference with his Attorneys, so the “Eating/Shower Chart" all of his meals. He stated he was served one meal in Attorney Conference yesterday. He stated he dri at night. The Psych Observation log noted he talked about life in general population and he slept. Earlier he had complained that his right arm was numb and hanging. Nurse {EH from Medical had seen him for this. | When this writer was interviewing him, he said his right arm still feels somewhat numb and he said he can ot make a fist with thet hand. He also said he has numbness on his neck. This writer notified Nurse (H- He stated last night when he flushed the toilet it kept flushing for 45 minutes. He stated he found it so a’ upsetting that he said he sat in the comer and held his ears. He said because of this he was agitated for not able to sleep. The Lt. will be moving him to a different cell and he was informed of this. He stated the with the noise of the toilet was similar to when he was in SHU. He said he may have something on the Au! spectrum. He said in the movie "Rain Man," the person with Autism had an aversion to noise. He stated really good with numbers. Current Mental Status: He exhibited a mildly anxious mood with a full range of affect. His speech was logical and hallucinations were denied, and delusions were not elicited. He did not engage in any bizarre or inappropriate behavior. He ied current suicidal or self harm ideation and he agreed to immediately tell staff and Inmate Companions if he starts to have suicidal or self harm thoughts. He was future oriented. He does not appear to be an imm: self. He denied thoughts of hurting others and he agreed to tell staff and Inmate Companions if he has Supportive and educative interventions were again provided. He had not been given the Turing Point hi yesterday that were on his cell door, so they were handed to him by staff today. Exemention He will remain on Psych Observation in an abundance of caution and pending housing arrangements to be made on Monday. While on Psych Observation, he will be seen daily by Psychology. Completed by | PsyD on 07/28/2019 09:24 Generated 07/28/2019 09:24 by EEE Psyd Bureau of Prisons - NYM Page 1 of 1 SDNY_00007834 EFTA_00000958 ~ EFTA00135341

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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: 07/29/2019 10:01 Provider: Focus of Session , Inmate Epstein was seen while on psychological observation today in the hospital area. Sublective/Objective Presentation Same! |presentation today, but he said he thinks his memory for the incident (injury to his neck) may be im because of his sleep apnea. He is supposed to get his CPAP machine today. He is aware he will be ing to SHU, but said he is feeling unwell due to his inability to sleep and numbness in his arm. He requested to have good night of sleep with his CPAP and will return to SHU with a cellmate tomorrow. He then asked if he could remain|down here where it is "safe" for the entire week. | told him he can stay down one more night to receive his CPAP a good night's sleep, but that he would be returned to SHU tomorrow. It was explained that there is no mental health issues precluding him from returning to SHU tomorrow and that we could not house him in the SW/Hospital area ise he fol safe or more comfortable for him. It was explained to him that he would be placed in a safe situation ir| the SHU. ding to his log book and eating/shower chart, he has been eating and drinking when not in his legal visits. He has also been writing and attending his legal visits. Intervention(s) Inmate EPSTEIN was provided with brief supportive interventions and psychoeducation regarding additional coping strategies. Inmate EPSTEIN was somewhat receptive to these interventions, but appears more co! about getting his various needs in the prison (phone calls, recreation, housing placement concems, etc.) Progress/Plan He wil remain on psychological observation today and will transition to the SHU tomorrow. He will be seep by psychlogy daily to assess his mental status and psychological functioning. en | by EEE PhD /Chief Psychologist on 07/29/2019 10:26 Generated 07/29/2019 10:26 by II. MEM PRD/Chief Bureau of Prisons - NYM Page 1 of 1 SDNY_00007835 EFTA_00000959 EFTA00135342

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Psychology Services Clinical Intervention - Clinical Contact Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: Date: 07/30/2019 12:01 Provider: Focus of Session He was seen by writer while he was on Psych Observation. Sublective/Objective Presentation He stated he hasn't slept well at MCC-NY because he hasn't had his cpap machine. He stated it is here able to start using it tonight. He discussed how he does not think he will able to sleep in SHU and how he SHU because of the noise. He discussed issues on not getting some medication with Medical today. 76318-054 he will be not like The “Eating/Shower Chart" indicated yesterday he ate breakfast and dinner, drank liquids, and took a r when offered and so far today it noted he ate breakfast and drank liquids. The Psych Observation Log noted he slept, drank water, went to legal, and talked to an Inmate Companion about investments. no loosening of associations or tangential, circumstantial or irrelevant speech, Auditory and visual halluci denied, and delusions were not elicited. He did not engage in any bizarre or inappropriate behavior. There|was no indication of disturbed thought process or content. intellectual ability appeared to be above average. P have suicidal or self harm thoughts. He was future oriented. He does not appear to be an immediate da denied thoughts of hurting others and he agreed to tell staff if he has these thoughts. i Suppo and educative interventions were provided. When asked about the Turing Point handouts for|coping in Progress/Plan | The Chief Psychologist was consulted. Psych Observation will be discontinued. Mr. Epstein was edu routine and emergency procedures for contacting Psychology staff. He will be seen in follow up by Psychology tomorrow to monitor his mental status and to provide further intervention if needed and he was informed that he will be seen by Psychology tomorrow. In the meantime, he was encouraged to self-refer to Psychology if needed to which he agreed and seems capable of doing. If he remains in SHU, he will be seen by Psychology in SHU Rounds and in SHU Reviews. The SHU Lt. was informed that Mr. Epstein needs to be housed with an appropriate celimate. Completed by NEES PsyD on 07/30/2019 13:54 | | | | | | | | | | } Generated 07/30/2019 13:54 by SS Psy Bureau of Prisons - NYM Page 1 of 1 SDNY_00007836 EFTA_00000960 EFTA00135343

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| Psychology Services | Institution Disciplinary Process Report Inmate Name: EPSTEIN, JEFFREY EDWARD Reg#: | 76318-054 Date of Birth: 01/20/1953 Sex: M Facility: NYM Unit Team; 5 Date: 07/30/2019 12:01 Provider: Inmate Epstein was referred by Unit Manager Proto for an evaluation of competency to proceed with the disciplinary process for actions resulting in an incident report. On 7/23/19, inmate Epstein was charged with code 228 (Tattooing or Self-Mutilation). These infractions were assigned incident report number 3282555. Background Information According to a Suicide Risk Assessment dated 7/09/19 by EEE "inmate Epstein 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." | | According to a Suicide Risk Assessment dated 7/09/19 by [Eg "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 Accor ing to this writer's Suicide Risk Assessment dated 7/23/19, "It is unclear at this time if he had placedithe string aroun, his neck or if someone else did." Clinical Interview and Mental Status Exam inmate Epstein still does not remember how he obtained the marks around his neck. Current Mental Status: He exhibited a neutral mood with a full range of affect. His speech was logical and 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. There was no indication of disturbed thought process or content. Intellectual ability appeared to be above average. P: al hygiene was adequate. 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 denied thoughts of hurting others and he agreed to tell staff if he has these thoughts. Clinical Impression Corea’ wt et Deano Care Ls Formulation Note dated 7/09/19 by [EEE "No Diag Cu Eindings restored to competence with treatment; or (3) the inmate is NOT COMPETENT and is unlikely to become Recommendations Regarding Sanctions In the case of inmate Epstein, after a review of available psychological and psychiatric records as well as ing to the offense conduct, it is determined that this inmate is: (X) COMPETENT to proceed with the disciplinary process. () NOT PRESENTLY COMPETENT, but could become competent with treatment; it is recommended that an updated competency assessment in 30 days. () NOT COMPETENT and not likely to become competent. inmate for | Generated 07/30/2019 12:33 by (I. EEEBPsyO Bureau of Prisons - NYM EFTA_00000961 EFTA00135344

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Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: Date: | 07/30/2019 12:01 Provider: M Facility: NYM PsyD Completed by [EEE PsyD on 07/30/2019 12:33 Generated 07/30/2019 12:33 by I, MENS Psyo Bureau of Prisons - NYM Unit Team:| 5 Page 2 of 2 SDNY_00007838 EFTA_00000962 EFTA00135345

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Bureau of Prisons “SENSITIVE BUT UNCLASSIFIED** Psychology Services General Administrative Note Inmate Name: EPST EIN, JEFFREY EDWARD Reg #: Date of Birth: 01/20/1953 Sex: Facility: NYM Date: | 07/30/2019 12:01 Provider: Comments Psych Observation Discontinuation Note: 76318-054 Please see "Clinical Contact" dated today. Completed by [ENE PsyD on 07/30/2019 12:33 Generated 07/30/2019 12:33 by [EES Psyo Bureau of Prisons - NYM Page 1 of 1 IN¥_00007839 EFTA_00000963 EFTA00135346

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~~ lame Psychology Services Clinical Intervention - Clinical Contact ama Nae EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Facility: NYM Unit Team:| 5 Date: 07/31/2019 10:35 Provider: Focus of Session Mr. EPSTEIN was seen today by this writer for a follow up appointment after he was removed from Psycho} Observation yesterday. ical Sublective/Objective Presentation Mr. Mr. EPSTEIN presented in a pleasant mood and reported he is generally doing well. He stated, "| could be better,” but acknowledged he is doing as well as can be expected given his circumstances. He reported he is going to ¢o pve reported getting along well with his cell mate. He was informed of appropriate procedures for contacting staff while he is in SHU, if needed. Cure art Status: Mr. EPSTEIN was alert and oriented. He was polite, calmengg coopers in demez suicidal ideation or or paychctogiont distress. He also denied thoughts of harming others. Suppottive interventions and cognitive behavioral therapeutic techniques were utilized. Mr. EPSTEIN was recepti all interventions. Progress/Plan Mr. EPSTEIN was educated about both routine and emergency procedures for contacting psychology. be no need for follow-up at this time and he expressed willingness to self refer to psychology staff if needed. continue to be seen during routine SHU rounds and SHU reviews while he is housed in SHU. He was e reach out for PRN services should he experience any psychological distress. | Completed by [NE PsyD/DAPC on 07/31/2019 10:56 Generated 0773112019 10:56 by EY PsyO/OAPC Bureau of Prisons - NYM Page 1 of 1 SDNY_00007840 EFTA_00000964 EFTA00135347

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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: 5 Date: 08/01/2019 13:29 Provider: Type of Housing: SHU- Administrative Segregation Cell Accommodation: Double-Cell a and the resulting recommendations are based on the following sources of information: Clinical Interview, Medical Record, Psychology Data System, Sentry R & D staff reported to this writer this morning at about 8:30 AM on 8/01/19 that yesterday when Mr. Ep brought back from court the US Marshals asked him to sign a form that noted Mr. Epstein has "suicidal Epstein was seen for a Suicide Risk Assessment at about 1:00 PM on 8/01/19 in Attorney Conference. | This note is being entered at about 4:20 PM on 8/01/19. According to a Suicide Risk Assessment dated 7/09/19 by EH “Inmate Epstein denied any history gf mental health treatment, either on an inpatient or outpatient basis. Inmate Epstein denied any treatment in the or present with jsychotropic 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 NH "inmate Epstein denied any past or present oat ideation, intention or plan. He denied ever engaging in any suicide attempts or self-injurious behavior in the past." According to this writer’s Suicide Risk Assessment dated 0 veneers, nil his neck or if someone else did." R& } staff reported to this writer this morning at about 8:30 AM on 8/01/19 that yesterday when Mr. bro eaty de to tw inckiord dy T22a/1Ofput os eproctadion enter Suicide f Epstein has “suicidal Mr. oo seemed surprised that there was a form noting suicidal tendencies. He denied stating he He said he saw the DHO today and he said his incident report for the marks on his neck was expunged. th he has his cpap machine now, he said his cellmate talks at night and he stated this keeps him up} This writer to talk to the SHU Lt. to have him housed with a different cellmate, but he stated he wants to givelit 3 to 4 days > if he wants a different cellmate. He complained about the noise in SHU. Current Mental Status Level of Consciousness: Alert and Oriented jotor Activity: Normal Cage Appearance: Normal Mood: Appropriate to Content . Thought Process: Goal Directed Thought Content: Normal Current Mental Status: He exhibited a neutral mood with a mildly restricted range of affect. His speech was Generated 8101/2019 16:21 by syo Bureau of Prisons - NYM logical and Page 1 of 3 SDNY_00007841 EFTA_00000965 - EFTA00135348

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Inmate Name: EPSTEIN, JEFFREY EDWARD Reg# 76318-054 Date of Birth: 01/20/1953 Sex: M Facility: NYM Unit Team: 5 Date: | 08/01/2019 13:29 Provider: PsyD coherent, with no loosening of associations or tangential, circumstantial or irrelevant speech. Auditory and visi hallucinations were denied, and delusions were not elicited. He did not engage in any bizarre or inappropriate 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 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 behaviors: Current physical pain, Sleep problems The following PROTECTIVE factors were assessed to be present and may decrease the inmate's risk of suicide:Able to identify relationships, View of death as negative, Willingness to engage in treatment Risk Factors: He was found by staff in his cell in SHU on 7/23/19 with a string loosely tied around his neck, whi stated he did not remember anything about. It is still unclear at this time if Mr. Epstein had placed the string « Protective Factors: He denied current suicidal or self harm thoughts and agreed to tell staff if he starts to have these thoughts. He had denied a history of self harm and suicide attempts. He had denied a family history of suicidal and self ha attempts. He had denied having any chronic medical conditions. He denied feeling hopeless. He had denied a history of cl iidhood abuse. He denied tepring for hie safety at this me. He denied feeling BRS « burda to anyone. He stated he ve te at plans case and to go back to his normal life. He said his friends and Lawyers are emotionally supportive. He said he said in his religion suicide is against the religion. | Overall, his current protective factors override his risk factors for suicidality. He is currently psychologically stable. He denied feeling hopeless. He is reporting positive future plans and reasons to live for. He said he has social supports in the community and his Lawyers visit him often. He denied any current suicidal or self harm ideation, intention or plan. Suicide|Watch is not indicated at this time. DIAGNOS 1S: No Diagnosis, No Dx - Current The Overall Acute Suicide Risk for this Inmate is: Low Overall Chronic Suicide Risk for this Inmate is: Absent RECOMMENDATIONS 1. Suicide Watch is not indicated at this time. 2. Supportive and educative interventions were provided. 3. He was educated about both routine and emergency procedures for contacting Psychology staff. 4. He will be seen in follow up by Psychology next week to monitor his mental status and to provide further interve if needed. 5. In thet ime, he was encouraged to self-refer to Psychology if needed to which he agreed and seems le of doing. 6. Ifhe remains in SHU, he will be seen by Psychology in SHU Rounds and in SHU Reviews. Suicide Watch: A suicide watch Is not warranted at this time | | | Generated pso12018 16:21 by EE Psy Bureau of Prisons - NYM Page 2 of 3 | | Pi oovoreee EFTA_00000966 ee en EFTA00135349

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Inmate Name: EPSTEIN, JEFFREY EDWARD Reg# 76318-054 Date of Birth: 01/20/1953 Sex: M Facility: NYM Unit Team: 5 Date: 08/01/2019 13:29 Provider: PsyD Completed by PsyD on 08/01/2019 16:21 | | Generated 08/01/2019 16:21 by Psy Bureau of Prisons - NYM Page 3 of 3 SDNY_00007843 EFTA_00000967 EFTA00135350

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=~ o~ 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 Unit Team:| 5 Date: 08/08/2019 10:02 Provider: (NNN PhD/Chief Inmate Epstein was seen today for a follow-up session in SHU. Subjective/Objective Presentation Inmate Epstein stated he is feeling okay and has been eating his meals. He reported his sleep as “fair” would like to go the general population. He denied any mental health symptoms at this time and denied any feelings of depression and/ot anxiety. Inmate Epstein denied any suicidal ideation, intention, or plan. He currently has a cellmate to interact with him. Inmate Epstein continues to spend his days and evening with his attorney's in the conference room. He told this writer he received his PAC number to make phone calls. Inmate Epstein led he has only had a couple of phone calls over the speaker phone and wondered "if that counted as his monthly phone contact. He also reported he his missing some books he was reading in the suicide watch area prior to ing to the SHU. | | Other than complaints about the prison and concems regarding his housing, he had no mental health concerns today. He did not appear to be in any distress and the SHU Staff have not reported any unusual behaviors on his ppt Intervention{s) Inmate EPSTEIN was provided with brief supportive interventions and psychoeducation regarding additional coping strategies. Inmate EPSTEIN was receptive to these interventions. 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 weekly rounds and monthly for SHU reviews. Completed by IIH PhD/Chief Psychologist on 08/08/2019 10:09 Generated 08/08/2019 10:09 by IEEE PhO/Chiet Bureau of Prisons - NYM | Page 1 of 1 sdNy_00007844 EFTA_00000968 EFTA00135351